The approaches for the diagnosis of transurethral diagnosis of bladder tumor should be:

1. Is it a papillary or flat lesion: papillary

2. Is it a low grade or high grade: some high grade area

3. Is there invasion or not: very suspicious

4. How much and how deep is the invasion: focal superficial invasion

5. Any variant histology: glandular differentiation

If this is true, this patient may have recurrence and progress to invasive disease; but it is debatable whether the patient need a cystectomy or not at the present time.