The initial treatment of bladder cancer is trans-urethral resection of bladder tumor. Under general or spinal anesthesia, a thin tube called cystoscope is passed through urine passage into the bladder. The tumor is directly visualized and cut out and sent for biopsy. For small tumors which are not muscle invasive this is all that needs to be done. Patient however has to remain on strict follow up which involves ultrasound, urine cytology and cystoscopy every three months.