5th May 2024

A 72-year-old man, a former smoker, presents with painless hematuria for the past two weeks.

A 72-year-old man, a former smoker, presents with painless hematuria for the past two weeks. His medical history is significant for hypertension, controlled with medication. Cystoscopy reveals a solitary, 2 cm papillary tumour on the lateral wall of the bladder. A CT scan shows no evidence of metastasis or lymph node involvement. Biopsy confirms a diagnosis of low-grade non-muscle invasive bladder cancer (Ta).

Which is the most appropriate initial management?