How are urothelial/ transitional tumors?

In transitional epithelium of UTI, pelvis, ureters, bladder, men after 40 usually, risk factors include tobacco, occupational exposure (aniline) clinical presentation w/hematuria and voiding disorders (pollakiuria, voiding burn) 75% papillary vegetative aspect, aggressive acc to cytology grade (differentiation) and stage (infiltration). Classified into papillary tumors w/low malignancy, low grade carcinoma and high grade carcinoma. Usually if no infiltrate we just remove the tumor, if papillary tumor recurr we have risk of worsening and infiltration, if infiltration occurs we remove the bladder (cystectomy), and 15% infiltrate to outset and gets metastasized, they may result from flat lesions of carcinoma in situ so we should monitor by US, cytology (CIS)