Cystoscopy is the gold standard for the initial diagnosis of bladder cancer especially given that patients present with hematuria. For the tumors that are originating in the renal pelvis the standard procedure is bilateral ureteroscopy especially if the cystoscopy is normal. Those procedures are combined with urine cytology as that could detect small tumors that are not visible with the endoscopies. For those patients with diagnosed urothelial cancer will need to undergo staging scans that will include CT of chest/abdomen/pelvis