Objective: The diagnoses, treatments and follow-up criteria with risk analysis of the patients who were followed up due to chronic irritative and/or obstructive urinary complaints and persistent hematuria will be presented.

Material and Method: The hematological, biochemical, cytological (according to Koss LG and Murphy WM), radiological, cystoscopic and pathological results of the patients were scanned between 2005 and 2015. The treatments, bladder biopsies were examined (according to 2004 WHO/ISUP (International Society of Urological Pathology). Ten-year follow-up criteria with risk analysis were created appropriate to the diagnosed lesions.

Results: A total of 1086 patients with a mean age of 64.45±15.6 were examined. Laboratory findings were revealed macro/micro hematuria in all of them. Patients with PAP II/III (low/high malignancy potential) were detected in cytological examinations. Bladder wall thickening/irregularity or papillary appearances were observed in radiological examination. While different types of bladder lesions were observed in cystoscopy in n =297 patients, n =789 patients had typical bladder cancer appearance. In the pathology pathological evaluation, n =789 patients were diagnosed with different degrees of bladder cancer. In cystoscopy, from 297 lesions 78% were described as mucosal hyperemia, ulcer and nodule where mucosal bulging/hyperemia was found in 18.82%, and mucosal bulging/papillary in 3.18%. Bladder cancer precursor lesions and bladder cancer were found in 10.1% (n =30/297) of the bladder lesions and in 2.76% (n =30/1086) of all patients. In the pathological examinations of n =30 of the total 297 patients, were revealed dysplasia was found in n =9 (3.03%), invasive papillary carcinoma in n =1 (0.33%), cystitis cystica/glandularis in n =16 (5.38%) and carcinoma in situ in n = 4 (1.37%). Then, ten-year follow-up criteria were created according to pathological diagnoses and complaints.

Conclusion: Different bladder lesions observed on cystoscopy in the presence of persistent macro/micro hematuria with chronic obstructive and/or irritative symptoms that do not improve despite different treatments, It may be precancerous or early-stage bladder cancer. Advanced stage bladder cancer can be prevented with established follow-up criteria, and may increase the survival rates.