After resection of a primary non–muscle-invasive bladder cancer (NMIBC), about two-thirds of patients will develop recurrences. Kompier 1 Kompier L.C. van der Aa M.N. Lurkin I. et al. The development of multiple bladder tumour recurrences in relation to the FGFR3 mutation status of the primary tumour. J Pathol. 2009; 218: 104-112 Crossref PubMed Scopus (47) Google Scholar followed 118 patients with NMIBC. During a median follow-up of 8.8 years, these patients underwent 2133 cystoscopies and 80 patients developed 414 recurrences. The 38 patients who did not develop any recurrences underwent on average 14 cystoscopies. For these patients, surveillance by cystoscopy can be considered as overtreatment. Cystoscopy is an invasive technology that is associated with anxiety and pain. 2 van der Aa M.N. Steyerberg E.W. Sen E.F. et al. Patients' perceived burden of cystoscopic and urinary surveillance of bladder cancer: a randomized comparison. BJU Int. 2008; 101: 1106-1110 Crossref PubMed Scopus (88) Google Scholar Although the gold standard, its sensitivity is estimated to be between 46% and 86% and specificity between 31% and 93%. 3 Witjes J.A. Douglass J. The role of hexaminolevulinate fluorescence cystoscopy in bladder cancer. Nat Clin Pract Urol. 2007; 4: 542-549 Crossref PubMed Scopus (107) Google Scholar The limited sensitivity is often ignored, and this oversight is one of the reasons that urine tests have not been introduced in the clinic. We and others have demonstrated that molecular assays can detect recurrences in cells obtained from voided urine with a sensitivity that allows implementation of urine diagnostics especially for patients who are at low risk of progression and which is also cost-effective. 4 Zuiverloon T.C. Tjin S.S. Busstra M. et al. Optimization of nonmuscle invasive bladder cancer recurrence detection using a urine based FGFR3 mutation assay. J Urol. 2011; 186: 707-712 Abstract Full Text Full Text PDF PubMed Scopus (35) Google Scholar , 5 Zuiverloon T.C. Beukers W. van der Keur K.A. et al. Combinations of urinary biomarkers for surveillance of patients with incident nonmuscle invasive bladder cancer: the European FP7 UROMOL project. J Urol. 2013; 189: 1945-1951 Abstract Full Text Full Text PDF PubMed Scopus (30) Google Scholar , 6 van Kessel K.E. Kompier L.C. de Bekker-Grob E.W. et al. FGFR3 mutation analysis in voided urine samples to decrease cystoscopies and cost in nonmuscle invasive bladder cancer surveillance: a comparison of 3 strategies. J Urol. 2013; 189: 1676-1681 Abstract Full Text Full Text PDF PubMed Scopus (27) Google Scholar The Diagnostic and Prognostic Performance of Urinary FGFR3 Mutation Analysis in Bladder Cancer Surveillance: A Prospective Multicenter StudyUrologyVol. 86Issue 6PreviewTo assess the diagnostic and prognostic performance of a noninvasive FGFR3 mutation analysis. After transurethral resection (TUR) of noninvasive bladder transitional cell carcinoma (B-TCC), recurrence occurs in 70% of patients, thus justifying cystoscopic surveillance. Full-Text PDF