On reading the article "Treatment strategy for newly diagnosed T1 high-grade (HG) bladder urothelial carcinoma" by Klaasen et al. in this month's issue of European Urology, a urologist who retired 25 yr ago could be forgiven for thinking that little has changed since then in the management of this disease. Whilst early repeat transurethral resection (re-TUR) has become standard practice and the 1973 grading classification has been supplemented, but not necessarily replaced, by the 2004 grading classification, the mainstay of treatment remains a meticulous TUR of the bladder tumour followed by either intravesical therapy with bacillus Calmette-Guérin (BCG) or radical cystectomy (RC)