Dear practo user, she is having a high grade urothelial carcinoma, The treatment of bladder cancer depends on the whether it is muscle invasive bladder cancer or it is muscle non invasive tumor. In your previous biopsy report adequate amount of muscle is not taken so it is difficult to say whether it is muscle invasive or non muscle invasive bladder cancer. You need to do some more tests to confirm this like MRI pelvis, PET CT, sometimes cystoscopy should be repeated. There are different options of treatment depending on this like surgery or radiation therapy. You can consult me at my clinic in pune for further information. Hope this answer is helpful for you.