Tim, you have had 40 tumors removed over the years?!!! In how many years? I guess I could have had a lot more TURB's if I didn't let those low grade papillary grow and be watched rather than an immedicate surgery. It seems these low grade papillary's are like the energizing battery in reverse - they just keep coming, and coming and coming. When I complained to my original urologist that I couldn't see having a TURB every year he replied that some people have 3 and 4 a year. Now that a long term study has shown that people with papillary low grade recurrance need not have them removed immediately but rather to watch them until removal becomes more necessary, there should not be people having 3 and 4 TURB's or even flugerizations each year. It is damaging to the bladder, our emotions and our spirit to have to constantly be about to have or just come from surgery. It is also hard on the pocket book. The type of low grade papillary is called a nuisance disease by many bladder cancer specialists.