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Clinical Features: Inverted urothelial papilloma occurs over a wide age range but is usually seen in the sixth and seventh decades of life, with a male predilection (M:F=7:1). Most patients present with gross hematuria and obstructive voiding symptoms. The majority of lesions are located in the bladder neck and trigone. Upper urinary tract and urethra are infrequently involved. On cystoscopy, the lesions are small, solitary, and appear as raised, pedunculated, or polypoid nodules covered with a smooth mucosa. Less than 5% of cases are multifocal.