Hello Welcome to HCM.. I am really sorry to hear this about your bladder problem.. I thank you for posting your query here and I m definitely going to help you out.. I being a surgeon, we encounter so many such cases day in and day out. I read your question completely and have understood it well enough.. I will analyze all your points and provide necessary explanation and how to go about. 1. Bladder wall 4cm protruding mass is a thing to be given importance.. With age, 58 you fall into high risk category for bladder tumor. Do you have Hematuria? Bleeding on passing urine!? This is the classical symptom seen in most of the patients.. 2. It s not a dangerous situation, but definitely you need further evaluation. I m not trying to scare you but telling you nothing but the facts. 3. With the history of ureteroscopy it could be a benign diverticulum in the bladder. But only on further investigation we can conclude.. 4. Please note these following things.. A. Get your urine routine.. We can see if you have microscopic Hematuria B. Cystoscopy is gold standard in your case. This will diagnose, if needed we can take biopsy and then send for pathological examination. Later we can plan accordingly.. Hope this helps you, in case you need any further assistance, please let me know. Take care and God bless.