Patients with invasive disease treated with cystectomy should undergo lifelong follow-up, with a chest radiograph, complete metabolic panel, liver function tests, contrast-enhanced C T, and urine cytology performed every 6 to 12 months. If an ileal conduit has been created, vitamin B₁₂ levels should also be checked each year. If urethrectomy was not performed at the time of cystectomy, urethral wash cytology should be performed every 6 to 12 months. If patients experience urethral symptoms or are at increased risk for urethral recurrence, urethroscopy may be indicated.