Inclusion Criteria:  Adult patients (aged >18 years) Patients with primary or recurrent papillary NMIBC. Complete TURBT. Patients with IR NMIBC confirmed by histopathology.  Exclusion Criteria:  Inability to give informed consent. Patients with history of previous radiotherapy or systemic chemotherapy. Patients suffering from immuno-deficiency or other malignancies. Patients with history of hypersensitivity reaction to BCG or epirubicin. Examination under anesthesia (EUA) reveals palpable bladder mass. Patients with low or high risk NMIBC by histopathology