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Over the last years, many biological markers emerged that act as an adjunct for the detection of early bladder cancer recurrence. Some of these markers had a proven better sensitivity and specificity for cancer detection than urine cytology. Nevertheless, the majority of these biological makers are still in advanced stages of clinical trials and are not used for routine clinical purposes. In this article, we give an overview on the biological markers that can play a role in early bladder cancer detection and can perhaps subsequently reduce the need for frequent cystoscopies.