When I was a medical student there was a famous saying that Egypt is the country of menstruating men,as all boys of the village develop haematuria at the age of 9 to 11(menarche). We have both types of Bilharziasis(Haematobium urinary tract and Mansoni colon and rectum ). The urinary affection is profound and starts with sandy patches(seen on cystoscopy as small white subepithelial patches),bladder ulcers with haematuria,recurrent UTI,stone formation,uriteric strictures,bilateral hydronephrosis,renal failure. Carcinoma of the urinary bladder is very common( I have no up to date statistics),occurs in very young age late twenties and early therties,it almost always squamous cell carcinoma and usually advanced and is treated by radical cystectomy with poor prognosis. Affection of the colon is in the form of bilharzial polyps(inflammatory),and colonic strictures mostly in the sigmoid or left colon. No relation between bilharziasis and cancer colon.