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\frac{\frac{\left(x+9\right)\left(x+9\right)}{\left(x-9\right)\left(x+9\right)}+\frac{\left(x-9\right)\left(x-9\right)}{\left(x-9\right)\left(x+9\right)}}{\frac{x+9}{x-9}-\frac{x-9}{x+9}}
To add or subtract expressions, expand them to make their denominators the same. Least common multiple of x-9 and x+9 is \left(x-9\right)\left(x+9\right). Multiply \frac{x+9}{x-9} times \frac{x+9}{x+9}. Multiply \frac{x-9}{x+9} times \frac{x-9}{x-9}.
\frac{\frac{\left(x+9\right)\left(x+9\right)+\left(x-9\right)\left(x-9\right)}{\left(x-9\right)\left(x+9\right)}}{\frac{x+9}{x-9}-\frac{x-9}{x+9}}
Since \frac{\left(x+9\right)\left(x+9\right)}{\left(x-9\right)\left(x+9\right)} and \frac{\left(x-9\right)\left(x-9\right)}{\left(x-9\right)\left(x+9\right)} have the same denominator, add them by adding their numerators.
\frac{\frac{x^{2}+9x+9x+81+x^{2}-9x-9x+81}{\left(x-9\right)\left(x+9\right)}}{\frac{x+9}{x-9}-\frac{x-9}{x+9}}
Do the multiplications in \left(x+9\right)\left(x+9\right)+\left(x-9\right)\left(x-9\right).
\frac{\frac{2x^{2}+162}{\left(x-9\right)\left(x+9\right)}}{\frac{x+9}{x-9}-\frac{x-9}{x+9}}
Combine like terms in x^{2}+9x+9x+81+x^{2}-9x-9x+81.
\frac{\frac{2x^{2}+162}{\left(x-9\right)\left(x+9\right)}}{\frac{\left(x+9\right)\left(x+9\right)}{\left(x-9\right)\left(x+9\right)}-\frac{\left(x-9\right)\left(x-9\right)}{\left(x-9\right)\left(x+9\right)}}
To add or subtract expressions, expand them to make their denominators the same. Least common multiple of x-9 and x+9 is \left(x-9\right)\left(x+9\right). Multiply \frac{x+9}{x-9} times \frac{x+9}{x+9}. Multiply \frac{x-9}{x+9} times \frac{x-9}{x-9}.
\frac{\frac{2x^{2}+162}{\left(x-9\right)\left(x+9\right)}}{\frac{\left(x+9\right)\left(x+9\right)-\left(x-9\right)\left(x-9\right)}{\left(x-9\right)\left(x+9\right)}}
Since \frac{\left(x+9\right)\left(x+9\right)}{\left(x-9\right)\left(x+9\right)} and \frac{\left(x-9\right)\left(x-9\right)}{\left(x-9\right)\left(x+9\right)} have the same denominator, subtract them by subtracting their numerators.
\frac{\frac{2x^{2}+162}{\left(x-9\right)\left(x+9\right)}}{\frac{x^{2}+9x+9x+81-x^{2}+9x+9x-81}{\left(x-9\right)\left(x+9\right)}}
Do the multiplications in \left(x+9\right)\left(x+9\right)-\left(x-9\right)\left(x-9\right).
\frac{\frac{2x^{2}+162}{\left(x-9\right)\left(x+9\right)}}{\frac{36x}{\left(x-9\right)\left(x+9\right)}}
Combine like terms in x^{2}+9x+9x+81-x^{2}+9x+9x-81.
\frac{\left(2x^{2}+162\right)\left(x-9\right)\left(x+9\right)}{\left(x-9\right)\left(x+9\right)\times 36x}
Divide \frac{2x^{2}+162}{\left(x-9\right)\left(x+9\right)} by \frac{36x}{\left(x-9\right)\left(x+9\right)} by multiplying \frac{2x^{2}+162}{\left(x-9\right)\left(x+9\right)} by the reciprocal of \frac{36x}{\left(x-9\right)\left(x+9\right)}.
\frac{2x^{2}+162}{36x}
Cancel out \left(x-9\right)\left(x+9\right) in both numerator and denominator.
\frac{2\left(x^{2}+81\right)}{36x}
Factor the expressions that are not already factored.
\frac{x^{2}+81}{18x}
Cancel out 2 in both numerator and denominator.
\frac{\frac{\left(x+9\right)\left(x+9\right)}{\left(x-9\right)\left(x+9\right)}+\frac{\left(x-9\right)\left(x-9\right)}{\left(x-9\right)\left(x+9\right)}}{\frac{x+9}{x-9}-\frac{x-9}{x+9}}
To add or subtract expressions, expand them to make their denominators the same. Least common multiple of x-9 and x+9 is \left(x-9\right)\left(x+9\right). Multiply \frac{x+9}{x-9} times \frac{x+9}{x+9}. Multiply \frac{x-9}{x+9} times \frac{x-9}{x-9}.
\frac{\frac{\left(x+9\right)\left(x+9\right)+\left(x-9\right)\left(x-9\right)}{\left(x-9\right)\left(x+9\right)}}{\frac{x+9}{x-9}-\frac{x-9}{x+9}}
Since \frac{\left(x+9\right)\left(x+9\right)}{\left(x-9\right)\left(x+9\right)} and \frac{\left(x-9\right)\left(x-9\right)}{\left(x-9\right)\left(x+9\right)} have the same denominator, add them by adding their numerators.
\frac{\frac{x^{2}+9x+9x+81+x^{2}-9x-9x+81}{\left(x-9\right)\left(x+9\right)}}{\frac{x+9}{x-9}-\frac{x-9}{x+9}}
Do the multiplications in \left(x+9\right)\left(x+9\right)+\left(x-9\right)\left(x-9\right).
\frac{\frac{2x^{2}+162}{\left(x-9\right)\left(x+9\right)}}{\frac{x+9}{x-9}-\frac{x-9}{x+9}}
Combine like terms in x^{2}+9x+9x+81+x^{2}-9x-9x+81.
\frac{\frac{2x^{2}+162}{\left(x-9\right)\left(x+9\right)}}{\frac{\left(x+9\right)\left(x+9\right)}{\left(x-9\right)\left(x+9\right)}-\frac{\left(x-9\right)\left(x-9\right)}{\left(x-9\right)\left(x+9\right)}}
To add or subtract expressions, expand them to make their denominators the same. Least common multiple of x-9 and x+9 is \left(x-9\right)\left(x+9\right). Multiply \frac{x+9}{x-9} times \frac{x+9}{x+9}. Multiply \frac{x-9}{x+9} times \frac{x-9}{x-9}.
\frac{\frac{2x^{2}+162}{\left(x-9\right)\left(x+9\right)}}{\frac{\left(x+9\right)\left(x+9\right)-\left(x-9\right)\left(x-9\right)}{\left(x-9\right)\left(x+9\right)}}
Since \frac{\left(x+9\right)\left(x+9\right)}{\left(x-9\right)\left(x+9\right)} and \frac{\left(x-9\right)\left(x-9\right)}{\left(x-9\right)\left(x+9\right)} have the same denominator, subtract them by subtracting their numerators.
\frac{\frac{2x^{2}+162}{\left(x-9\right)\left(x+9\right)}}{\frac{x^{2}+9x+9x+81-x^{2}+9x+9x-81}{\left(x-9\right)\left(x+9\right)}}
Do the multiplications in \left(x+9\right)\left(x+9\right)-\left(x-9\right)\left(x-9\right).
\frac{\frac{2x^{2}+162}{\left(x-9\right)\left(x+9\right)}}{\frac{36x}{\left(x-9\right)\left(x+9\right)}}
Combine like terms in x^{2}+9x+9x+81-x^{2}+9x+9x-81.
\frac{\left(2x^{2}+162\right)\left(x-9\right)\left(x+9\right)}{\left(x-9\right)\left(x+9\right)\times 36x}
Divide \frac{2x^{2}+162}{\left(x-9\right)\left(x+9\right)} by \frac{36x}{\left(x-9\right)\left(x+9\right)} by multiplying \frac{2x^{2}+162}{\left(x-9\right)\left(x+9\right)} by the reciprocal of \frac{36x}{\left(x-9\right)\left(x+9\right)}.
\frac{2x^{2}+162}{36x}
Cancel out \left(x-9\right)\left(x+9\right) in both numerator and denominator.
\frac{2\left(x^{2}+81\right)}{36x}
Factor the expressions that are not already factored.
\frac{x^{2}+81}{18x}
Cancel out 2 in both numerator and denominator.