Urine Cytology
The term “cytology” involves studying cells or a cluster of cells closely, and is used mainly to screen or diagnose cancer. A urine cytology refers to the microscopic examination of the patient’s urine to detect abnormal cells that may indicate cancer in the urinary tract, namely:
- Bladder cancer
- Urethral cancer
- Ureter cancer
Cells needed for a urine cytology exam are taken from a urine sample which you would be required to provide by urinating in a sterile container.
Why would I need a urine cytology test?
Generally, your urologist will recommend a urine cytology if there is blood in your urine (haematuria), as this is the most common symptom of bladder cancer. Other reasons for doing a urine cytology are symptoms such as:
- A burning sensation during urination
- Persistent pain during urination
- Difficulty urinating
Obtaining a clean catch urine sample
Generally, the sample should not be taken from the first time you urinate in the morning as the cells may be too degraded for an accurate analysis. When obtaining a clean catch urine sample, steps to take note of are:
- Wash your hands thoroughly with water and soap
- Clean the area around your urethral opening with the provided towelette
- Urinate first into the toilet for a few seconds and then stop
- Continue urinating into the sterile specimen cup provided until it is at least half full
- Ensure that the lid is placed securely
- Ensure that the specimen cup is labelled accurately
- Return the sample to your nurse or healthcare provider
Obtaining an uncontaminated specimen is very important in making an accurate diagnosis
For some patients, it may be necessary to obtain the urine specimen using a catheter. In this procedure, the urine sample is taken using a flexible catheter tube inserted into your urethra and into the bladder. A topical gel will be applied to numb the area, and the procedure will take about 5-10 minutes.
How much urine is needed for a cytology?
About 70ml of urine is necessary for a cytology test. When taking a clean catch sample, ensuring that the cup is at least half-filled will suffice.
What do my urine cytology results mean?
A pathologist examines the urine sample, and the results are relayed to your urologist. These could be:
- Unsatisfactory specimen — the results are inconclusive and you may need to repeat the test. There may not have been enough cells in the sample provided.
- Negative — cancer cells were absent in your urine sample.
- Atypical / Suspicious — atypical or suspicious results indicate that abnormalities were detected but they may or may not be cancerous.
- Positive — cancer cells were detected in your urine sample.
A urine cytology cannot diagnose cancer alone and additional tests are necessary to confirm the diagnosis. It is important to note that the test does not identify nor completely rule out cancer. If abnormalities are detected, your urologist will carry out other diagnostic tests such as:
Imaging studies
Imaging tests, such as a Computed Tomography (CT) scan or Magnetic Resonance Imaging (MRI), can help reveal any structural abnormalities by taking detailed pictures of your urinary tract.
Cystoscopy
This examination allows your urologist to study the lining of your bladder and urethra to rule out any infections or abnormalities using a thin telescope. An even smaller scope can also be used to study the ureters in the OT under anaesthesia, if necessary.
What’s the difference between a urine cytology and a biopsy?
During a biopsy, a small piece of tissue is taken for examination. A cytology examines individual cells that are shed into the urine, as opposed to pieces of tissue. Urine cytology poses a lower risk and less discomfort to the patient.
That being said, a biopsy may be performed to clarify a diagnosis if urine cytology results indicate any abnormalities.
How accurate are urine cytology results?
Urine cytology tests are better at detecting more significant, more aggressive cancers (high-grade carcinoma and carcinoma in situ) and may not accurately detect smaller, lower grade urinary tract cancers. Your urologist can conduct other tests to confirm and ensure an accurate diagnosis.
How long does it take to get my urine cytology results?
Urine cytology results take anywhere from 2 days to 2 weeks, depending on your healthcare provider.
At Aare Urocare, you will receive your results in 3-7 days. We will schedule a follow-up appointment with you, and Dr Fiona Wu will go over your results with you. After which, further diagnostic tests or a treatment plan may be arranged, depending on your condition.
Summary
Urine cytology is a first-line diagnostic test that helps your urologist determine the presence of cancer in the urinary tract. If you experience any worrying symptoms such as blood in your urine or difficulty urinating, please consult your urologist immediately.
