Urine Cytology

Urine cytology is a diagnostic test utilized by healthcare providers to screen for cancer cells in a patient's urine. This test aids in the detection of cancers in the urinary tract, such as bladder and ureter cancers.

However, urine cytology cannot solely confirm a cancer diagnosis; additional tests, such as a cystoscopy or imaging scans, are often used in conjunction with this screening.

During the urine cytology process, a patient’s urine sample is sent to a laboratory, where a pathologist examines the cells under a microscope, looking for signs of abnormalities or cancer. This test serves as a crucial tool for early detection and diagnosis of urinary system cancers.

Urine Cytology

What is a Urine Cytology Test Used For?

A urine cytology test is a diagnostic tool utilized by healthcare providers for several purposes:

  1. Detection of urinary system cancers: The test helps in diagnosing cancers of the ureter, urethra, and bladder by examining urine samples for the presence of precancerous or cancerous cells.
  2. Monitoring cancer recurrence: For individuals who have been treated for bladder cancer, urine cytology tests are conducted to check for any reappearance of cancerous cells.
  3. Identifying certain viral diseases: Urine cytology tests can detect cytomegalovirus, a herpes virus, and other related diseases.
  4. Screening for frequent urinary tract infections (UTIs): The test helps healthcare providers in monitoring bacterial presence in patients with recurrent UTIs.

When would a urine cytology test be needed?

  1. Blood in urine: A urine cytology test may be required when there is visible blood in the urine, which could indicate a potential cancer or other diseases in the urinary system.
  2. Cancer detection: Urine cytology can help diagnose urinary tract cancers such as bladder, urethral, and renal cancers.
  3. Cancer monitoring: The test is useful for monitoring individuals with a history of urinary tract cancer to detect any recurrence.
  4. High-risk individuals: People with a high risk of developing bladder cancer may require regular urine cytology tests for early detection.
  5. Viral infections: The test can also detect the presence of viral infections like cytomegalovirus in the urinary tract.
  6. Inflammation: Urine cytology can identify inflammation in the urinary tract or ureters, bladder, or urethra, which may be caused by various factors such as radiation therapy.
  7. Unexplained urinary symptoms: If an individual experiences symptoms like frequent urination or painful urination without any apparent infection, a urine cytology test can help the doctor understand the underlying causes.

Who performs a urine cytology test?

A urine cytology test is performed by a skilled medical professional, typically a laboratory technician or pathologist who specializes in examining bodily fluid samples. The process begins with the patient providing a urine sample, which is then transported to a laboratory for analysis. In the lab, the pathologist or technician carefully prepares the sample by centrifuging and filtering it to isolate any potential cancerous or abnormal cells. Using a microscope, the expert analyzes the sample to identify the presence of any cancerous or abnormal cells within the urinary tract. The results of the urine cytology test are then relayed to the patient’s healthcare provider, who determines the next steps for diagnosis or treatment.

How to Prepare for a Urine Cytology Test:

  1. Hydrate well: Drink several glasses of water 30 minutes to an hour before the test. This will help to flush out any possible harmful substances and aid in producing a good urine sample.
  2. Avoid the first morning urine: Refrain from collecting your first urine of the day, as overnight cellular breakdown may lead to difficulties in interpreting test results.
  3. Provide a clean catch midstream urine sample: To ensure accurate results, follow your healthcare provider’s instructions on collecting a clean catch sample. This involves urinating a small amount into the toilet before collecting the midstream portion in a sterile cup, without the stream being interrupted.
  4. Label the container: Properly label the urine sample container with your name, date of birth, and the date and time of collection to prevent any mix-ups at the laboratory.
  5. Transport the sample promptly: Deliver the urine sample to the laboratory as soon as possible to ensure accurate and timely results. 

How is a Urine Cytology Test Performed?

A urine cytology test helps diagnose urinary tract cancers and certain viral diseases by examining cells in a urine sample under a microscope. To perform the test, the patient provides a “clean catch” urine sample:

  1. Thoroughly wash hands with soap and water.
  2. Clean the urethral opening with the provided towelette.
  3. Begin urinating into the toilet, then stop.
  4. Resume urination, collecting the sample in the sterile cup.
  5. Secure the cap without touching the inside and label it.
  6. Submit the sample to a healthcare provider or lab technician.

In some cases, a healthcare provider may collect the urine sample using a catheter or during a cystoscopy procedure. The sample is then sent to a laboratory, where a pathologist or cytopathologist examines the cells under a microscope and prepares a report. 

What to expect after urine cytology

After undergoing a urine cytology test, patients can expect to receive their test results from their healthcare provider within a few days. The pathologist will examine the sample for abnormal or cancerous cells, which may indicate the presence of cancers in the urinary tract. It’s important to note that a urine cytology test alone cannot diagnose cancer, and if any suspicious cells are found, additional tests or procedures may be recommended for further evaluation. Patients should communicate with their healthcare provider to discuss the results and determine any necessary follow-up care or treatment plans. Throughout this process, the patient’s comfort and well-being should be prioritized.

Side Effects of the Test

Urine cytology tests are generally considered safe and non-invasive procedures with minimal side effects. Since the test typically involves providing a urine sample by peeing into a sterile cup, there are usually no risks or complications associated with the process. However, in some cases, a healthcare provider may need to insert a catheter to collect the urine sample. In such instances, potential side effects could include discomfort or irritation during catheter insertion and a slight risk of urinary tract infection. Although these side effects are rare, it is essential to inform your healthcare provider if you experience any discomfort or symptoms after the test to ensure prompt attention and care. 

Results and meaning

Normal cellsNo cancer or viral diseases detected; urinary tract is healthy
Atypical cellsUnclear results; further testing may be required to determine the cause of abnormalities
Abnormal cellsPossible urinary tract cancer or viral disease; additional tests needed for confirmation
Inflammation cellsInflammation in the urinary tract or ureters, bladder, or urethra
Post-radiationAbnormal cells due to radiation therapy near the bladder (e.g. prostate, uterine, or colon cancer)

Accuracy of urine cytology test

Urine cytology is a crucial diagnostic tool for detecting urothelial neoplasia, particularly in patients experiencing genitourinary symptoms or those with a history of bladder cancer. The accuracy of this test is influenced by factors such as tumor grade, specimen nature, and sampling. Urine cytology has been proven to be highly effective in diagnosing high-grade urothelial carcinoma, with cytohistologic correlation rates as high as 98%. However, its diagnostic yield for low-grade urothelial neoplastic lesions is significantly lower, with sensitivity and specificity values as low as 8.5% and 50% respectively. Despite its limitations, urine cytology remains an essential component in the accurate detection of urothelial neoplasms. 

Costs of Urine Cytology Tests in Major USA Clinics in 2023

  • The cost of urine cytology test at the Mayo Clinic ranges from $139 to $775, depending on the complexity of the test.
  • The cost of urine cytology test at the Cleveland Clinic is approximately $360.
  • The cost of urine cytology test at Cedars-Sinai Medical Center is $297, which includes the cost of the test, pathology consultation fee, and facility fee.
  • The cost of urine cytology test at John Hopkins Hospital is $278, which includes the cost of the test, pathology consultation fee, and facility fee.
  • The cost of urine cytology test at UCLA Health ranges from $250 to $750, depending on the complexity of the test.
  • The cost of urine cytology test at Stanford Health Care is approximately $415, which includes the cost of the test, pathology consultation fee, and facility fee.

The prices listed were taken from public sources for your reference. You can find out more precise information and possible changes in cost directly from the clinic you are attending.

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