More Than Just Pee in a Cup: Urine Cytology
What is urine analysis?
The microscope is used to examine the cells in the body. A doctor looks at cells from a urine specimen to see what types of cells are being eliminated from your body. The test checks for infections, inflammation, and cancer.
This test can not completely rule out cancer, nor can it identify it. Small, slow growing cancers are more likely to be found by urine cytology than by Urine cytology.
This procedure is different from a biopsy in that it examines individual cells, rather than pieces of tissue containing many cell clusters. The cells for urine cytology are easier to obtain than tissue, causing less discomfort and less risk to the patient. Sometimes a biopsy is necessary after abnormal results from urine cytology to clarify a diagnosis.
If you have any of the symptoms, your doctor may order a urine cytology exam.
- There is blood in your urine.
- burning during urination
- persistent pain during urination
The test also monitors those who’ve had urinary tract infections or cancer or who are at high risk for bladder cancer. It can also detect a variety of viral diseases.
There are two ways to obtain the cells needed for a cytology exam. Your doctor can collect a sample during a cystoscopy, which is an examination of the inside of the bladder, or you can provide a clean catch urine sample.
A cystoscopy is performed using a cystoscope, a thin tube with a small camera on the end. The procedure takes between 10 and 20 minutes.
“The cells from your first morning pee may degrade and not be useful for urine cytology because they remain in your bladder for many hours through the night. This doesn’t mean you should urinate before the test. You may need to hold urine in your bladder for a few hours before the cystoscopy. Ask your doctor for instructions before the test.”
For a cystoscopy, your doctor will clean the skin around your urethra (the tube coming out from the bladder) and use a topical gel to numb the area. They will insert the cystoscope into your urethra and up into your bladder. You may feel some pressure and an urge to urinate. Your doctor will drain your urine into a sterile container and then remove the catheter.
The procedure has a small risk of being contaminated. Your doctor will send the urine sample to a laboratory for analysis and then report.
Clean catch urine sample
A clean catch urine sample is easy, noninvasive, and carries no risk. Otherwise known as a midstream urine sample, you can do a clean catch urine sample in a doctor’s office or in the comfort of your own home.
“A special container will be provided by your doctor to collect the sample. Ask your doctor for specific instructions on how to get the sample and where to bring it when you’re done. Failure to follow instructions may result in a poor result.”
You will use special cloths to clean your urethra before the test. You will need to stop the flow of urine by urinating a small amount. You will urinate into the sterile container until you reach the desired level. You may finish urinating into the toilet.
In some cases, your doctor may want you to give urine samples over a period of days. Your doctor will send the urine sample to a laboratory for analysis and then report.
A pathologist will look at the cells under a microscope to see if there are any anomalies. They may look at the cells in the culture dish to see if they are growing.
The doctor will report the results of the urine cytology test to you. Ask your doctor how long you will have to wait for your results.
Your doctor will be able to explain what the results mean. There are some terms that describe your results.
- Negative. No cancer cells were identified.
- Atypical or suspicious. These terms describe when cells don’t appear normal, but it can’t be confirmed that they are cancerous or precancerous.
- Positive. Cancer cells have been found in the urine sample. Your report will likely say the test shows “the presence of cancer cells” rather than “positive.”
- Unsatisfactory. The sample could not be properly interpreted.
- Bostwick DG. (2020). Chapter 7: Urine Cytology. Urologic Surgical Pathology (Fourth Edition). https://www.sciencedirect.com/science/article/pii/B9780323549417000074
- O’Flynn H, et al. (2020). Diagnostic accuracy of cytology for the detection of endometrial cancer in urine and vaginal samples.
- The American Cancer Society medical and editorial content team. (2019). Can bladder cancer be found early?