Cytology exam of urine

Alternative names
Urine cytology

Definition
A cytology exam of urine is used to detect cancer and inflammatory diseases of the urinary tract.

How the test is performed

Collect a urine specimen and send it to the laboratory.

Collect a “clean-catch” (midstream) urine sample. To obtain a clean-catch sample, men or boys should wipe clean the head of the penis. Women or girls need to wash the area between the lips of the vagina with soapy water and rinse well. As you start to urinate, allow a small amount to fall into the toilet bowl (this clears the urethra of contaminants). Then, in a clean container, catch about 1 to 2 ounces of urine and remove the container from the urine stream. Give the container to the health care provider or assistant.

For an infant, thoroughly wash the area around the urethra. Open a Urine collection bag (a plastic bag with an adhesive paper on one end), and place it on your infant. For males, the entire penis can be placed in the bag and the adhesive attached to the skin. For females, the bag is placed over the labia. Place a diaper over the infant (bag and all).

Check your baby frequently and remove the bag after the infant has urinated into it. For active infants, this procedure may take a couple of attempts - lively infants can displace the bag, causing an inability to obtain the specimen. The urine is drained into a container for transport back to the health care provider.

Epithelial cells line the urinary tract and are normally shed into the urine. The urine is examined for the presence of abnormal cells which may indicate cancer of the kidney, ureters, bladder, or urethra. The urine sample is processed in the laboratory and examined under the microscope by a pathologist who looks for the presence of abnormal cells.

How to prepare for the test
Collect a clean catch urine sample 3 hours after the last voiding. The first morning voided specimen should not be used.

If the collection is being taken from an infant, a couple of extra collection bags may be necessary.

How the test will feel
There is no discomfort associated with a clean catch urine specimen.

Why the test is performed
The test is performed to detect cancer and inflammatory diseases of the urinary tract. The test is often performed when bladder lesions are noted on an X-ray. The test may occasionally be performed in individuals who are at high risk of developing bladder cancer. The test can also detect cytomegalovirus and other viral diseases.

Normal Values
The urine shows normal epithelial cells and is relatively free of debris.

What abnormal results mean
There may be an abundance of epithelial cells, red blood cells, white blood cells, or atypical-looking cells. Cancer cells may be present. The results can imply cancer or inflammation of the urinary tract (such as glomerulonephritis).

Renal cell carcinoma is an additional condition under which the test may be performed.

Special considerations
The diagnosis of cancer or inflammatory disease cannot be made exclusively by this test. The results are confirmed by other diagnostic tests or procedures.

Johns Hopkins patient information

Last revised: December 3, 2012
by Martin A. Harms, M.D.

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