Cytology is the examination of cells from the body under a microscope.
In a urine cytology exam, a doctor looks at cells collected from a urine
specimen, to see how they look and function. The test commonly checks for
infection, inflammatory disease of the urinary tract, cancer, or precancerous
It’s important to note that this test doesn’t
identify cancer, nor can it completely rule out cancer. Urine cytology is
better at finding larger and more aggressive cancers than small, slow growing
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 the
Your doctor may order a urine cytology exam
if you have any of these symptoms:
- unexplained blood in your urine
- burning during urination
- persistent pain during urination
The test also monitors patients who have 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.
Because the urine from your first morning
urination remains in your bladder for many hours through the night, the cells
may degrade and not be useful for urine cytology. However, this doesn’t mean
you should urinate right before the test. In fact, you may need to hold urine
in your bladder for a few hours prior to a cystoscopy. Be sure to ask your
doctor for specific instructions before the test.
For a cystoscopy, your doctor will clean the
skin around your urethra (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 carries a small risk of
infection or bleeding. Your doctor will send the urine sample to a laboratory
for analysis, and then will receive a 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.
Your doctor’s office will provide a special container
to collect the sample. Be sure to ask your doctor for specific
instructions regarding the proper way to get the sample and where to bring it
when you finish. Failure to follow instructions may provide a poor result, and
you may have to repeat the test.
You will use special cleansing cloths to
clean the skin around your urethra prior to the test. You will need to urinate
a small amount into the toilet, and then stop the flow of urine. Then you will
urinate into the sterile container until reaching the desired level. You may
then finish urinating into the toilet.
In some cases, your doctor may want you to
provide urine samples over the course of several days. Your doctor will send
the urine sample to a laboratory for analysis, and then will receive a report.
Happens in the Laboratory? | Lab Tests
A pathologist will analyze the cells under a
microscope to see if there are any abnormalities. They may also look at the
cells in a culture dish to see if bacteria or other organisms are growing.
The pathologist will send the results of your
urine cytology test to your doctor, who will report the results to you. Ask
your doctor how long you can expect to wait for your results.
Different laboratories use different language
in their reports. Your doctor will be able to explain what your results mean.
There are some common terms that can describe your results.
If your urine cells appear normal and are
free of bacteria and yeast, this is a normal result. Most labs will call this a
The lab may label your specimen
“unsatisfactory” if there weren’t enough usable cells in the sample. In this
case, you will likely have to repeat the procedure and provide a new sample.
Atypical or Suspicious
These terms describe when cells don’t appear
normal, but it can’t be confirmed that they are cancerous or precancerous.
If bacteria or yeast are present in the
culture, you probably have a bladder or urinary tract infection. Antibiotics
can usually treat these conditions.
Cells that appear abnormal in your urine may
also indicate inflammation in the urinary tract or cancer of the bladder,
kidney, ureter, or urethra. However, an abnormal urine cytology result can’t
diagnose these diseases. Additional tests are usually necessary to confirm the