Have you ever heard of a ' Urine Cytology test '? You may have been a little scared when a doctor asked you to have this test. But don't worry, it's usually done to confirm something. Simply put, this test involves taking a sample of your urine and having a specialist examine it to see if it contains cancer cells or cells that could potentially turn into cancer.
What exactly is Urine Cytology?
Okay, first let's look at what "Cytology" is. Cytology is the study of single cells taken from tissues or fluids in our bodies. In this, a specially trained doctor, called a "Cytopathologist," looks at these cells under a microscope to see if there are any abnormalities or changes in them.
So, urine cytology is a test that takes cells from your urine sample, looks at them under a microscope, and checks them for any abnormalities, especially cancer cells.
When is this test (Urine Cytology) performed?
This (Urine Cytology) test is mainly used to help diagnose cancers of the urinary system . That is:
- Bladder cancer
- Cancer of the ureter, the thin tube that carries urine from the kidney to the bladder
- Cancer of the urethra, the thin tube that carries urine from the bladder to the outside of the body
- Conditions like kidney cancer .
But remember, doctors don't usually just do this (Urine Cytology) test and immediately decide that there is cancer. Often, they also do several other tests.
In addition, this urine cytology test can also detect viral diseases such as cytomegalovirus (which belongs to the herpes virus family).
Are urine cytology and a general urine test (urinalysis) the same thing?
Yes, although both of these are tests performed using urine, there is a big difference between the two.
Urine cytology is a very specialized test. It involves looking at the cells in a urine sample under a microscope. The pathologist mainly looks for cancer cells.
On the other hand, a urinalysis is a basic urine test that doctors use to diagnose and manage various diseases and conditions, such as urinary tract infections (UTIs) , kidney disease, and diabetes mellitus .
A routine urinalysis examines the appearance, concentration, and content of urine. It can detect the presence of cells, cell fragments, or crystals, protein, and glucose (sugar) in the urine.
A doctor may order a urinalysis for a specific reason, but most of the time it's a routine test, maybe once a year. Urine cytology tests aren't done as often, and are only done when there are very specific reasons.
When will the doctor tell you to do this (Urine Cytology) test?
If your doctor suspects that you have symptoms of urinary tract cancer, he or she may order a urine cytology test. Symptoms include:
- Blood in the urine (hematuria) .
- Constantly feeling pain when urinating.
- Burning sensation when urinating.
Although urine cytology tests can help detect some types of cancer, they also have limitations. Just because a urine cytology test doesn't find cancer cells doesn't always mean that a person doesn't have cancer. That's why doctors often do several other tests along with this test, and may even do a urine cytology test again after a while.
A doctor may ask you to provide a urine sample for a urine cytology test for other reasons. For example:
- If you have had bladder cancer before and have received treatment, check to see if it has come back.
- If you have recurrent UTIs, monitor the bacteria in your urine.
- Check for some viral diseases.
Who performs this (Urine Cytology) test? How is the sample taken?
In most cases, the person performing the urine cytology test collects the urine into a sterile cup in a private bathroom. This is called a "clean catch urine sample." Sometimes, to collect the urine sample, the patient or a healthcare provider will need to insert a thin tube called a catheter through the urethra into the bladder.
A doctor may also take a urine sample for a urine cytology test during a cystoscopy , a procedure in which a doctor uses a thin camera-equipped instrument to examine the inside of the bladder and urethra.
The healthcare provider then sends the urine sample to a laboratory. A pathologist or cytopathologist examines the cells in the urine sample under a microscope and prepares a report.
How should you prepare before the test?
You should give your urine for a Urine Cytology test after you urinate first thing in the morning . This is because the cells in urine that have been in the bladder for a long time, like overnight, can break down. This can make it difficult for the pathologist to see the cells clearly when they are examined under a microscope. Therefore, your urine sample for a Urine Cytology test should not be your first thing in the morning.
You will most likely need to make an appointment at a hospital or lab to give a urine sample.
What are the steps involved in performing a urine cytology test?
There are generally four main steps in a urine cytology test:
1. Collecting the urine sample.
2. Preparing the cells in the urine sample.
3. Checking the cells in the urine sample.
4. Notification of results.
Okay, let's now look at these steps in a little more detail.
Collecting the urine sample
In most cases, the sample for the urine cytology test is collected by the person performing the test.
Before you collect your urine sample, your doctor may give you a special kit. It may contain a solution and sanitary wipes to clean your genital area. This is to stop germs from outside your urethra, such as the skin on your vulva or penis, from getting into the urine sample. It is very important to follow the instructions for using these cleaning wipes exactly. You will then need to urinate into the toilet and collect the rest in a sterile cup. Your doctor will tell you how much urine you need for the test.
In some cases, you or a doctor may need to insert a catheter and take a urine sample.
A doctor may also take a urine sample during a cystoscopy .
Your doctor will then send this urine sample to a laboratory.
Preparing cells from a urine sample
After the urine sample is collected, the pathologist or lab technician can use a machine called a centrifuge to separate the cells they want to look at from the urine. The centrifuge spins the sample very fast, separating the cells from the liquid. The pathologist then places the cells on a microscope slide and stains them with special dyes. This staining allows the pathologist to see some of the characteristics of the cells clearly when they are viewed under a microscope.
Examining the cells in the sample
After the pathologist or lab technician prepares and stains the urine cell sample, they look at the cells under a microscope to see if there are any abnormal cells. If they find any abnormal cells, they mark the areas on the slide where the cells were with a special pen. The pathologist then creates a report.
Notification of results
After the pathologist prepares the report, it is sent to your doctor . Your doctor will discuss the results with you and decide what to do next.
What happens after the test?
It may take a while for your test results to come back. Because urine tests have limitations, your doctor will likely order several more tests to look for cancer in the urinary tract. For this reason, your doctor may want to tell you about each test result as it comes in. Your doctor will tell you how the process will go, including determining the results and notifying you.
Are there any risks with this test?
Most people do urine tests by placing urine in a sterile cup, so there are no risks or side effects.
However, if your doctor uses a catheter (a thin tube inserted into your urethra) to collect urine, you have a small risk of developing a urinary tract infection (UTI) . However, UTIs are common and treatable conditions.
How do the results of the Urine Cytology test come out? What do they mean?
Pathologists may use different words in a urine cytology report. Your doctor will explain the results to you. Don't be afraid to ask questions.
Typically, the results tell whether the cells in the urine sample are negative or positive for abnormal cells, pre-cancerous cells, and/or cancer cells.
Your results report may contain words like:
- Unsatisfactory specimen: This means that there may not be enough cells in your urine sample for the pathologist to see. You will need to provide another urine sample if this is the case.
- Negative for high-grade urothelial carcinoma: This means that the pathologist did not find any cancer cells or abnormal cells in your urine sample.
- Atypical urothelial cells: This means that the pathologist found some abnormalities in your urine sample, but the cells are not abnormal enough to be considered cancer.
- Suspicious for high-grade urothelial carcinoma: This means that the pathologist found abnormal cells in your urine sample that could be cancerous.
- Positive for high-grade urothelial carcinoma: This means that the pathologist found cancer cells in your urine.
Abnormal cells in your urine can also be a sign that your urinary tract is inflamed . If you have had radiation therapy near your bladder, you may also have abnormal cells in your urine.
A urine cytology test can only help diagnose cancer. Doctors do not use this alone to determine if you have urinary tract cancer. If your urine contains abnormal, suspicious, or cancerous cells, your doctor will likely order further tests, such as a cystoscopy or CT scan, to examine your bladder and urethra.
How long will it take for me to know the results?
The time it takes for your Urine Cytology test results to arrive depends on several factors:
- Asking the pathologist if he needs to see more samples.
- Whether the test requires special stains or procedures.
- Whether you need a second opinion from your doctor or a pathologist.
- Have you done any more testing?
- Sample processing time.
Because everyone's situation is different, your doctor will give you a good idea of when you can expect results.
How accurate is the urine cytology test?
Urinary cytology is most helpful in detecting invasive high-grade tumors ( cancer cells that grow and spread quickly) and carcinoma in situ (a group of abnormal cells that only remain where they first formed). It has a 95% accuracy rate in detecting these two conditions.
However, urine cytology is not very effective in detecting low-grade carcinoma (cancer cells that grow and spread). It has an accuracy rate of 10% to 50% for such cancers. It also has a significant false-negative rate for this condition. That is, urine cytology results may show that a person does not have low-grade carcinoma, but other tests may show that the person does have low-grade carcinoma.
Finally, things to remember (Take-Home Message)
Urine cytology tests can be a useful tool in the diagnosis of urinary tract cancer. The most important thing to remember is that if your doctor suspects that you have urinary tract cancer, you will need to have more than just a urine cytology test. While waiting for the results of a diagnostic test can be stressful, know that your medical team is there to support you no matter what the results are. Don’t be afraid to ask your doctor questions throughout this process.
` Urine Cytology, Urine Test, Cancer, Bladder Cancer, Kidney Cancer, Cell Test
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