Do you sometimes feel like you're passing blood in your urine? Or do you have a burning or pain when you urinate? When you go to see a doctor because of something like this, he may have asked you to do a test called "Urine Cytology." Some people are a little scared when they hear this name, because they wonder what kind of test it is and what the results will be. But there's no reason to be scared. It's actually very simple. Today, let's talk about what this Urine Cytology test is, why it's done, and what we can learn from it.
What is Urine Cytology in simple terms?
Okay, so let's first look at the meaning of this name. Cytology is the study of the cells in our body. More precisely, it is the study of the shape, size, and differences in cells by looking at them under a microscope. Urine Cytology is the study of the cells in a sample of your urine in this way.
This test is performed by a doctor who specializes in cytology . We call them Cytopathologists. They look at the cells in your urine sample under a microscope to see if there are any abnormalities, cancer cells, or cells that could become cancer.
Simply put, it's like a detective looking for some "bad cells" hiding among the cells in your urine sample.
What can this test find?
The main purpose of this test is to detect cancers of the urinary tract early. Doctors use this test mainly when they suspect the following types of cancer:
- Bladder cancer: This is the most commonly diagnosed type of cancer.
- Cancer of the ureter: Cancer of the thin tubes that carry urine from the kidneys to the bladder.
- Cancer of the urethra: Cancer of the tube that carries urine from the bladder to the outside of the body.
- Kidney cancer: Some types of kidney cancer can also be detected with this test.
In addition to detecting these cancers, this test can also detect certain viral diseases, such as cytomegalovirus.
Are Urine Cytology and Urinalysis the same thing?
No. This is where many people get confused. Urine Cytology and Urinalysis (what we commonly call a 'urine report') are two different tests. Although both use a sample of your urine, their purposes are completely different.
Let's look at this table to clearly understand the difference between the two.
| The point | Urine Cytology Test | Urinalysis (general urine test) |
|---|---|---|
| Main objective | Accurately identifying cancer cells or abnormal cells in a urine sample. | Checking the general condition of the urine. For example, getting clues about infections (UTI), kidney disease, diabetes, etc. |
| What are you checking? | Things like the shape, size, and nucleus of cells are examined in depth under a microscope. | Urine is checked for color, clarity, sugar (glucose), protein, blood cells, and pus cells. |
| Who does? | A doctor who specializes in cytology (Cytopathologist). | Usually performed by a laboratory technologist. |
| When do you do it? | Only when there is a specific suspicion of cancer. | It is often performed as a routine health checkup or when there are symptoms. |
Do you understand the difference now? Urinalysis is a general test. Urine Cytology is a specialized test that looks for something more in-depth and specific.
Why would a doctor ask you to do this test?
There may be several reasons why your doctor may recommend a urine cytology test.
- Blood in the urine (Hematuria): This is the main cause. If there is blood in the urine, this test is very important to find the cause.
- Pain or burning during urination: If there is persistent pain or burning.
- Frequent urinary tract infections (UTIs): Sometimes, check to see if there is another cause behind frequent urinary tract infections.
- Follow-up after cancer treatment: If you have previously had bladder cancer and received treatment, this test is used to see if the cancer has come back.
But remember one thing. Just because this test does not find cancer cells does not mean that you are 100% cancer-free. Therefore, doctors recommend doing several other tests (e.g., cystoscopy, CT scan) along with this test.
How do I prepare for the test and provide the sample?
This is a very simple process, but there are a few important things to get right.
The most important thing to know before the test!
This is the most important thing. Do not give your first urine sample in the morning for this test. The reason is that the cells in the urine that have been sitting in your bladder all night can break down and break down. This can make it difficult for the doctor in the lab to identify the cells. Therefore, it is best to give a sample of urine that you pass first thing in the morning and then give a sample of urine that you pass the second or third time of the day.
How to give the sample (Clean Catch method)
The lab will give you a special bottle (sterile container) for this. They will also probably give you cleaning solution and wipes. Follow these steps before giving the sample.
1. Wash your hands thoroughly with soap: This is very important.
2. Clean the genital area: Clean the genital area thoroughly with the wipes provided by the lab or with clean water. This is to prevent germs from the outer skin from getting on the sample.
3. Start urinating: First, empty some urine into the toilet.
4. Collect the sample: Then, without stopping to urinate, hold the bottle provided by the lab to the urine stream and collect the required amount (usually about half the bottle).
5. Empty the rest: Remove the bottle and empty the rest of the urine into the toilet.
6. Close the bottle tightly and hand it over: Close the bottle tightly, do not touch the inside, and hand it over to the lab as soon as possible.
In some cases, if the patient is unable to provide the sample themselves or for other reasons, a doctor may need to insert a catheter , a thin tube inserted into the urethra, to take a sample from the bladder. This type of sample can also be taken during a cystoscopy (examination of the bladder with a camera).
What happens to your urine sample in the lab?
After you provide the sample, several steps take place in the lab.
- Preparing the sample: First, your urine sample is placed in a machine called a centrifuge . This spins the urine sample at high speed, similar to how a washing machine spins clothes to remove water, separating the cells from the liquid.
- Staining and staining on a glass slide: The separated cells are then spread on a glass slide (microscope slide) and stained using special dyes (stains). This staining allows the different parts of the cells to be clearly identified when viewed under a microscope.
- Microscopic examination: This is where the Cytopathologist begins his work. He places this prepared slide under the microscope and carefully examines the cells one by one. He pays special attention to whether there are any cells that are different from normal cells, have unusual shapes, or have large nuclei.
- Preparing the report: After this examination, the doctor will prepare a report based on what he or she observed and send it to the doctor who is treating you.
What are the things in the report and what do they mean?
There may be various words on your report. Don't be alarmed when you see them. Your doctor will explain them all to you. But let's look at the things that can usually appear on a report and their simple meanings.
| What may be stated in the report | Simple meaning |
|---|---|
| Unsatisfactory specimen | It means that there were not enough cells in the sample to test. In such cases, you may need to give another sample. |
| Negative for high-grade urothelial carcinoma | This is good news. No cancer cells or suspicious abnormal cells were found in the sample. |
| Atypical urothelial cells | There are some abnormal cells in the sample, but they haven't changed enough to be definitively cancer cells. This could be due to something like an infection. |
| Suspicious for high-grade urothelial carcinoma | The abnormal cells found in the sample have a high probability of being cancer cells. |
| Positive for high-grade urothelial carcinoma | It means that cancer cells have definitely been found in the sample. |
The most important thing: Whatever the result of the Urine Cytology report, it alone does not make a final decision about whether or not there is cancer. Especially if the result is 'Atypical' or 'Suspicious', your doctor will definitely do further tests like Cystoscopy or CT scan to confirm the situation. So, do not panic after seeing the report.
How accurate is the urine cytology test?
The accuracy of this test depends on the type of cancer being detected.
- High-grade tumors: These are fast-growing, aggressive types of cancer. Urine cytology is about 95% accurate in detecting these.
- Low-grade tumors: These are slow-growing, less aggressive types of cancer. This test is not very effective at detecting these. Its accuracy can range from 10% to 50%. This means that even if such a cancer is present, it is more likely to be missed in the report (false-negative).
This is why doctors don't rely on just one test.
Take-Home Message
- Urine Cytology is not a regular urine test (urinalysis). It is a special test that looks for cancer cells or abnormal cells in the urine.
- When providing the sample for this test, do not provide the first urine sample that you pass in the morning.
- Whatever the test result, it is not a final diagnosis. Your doctor will likely order further tests to confirm it.
- This test is very effective in detecting fast-growing (high-grade) cancers.
- If you have any questions about the test report or the next steps, don't be afraid to ask your doctor. It's very important to talk openly with him.
💬 අදහස් (0)
තවමත් කිසිදු අදහසක් පළ කර නොමැත. ඔබේ අදහස පළමු වරට මෙහි එක් කරන්න.
ඔබේ අදහස එක් කරන්න