URINE

Urine Cytology is used as a non-invasive screening tool for:

1.    Diagnosing high-grade urothelial carcinoma

2.    Monitoring for recurrence or progression in patients with history of urothelial carcinoma

3.    Evaluation of hematuria

4.    Screening of high-risk individuals (e.g. exposure to certain chemical or radiation therapy)

5.    Assessing inflammation (UTIs)

6.    Detecting specific viral infections, such as polyomavirus in kidney transplant recipients

Voided Urine

Urine cytology is a specialized test used to look for abnormal or cancerous cells in the urinary tract. Because cells in urine can degrade very quickly, proper collection and handling are critical for an accurate diagnosis. To prevent contamination (external bacteria or skin cells) and deterioration (the breakdown of the cells you want to study), follow these essential guidelines:

1. Timing: Avoid the "First Morning" Urine

Unlike many other urine tests, the very first urine you pass in the morning is not suitable for cytology.

Why: Cells that have sat in the bladder overnight have likely started to break down (degenerate), making them difficult for a pathologist to read. Collect your sample from the second time you urinate that day (mid-morning).

2. Proper Hydration

Drinking water helps produce a "fresh" sample that hasn't been sitting in the bladder for long. Drink 2–3 large glasses of water about 1–2 hours before you plan to collect the sample. This ensures the cells are "freshly shed" and well-hydrated.

3. The "Clean Catch" Midstream Technique

To prevent contamination from skin cells or bacteria around the urinary opening, use the midstream method:

Cleanse: Wash your hands and clean the genital area with water (front-to-back for females; retract the foreskin for uncircumcised males).

The "Start-Stop" Method:

    1. Begin urinating into the toilet.

    2. After a few seconds, place the sterile specimen container (red cap) into the stream.

    3. Collect the "middle" portion of the urine. Typically, about 30-50ml of urine should be collected.

    4. Finish urinating into the toilet.

Avoid Contact: Do not let the inside of the container or the lid touch your skin or clothes.

4. Preservation and Storage

Cells in urine are sensitive to pH changes and bacterial growth, which can destroy them within an hour at room temperature. Please labelled urine specimen bottle at designated location. Deliver the sample to the lab as soon as possible—ideally within 1–2 hours. After laboratory hours, deliver to CSM for refrigerated storage.

Submit specimen in a sterile container within one hour of collection. 

Indicate in the CPOE request if urine collected is "voided" or "catheterised". Clinical information is essential as instrumentation and the presence of urinary tract stones may result in cytologic changes that mimic malignancy. 

If detection of eosinophils is required, indicate clearly in the CPOE request. 

If detection of polyomavirus/BK virus is required, indicate clearly in the CPOE request. Immunocytochemistry test (SV40) may be required for confirmation.

5 working days (excluding additional immunocytochemistry stain)

​Daily