Urine Cytology

Principle of Examination

Urine cytology samples are repeatable, non-invasive initial investigations performed either for diagnosis of malignancy or as routine post-operative or treatment follow up. Urine cytology has a high sensitivity for high grade transitional cell carcinomas which can appear normal on cystoscopy. Voided, aspirated and catheterised urine, as well as washes or brushings from anywhere in the urinary tract may be collected.

Specimen Requirements

When sending urine samples for cytological investigation, please note the following:

• Please do not send early morning urine.
• For voided urine whole output second urine is required in a sterile suitable container. We regret that we are unable to accept specimens in drainage bags or leaking containers.
• There should be adequate clinical information provided on the request, which should clarify the indication for a cytological examination.
• State on the request whether the specimen is a voided or catheter specimen.
• Indicate on the request if there is a history of relevant foreign travel.
• Samples should be sent to laboratory immediately after sample collection (within the same day). If there is a delay in specimen transport then the sample can be fixed with an alcohol-based fixative or stored for a few hours at 4°C.
• Any samples processed more than a day old may need to be repeated.
• Send a separate specimen and request form to Microbiology if a microbiological investigation is required.
• Urinary tract brushing specimens must be collected directly into a PreservCyt solution vial to ensure rapid fixation. Direct slide preparations from urinary tract brushing samples should not be produced as there is usually considerable cell loss and air-drying artefact.
• Physiological media such as phosphate-buffered saline may be used if there is an expectation that ancillary tests that preclude alcohol fixation, such as flow cytometry, are needed. In these cases, the specimens must be transported to the laboratory immediately to minimise cell degeneration.

Specimen Delivery and Labelling

All Trust specimens must be requested on Epic and labelled with an Epic label. GPOCS specimens must be labelled with a GPOCs label. All other samples must have a request form.

HIGH RISK SPECIMENS: Requests must indicate if a specimen is high risk.  Please indicate details of the risk, e.g.: TB, blood-borne virus, MPOX etc.

URGENT SPECIMENS: Please label urgent specimens clearly; an explanation as to why the specimen is urgent is helpful.  On receipt, laboratory staff will notify the pathologist who will report the specimen as soon as possible.

Turnaround Time

The Laboratory aims to comply with The Royal College of Pathologists Key Performance Indicator (KPI 6.4) for Cellular Pathology reporting turnaround times with 90% of all cases reported within 10 calendar days.