Cytology is the examination of cells from the body under a microscope. The test commonly checks for infection, inflammatory disease of the urinary tract, cancer, or precancerous conditions.

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 cancers.

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 a diagnosis.

Your healthcare professional may order a urine cytology exam if you have any of these symptoms:

The test also monitors those who’ve 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 healthcare professional can collect a sample during a cystoscopy, which examines the inside of the bladder, or you can provide a clean catch urine sample.

Cystoscopy

A cystoscopy is performed using a cystoscope, a thin tube with a small camera on the end. The procedure typically takes 10 to 20 minutes.

You may need to hold urine in your bladder for a few hours prior to cystoscopy. Be sure to ask your healthcare professional for specific instructions before the test.

For a cystoscopy, your healthcare professional will clean the skin around your urethra (the 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 healthcare professional will drain your urine into a sterile container and then remove the catheter.

The procedure carries a small risk of infection or bleeding. Your healthcare professional 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 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 healthcare professional’s office will provide a special container to collect the sample. Be sure to ask your healthcare professional 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 an unclear result, and you may have to repeat the test.

You’ll use special cleansing cloths to clean the skin around your urethra prior to the test. Then, you’ll need to urinate a small amount into the toilet and 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 healthcare professional may want you to provide urine samples over several days. They will send the urine sample to a laboratory for analysis and then receive a report.

A pathologist will analyze the cells under a microscope to find abnormalities. They may also examine 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 healthcare professional, who will report the results to you. Ask your healthcare professional how long you can expect to wait for your results.

Your healthcare professional will be able to explain what your results mean. Some common terms may describe your results:

  • Negative: No abnormal cells were identified.
  • Atypical or suspicious: These terms describe when cells don’t appear typical but cannot be fully identified as cancerous or precancerous.
  • Abnormal: Abnormal cells have been found in the urine sample. Your report will likely say that further testing is recommended.
  • Unsatisfactory: The sample could not be properly interpreted.