1. Cytology of urine
Sample collection technique:
 Voided urine
 Ileal conduit urine
 Catheter urine
 Bladder washing
 Upper urinary tract brush cytology
Voided urine
 It is the most common sample type
 Voided urine undergoes degeneration very quickly hence preservative are
used to reduce cellular degeneration and stopping bacterial growth.
 Voided urine should be obtained 3 to 4 hours after the patient has last
urinated.
 First morning voided urine specimens should be avoided because stagnant
cells in the low acid-base balance (pH) and hypertonic environment
undergo degenerative changes, making cytologic assessment difficult.
 The minimum amount of urine necessary to ensure adequate cellularity is
unknown, but it may be as high as 25 to 100 mL.
 In women, voided urine can be contaminated by vaginal cells, so to ensure
the adequacy of the sample, a midstream (“clean catch”) specimen is
recommended.
Ileal conduit urine
 This specimen type is useful for follow up of patient who have been treated
for bladder cancer.
 An ileal conduit is a urinary diversion that is constructed from a section of
ileum when a patient has had their bladder removed during surgery for
bladder cancer.
 Urine sample of these patient has quiet varied appearance, may show large
number of degenerating interstitial epithelial cell macrophage
inflammatory cell and mucus.

2. Catheter urine
 A urinary catheter is short plastic tubing that is inserted into the bladder to
allow urine to drain freely into a bag.
 Catheterization carries a risk of urinary tract infection
 Urine collected from an indwelling catheter is often a pooled specimen that
has been at room temperature for many hours, and cellular degeneration
can be pronounced.
Bladder washing
 Bladder washing is not a common source of urine sample as the procedure
is invasive.
 It involves injecting 50-100 ml of saline through a catheter and aspirating
fluid before collection.
 The advantages of bladder washings over voided urine are better cellular
preservation, greater cellularity, and less chance of contamination by
background debris.
Upper urinary tract brush cytology
 When an upper urinary tract malignancy is suspected, directed washings,
brushings, or biopsies of a ureter or renal pelvis lesion can be performed
 Using endoscopy and X-ray control a fine brush is passed into the ureter.
Once the brush has been passed into the suspicious area the brush is
moved back and forth to dislodge cell.
 These cells adhere to bristle of brush and can be spread onto a slide.