Norm of Cytologic Study of Urine
Normal type and amount of squamous and epithelial cells of the urinary tract and little or no cellular debris; red blood cell count ≤3; white blood cell count ≤4; no abnormal cells such as cytomegalic inclusion bodies, malignant cells, parasites, or yeasts.
Usage of Cytologic Study of Urine
Anemia (hemolytic), cerebral metachromatic leukodystrophy, cytomegalovirus infection (cytomegalic inclusion bodies), measles (cytomegalic inclusion bodies), renal hemosiderosis, screening for premalignant cell changes, transplant rejection, urinary tract infections (herpesvirus, fungi, Schistosoma, others), urinary tract inflammation (epithelial cells, RBCs, WBCs), and urinary tract primary or metastatic cancer (malignant cells).
Description of Cytologic Study of Urine
Urine cytology is the microscopic study of cells in urine to detect the presence of abnormal cells, including tumor or pretumor cells, or evidence of an infective process. Any abnormalities found are correlated to clinical data for a diagnosis of urinary tract neoplasm, infection, or other diseases that may affect the urine.
Professional Considerations of Cytologic Study of Urine
Consent form NOT required.
- Obtain a sterile container.
- Hydrate the client ½ to 1 hour before specimen collection.
- Urine cytology involves centrifuging and filtering the urine, or cytocentrifuging, staining, and examining the filtered sediment.
- For a voided specimen, have the client urinate directly into a sterile container. Tightly cover the container.
- Catheterization may be used if it is otherwise difficult to obtain the specimen or if a high urinary tract lesion is suspected.
- Send the specimen to the laboratory immediately.
Client and Family Teaching
- Discard the first morning void if collecting the sample in the morning. With the next void, urinate directly into the container and then cap it tightly.
- Results are normally available within 48 hours.
Factors That Affect Results
- An early-morning specimen is unsuitable because cell death occurs in the bladder overnight.
- Recent instrumentation may cause cell injury or changes that give false-positive results.
- Hypotonic solutions used as washing during cystourethroscopy procedures may alter the results by directly affecting cell structure and appearance.
- Chemotherapeutic agents such as cyclophosphamide may alter the results.
- A voided specimen is preferred except when specific study of high urinary tract areas is needed. Urine from each ureter may be studied and compared.
- Cytomegalovirus (CMV) can be diagnosed by urine cytologic examination. Several specimens are recommended because cytomegalovirus is not shed continuously. The presence of CMV in the urine may indicate CMV disease or an asymptomatic reactivation of CMV disease. The herbs Geum japonicum, Syzygium aromaticum, and Terminalia chebula have demonstrated anti-murine CMV activity in mice.