Urologic Specimens

Urine is commonly evaluated cytologically for the presence of malignant cells in the detection of urologic malignancies. Method of specimen collection as well as time of collection will affect the cytologic evaluation in many instances.

Voided/Catheterized Urine

Indications: Detection and characterization of malignant cells and other urologic abnormalities in symptomatic (usually hematuria) patients; screening for malignancy in selected individuals at high risk for the development of urologic malignancy.
Specimen Required: 50 mL of an appropriately collected voided, catheterized, or cystoscopically obtained urine specimen.
Supplies: Clean collection container of appropriate size. Fixative (Saccomanno Fixative).
Collection Procedure: For purposes of obtaining the greatest yield of diagnostic material, a second morning voided urine specimen should be obtained, if possible. A midstream, clean catch specimen is recommended to avoid vaginal contamination in female patients. A midstream specimen, not necessarily clean catch, is recommended for male patients. If the patient must be catheterized to obtain the specimen, this should be noted on the specimen requisition as catheterization can lead to artifacts which may be misinterpreted without the knowledge that the specimen was catheterized. Submit the specimen along with the completed cytology request form. Add an equal volume of Saccomanno fixative (if sample size is too large to accommodate this volume, a well-mixed aliquot of the specimen with an equal volume of fixative may be utilized.  With Saccomanno fixative added, specimen may be transported at room temperature.  If fixative is not available, the specimen should be refrigerated or kept on wet ice until transported to the lab.

Other Urologic Specimens

Indications: Detection of suspected malignancy utilizing lavage specimens obtained cystoscopically (bladder washing, ureteral washing); staging of urologic malignancies.
Specimen Required: 10 mL (or more) of an appropriately collected cystoscopically derived specimen.
Supplies: Standard cystoscopy equipment. Clean collection container of appropriate size. Fixative (Saccomanno Fixative).
Collection Procedure:

Using standard cystoscopy technique, obtain washing specimens, carefully denoting specific specimen sites for each specimen on the requisition. Add an equal volume of Saccomanno fixative to the specimen Submit the specimen along with the completed cytology request form.  With Saccomanno fixative added, specimen may be transported at room temperature If fixative is not available, the specimen should be refrigerated or kept on wet ice until transported to the lab.

 

Urine for BK Virus
Indications: Detection and characterization of BK viral changes in urologic specimens (voided urines) and potentially other urologic abnormalities in transplant patients.
Specimen Required: 50 mL of an appropriately collected voided urine specimen.
Supplies: Clean collection container of appropriate size. Fixative (Saccomanno Fixative).
Collection Procedure: For purposes of obtaining the greatest yield of diagnostic material, a second morning voided urine specimen should be obtained, if possible. A midstream, clean catch specimen is recommended to avoid vaginal contamination in female patients. A midstream specimen, clean catch, is recommended for male patients. If the patient must be catheterized to obtain the specimen, this must be noted on the specimen requisition. Catheterization can cause cellular artifacts which may be misinterpreted without the knowledge that the specimen was catheterized. Submit the specimen along with the completed Cytology Request form stating Urine for BK Virus. Add an equal volume of Saccomanno fixative (if sample size is too large to accommodate this volume, a well-mixed aliquot of the specimen with an equal volume of fixative may be utilized. With Saccomanno fixative added, specimen may be transported at room temperature. If fixative is not available, the specimen should be refrigerated or kept on wet ice until it is transported to the lab.

Urine for Hemosiderin (Iron Stain)
Indications: Detection and characterization of hemosiderin-laden cslls in urologic specimens and potentially other urologic abnormalities.
Specimen Required: 50 mL of an appropriately collected voided, catheterized, or cystocopically obtained urine specimen.
Supplies: Clean collection container of appropriate size.
Collection Procedure: For purposes of obtaining the greatest yield of diagnostic material, a second morning voided urine specimen should be obtained, if possible. A midstream, clean catch specimen is recommended to avoid vaginal contamination in female patients. A midstream specimen, clean catch, is recommended for male patients. If the patient must be catheterized to obtain the specimen, this must be noted on the specimen requisition. Catheterization can cause cellular artifacts which may be misinterpreted without the knowledge that the specimen was catheterized. Submit the specimen along with the completed Cytology Request form stating request for hemosiderin. The specimen should be refrigerated or kept on wet ice until it is transported to the lab.