Javascript er ikke aktivert i din nettleser. Dette er nødvendig for å bruke Oncolex. Kontakt din systemadministrator for å aktivere JavaScript.

Urine cytology of urothelial cancer

Medical editor Aasmund Berner MD
Oslo University Hospital


A constant rejection of cells from normal urothelium and malignant cells occurs in the bladder. These rejected cells can be isolated from a regular urine sample and assessed and classified as normal or malignant.

Urine cytology is most reliable for detecting tumors of higher grade (WHO grade 2 and 3) and Tis. A tumor of WHO malignancy grade 1 will give a positive cytology to a lesser degree. Due to a low cell count, degenerative -, irritative - (for example calculous disease or cystoscopy urine) and therapy-induced (BCG and radiation therapy) changes, the cytological interpretation of the specimen may be problematic.


  • Hematuria not explained at cystoscopy and urography  
  • Ambiguous finding at cystoscopy
  • Negative cystoscopy in patient with suspect UTI-symptoms
  • Negative cystoscopy and possible tumor in upper urinary tract from urography/ultrasound 
  • Follow-up of certain patients (for exmple Tis)


  • Diagnostic
  • Follow-up


  • Reagent tube
  • Slide glass with matted end
  • 70% ethanol
  • Centrifuge
  • PreserveCyt solution
  • ThinPrep machine
  • Papanicolaou


  • Urine for a cytology examination is taken from spontaneous urine, catheter, or ilium bladder.
  • Night urine should not be used.
  • The sample is fixed with 70% ethanol/urine (50/50) and sent as a regular postal package
  • At least two, preferably three samples should be taken for cytology, at different urinations.


  • Pour the urine sample into a 50 ml reagent tube.
  • Centrifuge the sample for 10 minutes at 2000 rotations.
  • Remove the supernatant.
  • Preserve the sediment with PreserveCyt solution and allow to sit for at least 15 minutes.
  • Prepare the ThinPrep machine:
    • Insert the filter with holder
    • The "Fix-bath" holder should be filled with 70% ethanol.
    • Have a ThinPrep slide ready.
    • PreserveCyt solution container with the fixed material should be available.
  • Start the machine (program 2)
  • When the sample is finished rotating, remove the ThinPrep slide from the fix-bath holder.
  • Allow the sample to dry.
  • Stain by routine protocol in the staining machine with Papanicolaou. Remember: only one bath of hematoxylin.
  • Mount the smears immediately. If not, place them in Xylenes to avoid "Cornflakes."

Oslo University Hospital shall not be liable for any loss whether direct, indirect, incidental or consequential, arising out of access to, use of, or reliance upon any of the content on this website. Oslo University Hospital© 2018