Evaluation of initial, mid-stream and terminal urinary sample for cytology in follow up of bladder cancer and its comparison with cystoscopy

ABSTRACT

Study was carried out with a view to know which sample of urine [initial, midstream or terninal] is more useful in detecting the malignant cells. Cytological examination of the voided urine is the only non- invasive method of detection, diagnosis and follow up of tumours of the bladder. A pilot project of 75 patients with biopsy proven carcinomas of the bladder was carried out. Each patient provided fractionated urinary samples [initial, midstream. terminal]. The diagnostic value of each group was assessed and the results' were compared with cystoscopic examination. Twenty four [32%] of patients had both positive cytology and cystoscopy. Twenty-seven [36%] of patients had both negative cytology and cystoscopy. The false neative results were 24% and 0.75% were false positive. The fractionated sampling results showed that 93.33% of the urinary samples including initial, midstream and terminal had yielded cytological results, however, in our experience fractionated urinary sampling does not add to the routinely taken sample of urine for cystology. Study confirms that any sample of urine is satisfactory for diagnostic purpose: