Can sensitivity of voided urinary cytology or bladder wash cytology be improved by the use of different urinary portions?

Objective: To improve sensitivity by using different portions of voided uri ne cytology (VUC) and bladder wash material cytology (BWC). Materials and M ethods: 52 patients with biopsy-proven superficial transitional cell carcin oma (TCC) of the bladder were studied. Voided urine specimens were divided into a first stream, midstream and terminal stream. Bladder wash material w as also divided into a first portion, mid-portion and last portion. All por tions were investigated for cytology abnormalities. Results: Sensitivity fo r the detection of malignant cells was 34.6, 38.5 and 38.5% for the first, mid- and terminal stream of VUC and 34.6, 38.5 and 34.6% for the first, mid - and last portion of BWC, respectively. The sensitivity of VUC was 20-25% for grade I, 30-40% for grade II, and 50-75% for grade III tumors, respecti vely. The sensitivity of BWC was 25% for grade I, 35-45% for grade II, and 33-50% for grade III tumors, respectively. There was no statistical signifi cant difference for sensitivities between either grades (p = 0.06) or porti ons or streams (p = 0.3) of VUC and BWC. Conclusions: In this small group o f patients, we did not find any significant difference, but we found highes t sensitivity in grade III tumors with the terminal portion of the voided u rine when compared to other portions of VUC. Therefore, we believe that fur ther study in a large series is necessary to investigate this approach of d ifferentiated BWC and especially VUC. Copyright (C) 1999 S. Karger AG. Base l.