The pattern of urine cytology in a tertiary health care facility Northwest Nigeria

Abstract

Background: Urine cytology is an important investigation in the management of urothelial cancer. It is particularly an important test in the management of urinary tract cancers because of its non-invasive nature. Objective of study to review our practice of urine cytology as a diagnostic tool in the management of urinary tract pathology.Methods: A seventeen years retrospective study from 1st January, 2001 to 31st December, 2017 where records of patients who had urine cytology in Usmanu Danfodio University Teaching Hospital (UDUTH), Sokoto, Nigeria were reviewed and data was extracted and analyzed using the SPSS 20.Results: Of the 766 specimens, representing 10.1% of all cytology done in UDUTH (7,554) during the period under review, the highest number of urine cytology was done in 2013 (12%). The age range of the patients was between 2 to 90 years with modal age of 60 years. Majority of the patients were between the ages of 51 to 60 years (24.7%) and male to female ratio was 6.3:1. The commonest indication for urine cytology was bladder tumour (66.8%). However, the commonest cytological diagnosis was negative (44.6%) while 19.3% showed Non Specific Chronic Inflammation and only 77 specimens were malignant representing 10.1% of the specimen.Conclusions: Despite its variable sensitivity, urine cytology remains a useful tool in evaluating suspected bladder malignancies and can serve as an adjunct to cystoscopy in these cases.

Urine cytology as seen in Uyo, Nigeria: How relevant is it to medical practice?

“…and Manna et al . [ 1 9 10 ] The male preponderance in this study is also because a significant number of patients sent for UC by the surgeons were males suspected of having cancer of the prostate or lower urinary tract obstruction with hematuria due to benign prostatic enlargement.…”

“…The indications for UC in the index study are wide and nonspecific, similar to the study in Sokoto, Nigeria, and Bengal, India. [ 9 10 ] This is different from more specific bladder associated hematuria which was the main indication in Jeddah, Saudi Arabia, Midland, United Kingdom, and the Florida, United States of America. [ 1 6 11 ] The reason for the varied nonselective indications is due to the lack of other diagnostic aids.…”

“…Although previous studies have argued in favor of or against the usefulness of UC, especially in respect to its low sensitivity, nondefinitive nature of its diagnoses, high cost, and the need to always follow-up diagnosis with cystoscopy and biopsy, in our setting, it is still useful considering its affordability (less than 7 dollars), absence of general population health insurance coverage, and relative high cost of cystoscopy (100 dollars). [ 1 3 4 5 6 7 8 9 10 11 ]…”

“…This is less than observations in previous studies which reported a range 44.6%–72%. [ 3 9 10 11 ] Páez et al . in their study observed that negative for malignant cell smears does not exclude malignancy.…”

“…[ 3 4 5 6 7 8 ] Following a literature search, only one study on UC has been done in Nigeria, while numerous studies on UC has been done in various countries. [ 1 3 4 5 6 7 8 9 10 11 ]…”