Urine Cytology

Abstract

In this chapter we summarize the practice of urine cytology testing to diagnose neoplasia and its mimics in the urinary tract. We frame this chapter in terms of the total testing process (TTP), which is briefly outlined in the introduction. Like much of medicine, most of the decisions made regarding urine cytology testing steps are based on expert opinion, although we present published data that have helped to guide this field. Randomized control trials of urine cytology practice are few. As a consequence, specific aspects of the field of urine cytology testing are controversial, and have yet to be settled with definitive evidence. Throughout this chapter, we point out areas where further study is critical to fill information gaps with an emphasis on clinician–pathologist interactions that may improve practice. We primarily focus on the quality metric of safety, manifested as accuracy in diagnosis, although we will discuss the other Institute of Medicine quality metrics of efficiency, effectiveness, timeliness, patient centeredness, and equity as they arise.