title: Can sensitivity of voided urinary cytology or bladder wash cytology be improved by the use of different urinary portions?
abstract: OBJECTIVE
  To improve sensitivity by using different portions of voided urine cytology (VUC) and bladder wash material cytology (BWC).
  
  
  METHODS
  52 patients with biopsy-proven superficial transitional cell carcinoma (TCC) of the bladder were studied. Voided urine specimens were divided into a first stream, mid-stream and terminal stream. Bladder wash material was also divided into a first portion, mid-portion and last portion. All portions were investigated for cytology abnormalities.
  
  
  RESULTS
  Sensitivity for 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, respectively. 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 significant difference for sensitivities between either grades (p = 0.06) or portions or streams (p = 0.3) of VUC and BWC.
  
  
  CONCLUSIONS
  In this small group of patients, we did not find any significant difference, but we found highest sensitivity in grade III tumors with the terminal portion of the voided urine when compared to other portions of VUC. Therefore, we believe that further study in a large series is necessary to investigate this approach of differentiated BWC and especially VUC.
authors.affiliation: Department of Urology, Numune Hospital, Ankara, Turkey.
authors.forename: N A
authors.initials: NA
authors.lastname: Mungan
authors.forename: S
authors.initials: S
authors.lastname: Kulacoglu
authors.forename: M
authors.initials: M
authors.lastname: Basar
authors.forename: M
authors.initials: M
authors.lastname: Sahin
authors.forename: J A
authors.initials: JA
authors.lastname: Witjes
mesh_terms: D002295:Carcinoma, Transitional Cell / Q000473:pathology* / Q000652:urine; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D001749:Urinary Bladder Neoplasms / Q000473:pathology* / Q000652:urine; D014556:Urine / Q000166:cytology