Urine cytology evaluation in cases of uretero‐ileal cutaneous diversion

Abstract

Cytological examination of urine from the ileal conduit in cases of bladder cancer treated by radical surgery can be an important and effective follow-up procedure. A total of 19 patients (18 males and one female) on whom radical cystectomy for cancer was performed were studied. Three urine specimens were examined in each case using routine cytological methods. Three cases of recurrent carcinoma (mainly of papillary type) were diagnosed cytologically before any clinical evidence of disease. The cytological examination of urine at 3-6 month intervals after cystectomy for bladder carcinoma is considered advisable in all cases, since the recurrence rate of transitional cell neoplasms in the upper urinary tract after cystectomy for transitional carcinoma is quite high.

Diagnostic value of positive urinary cytology in the detection of recurrent urothelial carcinoma

“…We observed all the previously described 14 cytomorphological features of UCC in diverted urine specimens. We would like to underscore that although tumor cells were sometimes closely associated with bowel-derived cells or were embedded in bowel-derived mucin/debris, the cytomorphology of malignant cells was not obscured (Fig.…”

Comparison of Urine Cytology Between the Ileal Conduit and Indiana Pouch

“…[3][4][5] Shokeir et al analyzed follow-up data on 186 patients with various uroenteric reconstruction using bowel segments, including the ileum and large intestine, 6 but their paper did not provide a detailed description of cytologic features.…”

“…Since the tumors are usually in an invasive stage at cystectomy, urine cytology is important for follow-up to detect recurrence. 3 Cytology of the urinary diversions has rarely been reported. [3][4][5] We evaluated and compared the cytomorphologic features of urine from an ileal conduit and an Indiana pouch to reveal the characteristic features of urine cytology in these two different methods of urinary diversions.…”

Viral cytopathic changes in urine cytology of ileal conduit attributed to adenovirus: Report of a case

“…Diagnostic Cytopathology, Vol 30, No 4 duit providing continuous drainage through a cutaneous stoma, the Indiana pouch in which cecum is used as reservoir with the adjacent terminal ileal segment furnishing a cutaneous stoma for periodic catheterization, and the infrequently used ileocystoplasty, in which an ileal segment is connected to the posterior urethra, functioning as bladder substitute. [1][2][3][4] Urine cytology from the above collecting devices contains primarily intestinal mucosal cells, but varies somehow with the type as the different types of intestinal enclosure affect differently the viability, mucinous changes, etc., of the exfoliated cells. Thus, in the Indiana pouch there is more degeneration and rounding of the mucosal cells due to lack of continuous drainage, while in the ileal conduit the cells are more viable, with many retaining their columnar configuration with less pronounced mucinous changes.…”

“…So far the cytologic changes from such intestinal reservoirs or conduits have been described, as well as those of recurrent in the upper UT urothelial carcinoma for identifi-cation of which the cytologic studies are usually performed. [1][2][3][4] Specific inflammatory changes, such as viral, have not been described in such specimens, although there is an abundance of reports describing such changes, particularly indigenous to the UT in bladder urine cytology. The present report describes viral changes occurring in the ileal segment attributed to a virus usually affecting secretory epithelia, including that of the intestine, which enlarges the spectrum of pathologic changes peculiar to the cytology of such intestinal reservoirs and conduits.…”