Role of voided urine cytology in diagnosing primary urethral carcinoma

Objectives. To evaluate the role of voided urine cytology in diagnosing primary carcinoma of the urethra in male and female patients. Methods. We reviewed the medical records of all patients with urethral carcinoma seen at Memorial Sloan-Kettering Cancer Center between 1958 and 1996. The patients who had undergone voided urine cytology before any treatment were the subject of this report. Results. This report included 41 female and 29 male patients. In the cohort of female patients, the most common histologic type was adenocarcinoma (n = 16), followed by squamous cell carcinoma (SCC; n = 9) and transitional cell carcinoma (TCC; n = 6). Urine cytology was positive in 24 patients (59%). The sensitivity was greatest in patients with SCC (77%) and lowest in patients with TCC (50%). In the cohort of male patients, the most common histologic type was SCC (n = 14) followed by TCC (n = 10). Urine cytology was positive in 16 patients (55%). The sensitivity was greatest for patients with TCC (80%) and lowest for patients with SCC (50%). Conclusions. Voided urine cytology is not a very reliable method of diagnosing primary carcinoma of the urethra in either male or female patients. A cystoscopic evaluation with possible biopsy is warranted if suspicion of carcinoma of the urethra is high. (C) 2004 Elsevier Inc.