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.