Evaluation and comparison of voided urine and bladder washing cytologies according to the Paris system

Cystoscopy, biopsy, and urine cytology are gold standards for the diagnosis and surveillance of bladder carcinoma. Bladder washings, obtained via cystoscopy or by catheterization, are common in routine cytology practice, whereas voided urine is evaluated less frequently. The aim of this study was to perform a comparative cytologic assessment of voided urine and bladder washing specimens in patients with bladder carcinoma.

In this prospective study, second-morning voided urine and bladder washing samples were obtained from 75 patients with histologically confirmed bladder carcinoma over a 3-year period. Samples were re-evaluated cytologically according to the Paris system.

Bladder washing cytology showed higher sensitivity (81 vs. 62%) and the correlation coefficient (0.617 vs. 0.487), compared to voided urine cytology.

While bladder washing cytology showed superior diagnostic performance with a higher area under the curve and sensitivity in this cohort, voided urine cytology remains a valuable non-invasive alternative despite its lower sensitivity.