88120 Cytopathology, in situ hybridization (eg, FISH), urinary tract specimen with morphometric analysis, 3-5 molecular probes, each specimen; manual

Name of the Procedure:

Cytopathology, In Situ Hybridization (e.g., FISH), Urinary Tract Specimen with Morphometric Analysis, 3-5 Molecular Probes, Manual

Summary

This procedure involves analyzing cells from the urinary tract using in situ hybridization, which employs fluorescent dyes to detect specific DNA or RNA sequences within the cells. It uses 3-5 molecular probes to target multiple genetic markers. The analysis is performed manually by a trained cytopathologist.

Purpose

The primary purpose of this procedure is to diagnose and monitor diseases of the urinary tract, especially cancers. It helps detect genetic abnormalities, infections, and other pathological changes in the cells. The goal is to identify and understand the nature of urinary tract conditions, enabling targeted treatment.

Indications

• Hematuria (presence of blood in urine)
• Frequent or painful urination
• Unexplained urinary infections
• Follow-up of previously diagnosed bladder cancer
• Detection of early or recurrent urinary tract cancers in high-risk patients

Preparation

• No specific preparation is usually required.
• Patients may need to provide a fresh urine sample.
• They should inform their doctor about any medications or existing health conditions.

Procedure Description

1. A fresh urine sample is collected from the patient.
2. The sample is sent to a cytopathology lab.
3. Cells from the urine are prepared and fixed on a slide.
4. Fluorescence in situ hybridization (FISH) with 3-5 molecular probes is conducted to identify specific genetic sequences.
5. A cytopathologist manually examines the slide under a fluorescence microscope, assessing the morphology and genetic abnormalities of the cells.

Tools and Equipment:

• Fluorescent dyes/molecular probes
• Fluorescence microscope
• Urine sample collection containers

No anesthesia or sedation is required, as it is a non-invasive procedure.

Duration

The procedure itself takes a few minutes for sample collection. Analysis and interpretation may take a few days in the laboratory.

Setting

The urine sample collection is typically performed in a clinic or doctor's office. The analysis is done in a specialized cytopathology laboratory.

Personnel

• Primary care physician or urologist for sample collection
• Cytopathologist for manual microscopic examination
• Laboratory technicians

Risks and Complications

• Minimal risk associated with sample collection
• Potential but rare error in sample labeling or handling
• False-positive or false-negative results, though generally uncommon with proper technique

Benefits

• Early and accurate detection of urinary tract cancers and other diseases
• Helps guide treatment decisions and monitoring of disease progression or recurrence

Recovery

• No recovery time is necessary as the procedure is non-invasive.
• Normal activities can be resumed immediately after sample collection.

Alternatives

• Routine cytology (less sensitive in some cases)
• Urine culture for infections
• Imaging studies like ultrasound or CT scans
• Cystoscopy for direct visualization of the urinary tract

While these alternatives may also provide valuable information, FISH offers enhanced sensitivity and specificity for certain conditions, particularly genetic abnormalities.

Patient Experience

• Sample collection is straightforward and causes no discomfort.
• Patients will not feel anything during the analysis as it is conducted in the lab.
• Emotional reassurance may be needed while awaiting results, as diagnostic outcomes may carry significant implications.
• Communication with healthcare providers for results and further steps in management is essential.