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Does Urine From Bladder Contain Any Squamous Cells?

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Posted on Tue, 25 Mar 2014
Question: I went from Seattle to LA to receive a photo-dynamic diagnosis (not available in Seattle). My new highly-credentialed urologist told me that squamous cells in the urine do NOT come from the bladder, but as contaminants from the vaginal tract upon urine collection from a female. Sheer logic, used by a medically naïve layman, would indicate that this is not true. Think schistosomiasis. Or, squamous cell intra-epithelial lesions (which I have, low-grade and "possibly concerning high-grade", in my urine cytology results). I have had a total hysterectomy and had high-grade intra-ep. lesions on my cervix. I have HPV. I am really concerned that this doctor, whom I must rely on in a strange city and who is right now my only contact with this special cystoscopy, has been big-time illogical. Any ideas as to what would make a good doctor make such a statement? Please understand, this doctor seems a complete expert, works @ Keck Medical Center, but logic cuts through credentials in my opinion. I take it as a given that not all doctors are logical, any more than all rocket scientists are logical. Some people are educated and logical and some people are just educated. What do I think about a doctor that I need? And, if there are NOT squamous intra-ep. lesions in people's bladders, please let me know. Thanks! XXXXXXX
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Answered by Dr. Dr. Yogesh D (38 hours later)
Brief Answer: Your doctor is partially right, need better report Detailed Answer: Hello, Thanks for posting your query. I have gone through your question carefully and understand what you are saying. Normally urine should not contain squamous cells, that is when you don't have any issue in the bladder. Occasionally normal squamous cells from the outer urethra can be seen and in most cases, if you see squamous cells in the urine, that is because of the contamination from the vagina. That being said, presence of squamous cells becomes significant when there are any changes in the histological appearance of these cells, if they show any metalastic changes (CIN), then it needs to be evaluated further. So please get a good pathologist to do the cytology, if you the cytology report says that there are metaplastic changes, then it is prudent to go for a cystoscopy to see if there are indeed these metaplastic changes inside the bladder. What this means is, when you have abnormal squamous cells in urine, it could mean there is intra epethelial lesions/metaplasia, this needs close monitoring. It is not completely illogical of the doctor to say the squamous cells are because of contamination, that is because contamination is the most common cause for finding squamous cells in the urine. I hope this answers your query, however please feel free to ask me if you need any clarifications. Kind regards.
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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Dr. Dr. Yogesh D

General & Family Physician

Practicing since :2009

Answered : 1111 Questions

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Does Urine From Bladder Contain Any Squamous Cells?

Brief Answer: Your doctor is partially right, need better report Detailed Answer: Hello, Thanks for posting your query. I have gone through your question carefully and understand what you are saying. Normally urine should not contain squamous cells, that is when you don't have any issue in the bladder. Occasionally normal squamous cells from the outer urethra can be seen and in most cases, if you see squamous cells in the urine, that is because of the contamination from the vagina. That being said, presence of squamous cells becomes significant when there are any changes in the histological appearance of these cells, if they show any metalastic changes (CIN), then it needs to be evaluated further. So please get a good pathologist to do the cytology, if you the cytology report says that there are metaplastic changes, then it is prudent to go for a cystoscopy to see if there are indeed these metaplastic changes inside the bladder. What this means is, when you have abnormal squamous cells in urine, it could mean there is intra epethelial lesions/metaplasia, this needs close monitoring. It is not completely illogical of the doctor to say the squamous cells are because of contamination, that is because contamination is the most common cause for finding squamous cells in the urine. I hope this answers your query, however please feel free to ask me if you need any clarifications. Kind regards.