Urologic Pathology
Urologic Pathology Overview
We Are Committed to Being Accessible.
The Sagis urologic pathology service is led by Dr. Thomas Wheeler, a nationally and internationally recognized expert in genitourinary (GU) and prostate pathology. Under his leadership, our team delivers expert interpretations with subspecialty precision—offering what we often call: “The second opinion, first.”
Our pathologists bring decades of combined experience across academic medicine, reference laboratories, and private urology practices. We understand the clinical nuances of prostate biopsies, bladder tumors, and renal neoplasms, and work closely with urologists and surgical centers to provide clarity and confidence in every diagnosis.
Meet the Experts
Pathology Specialists
Our pathologists are readily available for direct phone consultations, providing timely, accessible answers to your clinical questions.
Urologic Pathology
Collections Guide
Microscopic examination for cytologic abnormalities, and aid in diagnosis of certain conditions, infections. The urinary specimens include: urine, bladder washings/lavage, urethral washings, ureter washings, and renal washings.
UrinesightTM PLUS
Comprehensive Moelcular Insight into Urinary Tract Infrections and Antibiotic Resistance
Sagis Diagnostics provides accurate and comprehensive insights for personalized and evidence-based treatment of urinary tract infections. As a high-complexity CLIA and CAP accredited laboratory, Sagis Diagnostics assists clinicians and health care providers quickly identify urinary tract pathogens and the underlying causes of disease.
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Delivers results in under 24 hours from receipt, significantly faster than urine culture.
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Provide accurate and comprehensive results from PCR assay to detect 29 UTI pathogens.
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Identities 20 antibiotic resistance markers for more precise treatment recommendations.
Why UTI PCR Test?
PCR (polymerase chain reaction) exhibits greater accuracy and speed than traditional bacterial culture for the detection and identification of bacteria. Our UTI PCR test also exceeds traditional bacterial culture in complex situations such as polymicrobial infections, fastidious bacteria, and yeast infections, which helps to provide physicians with timely and accurate results to treat their patients.
Why Sagis UrinsightTM Plus
Our innovative assay empowers health care systems to overcome the burden associated with conventional standards of care to rapidly detect and treat UTIs.
Diagnosis based on specific DNA strands
Applies nanoscale molecular technology to identify numerous pathogens more accurately
Improves antibiotic stewardship
Molecular Testing Services
Urinary Tract Pathogen Panel UrinsightTM
Our commitment to patient-centric diagnostics is powered by our dedication to excellence. Sagis incorporates the latest medical advancements including immunohistochemistry, fluorescent in-situ hybridization (FISH), and comprehensive molecular testing to provide the definitive diagnostic clarity required for optimal clinical decisions.
Meet Our Pathology Specialists
On the Cutting Edge of Patient-Focused Lab Services
Accurate Results. Reliable Partnership.
Sagis is a full-service pathology and laboratory testing provider, partnering with physicians, clinics, and health systems to deliver accurate, timelyresults. Our board-certified pathologists, laboratory experts, and responsive client services team work together to support better clinical decision-making and patient care.
Whether you need pathology interpretations, toxicology testing, or specialized lab services, Sagis offers the expertise, technology, and personalized service that help elevate your standard of care.
We are here to help
Frequently
asked questions
If your question isn’t addressed below, please contact us
About Urologic Pathology
What is urologic pathology?
Urologic pathology is a subspecialty of anatomic pathology focused on diagnosing diseases of the genitourinary system, including the prostate, bladder, kidneys, testes, and urinary tract. Urologic pathologists examine biopsies and surgical specimens at a microscopic level to render accurate diagnoses that guide clinical decision-making and treatment planning.
What types of conditions does Sagis diagnose through urologic pathology?
Our urologic pathologists evaluate the full spectrum of genitourinary disease. This includes prostate cancer and prostate biopsies, bladder tumors and urothelial carcinoma, renal neoplasms, testicular tumors, and urinary cytopathology findings. We also assess benign conditions such as prostatitis, interstitial cystitis, and other inflammatory or structural abnormalities.
What is a Gleason score, and how does it affect my patient's prostate cancer diagnosis?
The Gleason score is a grading system used to assess the aggressiveness of prostate cancer based on the microscopic appearance of tumor cells. It is expressed as a sum of the two most predominant patterns (e.g., 3+4=7). Higher scores indicate more aggressive disease. Our pathologists apply the current ISUP/WHO grading guidelines to ensure every Gleason score reflects the most accurate and clinically actionable interpretation.
What is urinary cytopathology, and when is it used?
Urinary cytopathology involves microscopic examination of cells shed into the urine to detect abnormalities including urothelial carcinoma and other conditions. It is commonly used to monitor patients with a history of bladder cancer, evaluate hematuria, or screen for malignancy. Sagis uses the Paris System for Reporting Urinary Cytology, the current international standard.
Working With Sagis
What makes Sagis different from other urologic pathology laboratories?
Sagis is 100% pathologist-owned. Unlike high-volume reference labs, we offer direct pathologist access, subspecialty precision on every case, and a level of personalized service that larger laboratories cannot match. Our urologic patholoty team is led by Thomas M. Wheeler, MD, a nationally and internationally recognized expert in genitourinary and prostate pathology with more than 40 years of experience.
How does a physician or urology practice set up service with Sagis?
Setting up service is straightforward. Contact your local Sagis sales representative to establish your account by using our Find My Sales Rep map or submitting our Become a New Client form. Once your account is active, you can order specimen supplies, requisition forms, and courier services through your rep or via our Supplies & Requests portal.
What types of specimens does Sagis accept for urologic pathology?
We accept a broad range of genitourinary specimens, including prostate needle biopsies, transurethral resections of the prostate (TURP), bladder biopsies and resections, radical prostatectomy specimens, nephrectomy specimens, orchiectomy specimens, and urine specimens for cytology. If you have a question about a specific specimen type, reach out to your local sales rep.
Does Sagis perform immunohistochemistry and molecular testing on urologic specimens?
Yes. When a case requires additional workup, we perform immunohistochemistry (IHC) and special stains in-house to support the most accurate diagnosis possible. We also offer molecular testing services, including our Urinsight Plus panel for urinary tract infections, which detects 29 pathogens and 20 antibiotic resistance markers using PCR technology.
Is Sagis accredited?
Yes. Sagis is a CAP- and CLIA-accredited medical diagnostic laboratory based in Houston, Texas. We also hold a Clinical Laboratory Permit from the New York State Department of Health. These accreditations reflect a rigorous commitment to quality, accuracy, and consistency in laboratory testing and reporting.
Turnaround Time & Reporting
How quickly will I receive urologic pathology results?
Most routine urologic pathology results are available within 24 to 72 hours of specimen receipt. Prostate biopsies and standard cases are typically reported within 24 to 48 hours. Cases requiring immunohistochemistry, additional levels, or more complex interpretation may require additional time. We are committed to timely reporting without compromising accuracy.
How will I receive pathology results?
Sagis integrates with all major EMR systems for electronic reporting. Results are also accessible through our secure online portal, providing immediate access to finalized reports. Critical or unexpected findings are communicated directly and promptly.
Can I consult directly with a urologic pathologist about a case?
Absolutely. Direct pathologist access is one of the defining features of our service. Our pathology team is readily available for phone consultations, whether you have a question before submitting a specimen or need to discuss a finalized report. We believe answers should be both accurate and easy to reach.
Prostate Pathology
Who leads Sagis's urologic pathology program?
Our urologic pathology service is led by Thomas M. Wheeler, MD, Director of Surgical Pathology and Cytopathology. Thomas M. Wheeler, MD is a top national and international expert in genitourinary and prostate pathology with more than 40 years of experience. He led the National Certificate Program on Prostate Pathology (AP3) for the College of American Pathologists and holds subspecialty board certification in urinary cytopathology.
How does Sagis handle complex or diagnostically challenging prostate cases?
Complex cases are reviewed collaboratively by our pathology team before a final report is issued. Thomas M. Wheeler, MD brings decades of expertise specifically in difficult prostate pathology scenarios, including small foci of adenocarcinoma, high-grade PIN, atypical small acinar proliferation (ASAP), and treatment effect evaluation. We also welcome outside cases for second-opinion review.
Does Sagis offer second opinions on urologic pathology cases?
Yes. We provide second-opinion consultations on outside cases, including complex prostate biopsies, ambiguous bladder lesions, and challenging renal neoplasms. If a case warrants another look, our team is available and welcomes the opportunity to review it. This is part of what we mean when we say: the second opinion, first.
Does Sagis evaluate radical prostatectomy specimens?
Yes. We evaluate radical prostatectomy specimens with detailed reporting that includes tumor grade (Gleason/ISUP), extent, surgical margin status, extraprostatic extension, seminal vesicle involvement, and lymph node status when applicable. Our reports are designed to give urologists and oncologists the complete picture they need for staging and treatment planning.
Bladder & Renal Pathology
What bladder specimens does Sagis evaluate?
We evaluate the full range of bladder specimens, including cystoscopic biopsies, transurethral resection of bladder tumor (TURBT), and cystectomy specimens. Our pathologists apply the most current WHO classification for urothelial tumors and report using standardized protocols to ensure clinically meaningful results.
How does Sagis handle renal mass biopsies and nephrectomy specimens?
Our pathologists evaluate renal core biopsies and nephrectomy specimens with subspecialty precision, classifying renal tumors according to the current WHO classification. We perform ancillary studies, including IHC, when needed to distinguish between tumor subtypes and render an accurate diagnosis.
UTI Molecular Testing (Urinsight Plus)
What is the Urinsight Plus panel?
Urinsight Plus is Sagis’s comprehensive UTI molecular testing panel that uses PCR technology to detect 29 urinary tract pathogens and identify 20 antibiotic resistance markers. It delivers results in under 24 hours from specimen receipt, significantly faster than traditional urine culture, and provides actionable data to guide targeted treatment.
Why should I consider molecular UTI testing over traditional urine culture?
Traditional urine culture can miss up to two-thirds of positive UTIs and is slower to return results. PCR-based testing like Urinsight Plus offers greater sensitivity and speed, and performs better in complex clinical scenarios such as polymicrobial infections, fastidious bacteria, and yeast infections. It also identifies antibiotic resistance markers, supporting better antibiotic stewardship.
What is the turnaround time for Urinsight Plus?
Results are available in under 24 hours from the time the specimen is received in the lab. While we strive to accommodate urgent clinical needs, the thoroughness of our molecular testing process does not allow for expedited processing beyond our standard turnaround.