Pus Cells in Urine: Understanding Pyuria, Treatment, and Tests

What are Pus cells?

Pus cells are the dead white blood cells that can accumulate in your blood when your immune system gets activated during an infection. These cells create a yellowish or whitish-yellow coloured fluid at the site of the disease, known as the liquor puris, rich in proteins. In some cases, you can find these pus cells in urine.

Pyuria is a condition where there is the presence of white blood cells and pus cells in urine. There are two distinct types of pyuria:

• Sterile: In this case, pus cells in urine are present but without the presence of any bacteria detected.
• Non-sterile: Here, tests can show the presence of both bacteria and pus cells in urine

Is the presence of pus cells in urine normal?

While a certain amount of pus cells in urine is considered normal, if there is a sudden increase in the number of pus cells in urine, it can be a cause of concern. The presence of pus in urine may indicate the possibility of:

• Urinary tract infection
• Problems with kidney function
• Other underlying conditions

Regular urine tests can help you identify these conditions early and get the required medical attention needed to find the solution.

Who Does Pyuria Affect?

Pyuria, or presence of pus cells in urine, can affect individuals of all ages and genders. However, it is more commonly observed in women due to their shorter urethra, which facilitates bacterial entry into the bladder. Individuals with certain risk factors are also more prone to developing pyuria:

• Those with underlying health conditions like diabetes, kidney disease or autoimmune disorders
• People using indwelling urinary catheters
• Individuals with sexually transmitted infections (STIs) or viral infections affecting the urinary tract
• Those on long-term medications that impact the urinary system

How Common Is Pyuria?

Pyuria is a relatively frequent finding, especially in people with urinary tract infections (UTIs), which are among the most prevalent bacterial infections worldwide. Women, particularly those who are sexually active or of reproductive age, have higher rates of pyuria due to increased susceptibility to UTIs.

What is the normal range of pus cells in urine?

A small amount of pus cells in urine is normal; however, when this number goes higher than the normal range of pus cells in urine, it could indicate some underlying problems. When observed under a high-powered microscope, the pus cells' normal range can differ for men and women.

The normal range of pus cells in urine for a male urine sample is less than four cells/HPF. On the other hand, the normal range of pus cells in urine for a female urine sample is 5 to 7 cells/HPF. Any changes in the number of pus cells in urine are also physically visible in your urine. The urine may appear thicker and cloudy, just like pus. This is why it is essential to contact your doctor if you observe any changes in your urine.

Why are Pus cells present in urine?

There can be several reasons why you may find pus cells in a urine test. Most of the time, it could be due to a viral or bacterial infection. Some of the other reasons you may find pus cells in urine are:

• Urinary tract infection can include an infection in any part of your urinary system like the bladder, ureter, urethra, or kidneys.
• Sexually transmitted infections (STIs) e.g., gonorrhoea
• Tuberculosis
• Interstitial cystitis
• Kidney diseases
• Bacteremia with sepsis
• Pneumonia
• Prostatitis
• Parasites
• Polycystic kidney disease
• Autoimmune disease
• Tumour in the urinary tract
• Urinary tract stones
• Consumption of nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or aspirin
• Diuretics
• Proton pump inhibitors like omeprazole
• Penicillin antibiotics

Are Pus Cells in urine a warning sign of an Infection?

The presence of pus cells in urine may not be alarming. However, if the number of pus cells is higher than the accepted normal range of pus cells in urine, it could indicate that you are suffering from an infection. You may need to undergo further testing to understand the underlying cause of this condition before starting the pus cells in urine treatment.

While the main component of pus is dead white blood cells, it can also contain the debris of other cells, such as dead neutrophils, that can indicate a bacterial infection.

Your body's immune system attacks these bacteria and the dead bacterial cells are cleared away by the macrophages, a type of immune cell dedicated for eating bacteria. Pus cells in urine can be an indicator and warning sign for such infections especially those in the urinary tract.

While the condition may not be serious it can still cause a lot of discomfort like pain and fever. Your urine sample will be scrutinised under a microscope to count the number of pus cells in urine and figure out if you need treatment. In most cases anything higher than four pus cells in urine are considered high chances of an active infection.

When should you get a pus cells in urine test done?

The presence of pus cells in urine usually indicates urinary tract infection or in some severe cases, can be the symptom of sepsis or other health conditions. It is essential to get pus cells in urine test done as soon as you observe one or more of the following symptoms.

Pus Cells in Urine Symptoms

Here are the symptoms indicating the pus cells in urine:

• Excretion of cloudy urine
• Changes in the colour or texture of your urine
• The presence of blood in your urine
• Increased frequency of urination
• Presence of blood in urine
• A burning sensation when you pee
• Passing urine that has a very foul smell
• Shortness of breath
• Pain in your abdomen and surrounding region
• Pain in your pelvis and the surrounding region
• Fever
• Nausea or vomiting
• Abnormal discharge from the vagina

How Do You Check for Pus Cells in Urine?

Pyuria diagnosis involves a urine test called urinalysis. The urine sample is examined under a microscope, and pyuria is confirmed if there are 10 or more white blood cells (WBCs) per cubic millimetre of centrifuged urine. The sample may also appear cloudy due to the pus cells in urine.

How Can I Reduce Pus Cells Naturally?

To naturally reduce pus cells in urine, focus on supporting your urinary tract health and boosting immunity. Here are some tips:

1. Drink plenty of water to flush out bacteria and toxins.
2. Consider cranberry juice or supplements, which may help prevent bacterial adhesion to the urinary tract lining.
3. Practice good personal hygiene, especially in the genital area.
4. Avoid irritants like harsh soaps or bubble baths.
5. Eat a balanced diet rich in antioxidants to support immune function.
6. Limit caffeine and alcohol intake, as they can irritate the bladder.

Who is affected by Pyuria?

Though anyone can get pyuria, but it is more likely to affect the people from following groups:

• Individuals born as women
• People who are over the age of 45
• Women with the symptoms of menopause

Treatment of Pus Cells in Urine

Your pus cells in urine treatment depends on the cause. For pus cells in urine 25-30 hpf treatment your healthcare provider will often prescribe a round of antibiotics as in this case pyuria can be caused by UITs, bacteria STIs, or tuberculosis.

How to Diagnose Pyuria?

You may often find pus cells in urinalysis. In this case, you need to contact your healthcare provider and conduct further tests to find out the underlying cause of pus cells in urine.

Finding pus cells in urine samples may need the following tests:

• Pus cells in urine test/urine analysis: This is the first step in finding pus cells in urine. A urine sample is observed under a microscope to quantify the amount of pus cells present.
• Urine culture: This test helps understand if a bacterial infection causes the presence of pus cells in urine. A sample of the bacteria in the urine sample is cultivated to help identify the specific type of bacteria causing pyuria.
• Additional tests: When the presence of pus cells in urine is because of an underlying condition other than a urinary tract infection, you may need to undergo additional tests to find the disease. These could include ultrasounds, kidney function, and complete blood count tests.

How Can We Prevent Pyuria?

Pyuria prevention largely revolves around reducing your risk of UTIs and managing any predisposing health issues:

• Maintain good personal and genital hygiene
• Stay well-hydrated and urinate regularly to flush out the urinary tract
• Always urinate after sexual activity
• Avoid using irritating feminine hygiene products
• If prone to recurrent infections, follow your doctor's advice on preventive strategies
• Keep chronic conditions like diabetes well-controlled
• Minimise prolonged use of urinary catheters and ensure proper catheter hygiene
• Promptly seek medical care if you have symptoms of a UTI or STI

Conclusion

Pyuria or pus cells in urine is a condition where you will find white blood cells or pus in your pee. If you notice a sudden change in the colour or smell of your urine it may be time to contact your healthcare provider and find out if there is a cause for concern. Usually, up to four pus cells in urine is considered normal however any more than that and you may have to undergo further tests. Metropolis Labs provides world class testing facilities from the comfort of your home. Contact our experts today to book your appointment.

FAQs

What are pus cells in urine?

Pus cells in urine, medically known as pyuria, refer to the presence of white blood cells in the urine. This indicates inflammation or infection somewhere in the urinary tract.

How do you reduce pus cells in urine?

Along with pus cells in urine treatment, there are a few simple and natural ways in which you can reduce pus cells in the urine, such as:

• Keeping yourself well hydrated
• Drink cranberry juice or green tea extract as it can help reduce the number of pus cells in urine
• Painkillers like aspirin help reduce the symptoms of pyuria
• Applying a warm, wet compress to the infected area

Follow these suggestions only after consulting your doctor.

What do pus cells in urine indicate?

The presence of pus cells in a urine test can be a general indicator of a urinary tract infection, or something like sepsis.

How to test for Pyuria?

The most accurate and best pus cells in urine test is counting the number of leukocytes in a fresh urine sample.

How serious are pus cells in urine?

While pyuria itself is a sign of the immune system fighting an infection, its presence can point to various issues ranging from simple UTIs to more serious infections or underlying diseases.

What if pus cells are high in urine?

Elevated pus cells in urine usually signify an active infection like a UTI or an inflammatory process within the urinary tract. Your doctor will likely recommend additional tests and start you on appropriate treatment.

What if pus cells are 15-20?

A pus cell count of 15-20 per cubic millimetre is higher than normal and generally indicates an ongoing infection or inflammation.

How to cure pus cells in urine naturally?

Some natural approaches to support urinary health include staying hydrated, drinking cranberry juice, practising good hygiene, and avoiding irritants.

Why do pus cells increase?

Pus cells increase in the urine as a result of your immune system responding to an infection, irritation or inflammation in the urinary tract.

Are 10-12 pus cells in urine normal?

A pus cell count of 10-12 per cubic millimetre in a urine sample is borderline and may or may not indicate an infection, depending on the clinical scenario. Your doctor will interpret this result in the context of your symptoms and decide if further testing or treatment is necessary.

Does cranberry juice help treat pyuria?

Some studies suggest that compounds in cranberries may help prevent bacteria from adhering to the lining of the urinary tract, potentially lowering the risk of infection. However, cranberry juice does not treat an active case of pyuria.

What happens if I don't treat pyuria?

Untreated pyuria can lead to serious complications like kidney infection (pyelonephritis), sepsis, or permanent kidney damage. Promptly addressing the underlying cause is crucial to prevent the infection from spreading.

What is the difference between pyuria and UTI?

Pyuria refers to the presence of elevated WBCs in urine, which is a sign of inflammation. A UTI specifically indicates a bacterial infection in the urinary tract. While most UTIs cause pyuria, not all cases of pyuria are due to UTIs.

Does pyuria indicate that I have a UTI?

Pyuria is a common finding in people with UTIs since the infection triggers an immune response, sending WBCs into the urine. However, pyuria alone does not definitively diagnose a UTI, as it can also occur with other conditions.