Pus Cells in Urine: Normal Range, Causes, Test & Treatment

Pus cells in urine, or Pyuria, is a common urinary problem worldwide. This condition is characterised by elevated levels of white blood cells (leukocytes) in urine.

Generally, pus in urine is a thick and colourless fluid. It comprises bacteria, white blood cells, dead cells, and tissues.

Scientific evidence has shown that women (13.9%) are more likely to get affected by pyuria than men (2.6%) as they are prone to urinary tract infections (UTIs)

Types of Pus Cells in Urine 

Based on the detection of bacteria during diagnosis, pus cells in urine have been broadly classified into two categories:

1. Sterile Pyuria is a class of pyuria in which the patient carries no detectable bacteria in the urine. It can occur due to a virus, undetected bacteria, or even due to a side-effect of medications. 

2. Non-Sterile Pyuria is a type of pyuria where bacteria are present in the urine. This can indicate an infection in the urinary tract or other underlying conditions such as kidney stones or bladder inflammation.

Several components contribute to pyuria. Nevertheless, the most common reason for the occurrence of pyuria is UTIs. Apart from UTIs, other major causes of pus cells in urine include.

1. Pneumonia (a respiratory infection that affects the lungs)

2. Sepsis (a potentially life-threatening condition that occurs when the body's response to infection causes damage to its own tissues and organs)

3. Interstitial cystitis (a chronic condition causing severe bladder pain)

4. Kidney stones

5. Rejection in organ transplant

6. STDs, such as Gonorrhea, HIV, Syphilis, HPV

7. Tuberculosis (TB)

8. Transvaginal surgical mesh

Certain medications can also surpass pus cells in urine normal range if used for a long time. A few such medications are as follows:

1. Diuretics (medications that help reduce fluid buildup in the body)

2. Proton pump inhibitors (medications that help reduce the production of stomach acid)

3. Antibiotics containing sulfa or penicillin

4. Nonsteroidal anti-inflammatory drugs (NSAIDs), including ibuprofen, aspirin, and naproxen sodium.

The most prevailing symptom of pyuria is the presence of pus, a thick, discoloured fluid. Moreover, urine can also appear cloudy when one has this condition. If there’s a UTI involved with urine pus cells, the patient can show several other symptoms, including: 

1. Frequent urges to urinate

2. A burning sensation when urinating

3. Blood in the urine

4. Foul-smelling urine

5. Pelvic pain

6. Fever

7. Pressure in the lower pelvis

8. Leakage (urinary incontinence)

9. Nausea and Vomit

To diagnose pyuria, a urine test (urine analysis or urinalysis) is recommended by the treating doctor. This test is a routine test that doctors often use to check for various conditions. The following are the steps involved in urinalysis:

1. Collection of Urine Sample: The first step is to collect a urine sample. A clean-catch midstream urine sample is usually collected, which involves collecting the middle portion of the pee after cleaning the genital area with an antiseptic solution.

2. Microscopic Examination: The sample is then examined under a microscope to check for the presence of pus cells. In a normal sample, there are usually no or very few pus cells present. However, in the case of an infection or inflammation, there would be high number of pus cells.

3. Quantification of Pus Cells: The number of pus cells in the urine sample is counted and reported as the number of cells per high-power field (HPF) of the microscope.

4. Culture and Sensitivity Testing: If the urinalysis shows a high number of cells, a culture and sensitivity test may be performed. This test helps to identify the specific bacteria causing the infection and to determine the most effective antibiotic to treat it.

Pus Cells in Urine Normal Range

The normal range for pus cells in urine varies depending on the laboratory and the method used for analysis. However, in general, urine pus cells normal range for adults is considered to be less than five pus cells per high-power field (HPF) of the microscope. However, some people may have more than ten pus cells without any trace of infection.

Pyuria often indicates an underlying medical condition, such as UTI. Here are some steps that can help an individual to prevent the occurrence of pyuria:

1. Maintain Good Hygiene: Practising good personal hygiene can help prevent the spread of bacteria that cause UTIs.

2. Stay Hydrated: Drinking plenty of water can help flush out bacteria from the urinary tract and prevent UTIs.

3. Urinate Regularly: Urinating regularly helps to flush out any bacteria that may have entered the urinary tract. Holding in urine for long periods of time can increase the risk of infection and the presence of pus cells in urine.

4. Practice Safe Intercourse: Using condoms during sexual intercourse can help prevent the transmission of bacteria that can cause UTIs. Additionally, urinating before and after sexual activity helps flush out any bacteria from the urinary tract.

5. Wipe from Front to Back: After using the bathroom, always wipe from front to back to prevent bacteria from the anus entering the urinary tract.

6. Wear Loose-fitting Clothes: Tight clothes, especially in the groin area, can trap moisture and increase the risk of bacterial growth.

7. Avoid Irritants: Certain personal care products such as douches, powders, and soaps can irritate the urinary tract and increase the risk of UTIs.

Pus cells in urine treatment depend on the underlying cause of the condition. If a bacterial infection is the cause, antibiotics are usually prescribed to eliminate the bacteria. The antibiotic prescribed will depend on the type of bacteria causing the infection.

In addition to antibiotics, drinking plenty of water and fluids (cranberry juice) can help flush out the bacteria from the urinary system. Pain relievers may also be prescribed to manage any discomfort or pain associated with the condition.

If there is an underlying medical condition causing pyuria, such as kidney stones or bladder inflammation, treating the underlying condition is necessary to resolve the issue. In some cases, surgery may be required to treat certain conditions.

In most cases, pyuria is not a matter of concern. However, it may prove to be fatal in certain cases. Below are a few serious complications of pyuria:

1. Kidney Damage: If left untreated, a UTI can spread to the kidneys, causing inflammation and potential damage. This can lead to chronic kidney disease, kidney failure, or other serious complications.

2. Sepsis: In some cases, a UTI can lead to sepsis, which is a life-threatening condition caused by the body's response to infection. Sepsis can cause organ failure, shock, and death.

3. Recurrent Infections: If a UTI is not treated properly, it can lead to recurrent infections, which can be difficult to treat and may require long-term antibiotic use.

4. Pregnancy Complications: Pregnant women with UTIs are at increased risk of premature delivery, low birth weight, and other complications.

5. Prostatitis: Men with UTIs may develop prostatitis, which is inflammation of the prostate gland. This can cause pain, discomfort, and potential complications such as infertility.

Pyuria during pregnancy can be a cause for concern. While it is normal to have some level of bacteria in the urinary tract during pregnancy, an increase in pus cells may indicate the presence of a UTI.

UTIs are more common in pregnant women due to hormonal changes (progesterone hormone) and pressure on the bladder. If left untreated, UTIs during pregnancy can lead to complications such as premature delivery, low birth weight, and even kidney infections.

Pregnant women need to seek medical attention if they notice any symptoms of a UTI, including frequent urination, pain or burning during urination, cloudy or foul-smelling urine, or lower abdominal pain.

A urinalysis will be conducted to check for pyuria if a urinary tract infection is suspected. If the test results show an elevated level of pus cells, further testing may be done to determine the specific bacteria causing the infection and its susceptibility to antibiotics.

It is recommended to consult a doctor for pus cells in urine if an individual has:

1. Persistent UTI symptoms, including painful urination, frequent urination, and foul-smelling urine.

2. Blood in the urine, or the urine appears cloudy or dark.

3. Fever, chills, or abdominal pain.

4. A history of kidney or urinary tract infections.

5. An underlying medical condition such as diabetes or a weakened immune system.

Pus cells in urine is a medical disorder which causes increased levels of white blood cells in the urine. This condition, also known as pyuria, is often a sign of an underlying urinary tract infection (UTI). While it is normal to have some bacteria in the urinary tract, increasing pus cells can indicate an infection that needs prompt attention.

Talk to your healthcare provider today if you or your loved ones have pus cells in urine or feel its symptoms. You can contact us at HexaHealth. We have a brilliant team of expert doctors who can help you treat pyuria effectively. If you’re new to HexaHealth, you’ll be happy to know that our first consultation call is FREE of cost. Wait no more. Register now.

Suggested Reads

To read more on changes in urine, visit the following links:

1. Bilirubin in Urine - Normal Range, Causes, Color, Symptoms

2. RBC in Urine Test - Meaning, Normal Range, Purpose, Results

3. Epithelial Cells in Urine: Normal Range, Causes, Test Results

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