Pus Cells in Urine (Pyuria): Causes, Symptoms, Tests, and Treatment

You’re peeing more often than usual and it burns. That’s probably a UTI, right? Well, not necessarily. Cloudy or foul-smelling urine could mean there’s pus in your pee, known as pyuria. Seeing pus cells in your urine test is a red flag. What does it mean and what should you do about it? Let’s dive into the causes of pus cells in urine, what it could signal, how it’s detected, and what treatments may help if you have this condition. We’ll cover the basics so you understand what pyuria is all about if your doc says your urine test found too many white blood cells.

What Are Pus Cells?

Pus is a thick fluid that contains white blood cells, dead tissue, and bacteria, and is produced by the body to fight off infections. Pus cells are dead white blood cells that can build in your blood after your immune system is stimulated during an infection. These cells produce a yellowish or whitish-yellow fluid at the disease site called the liquor puris, which is high in protein.

When bacteria enter your urinary tract, your body sends white blood cells to fight the infection. These cells can leak into your urine, which is how they end up being detected. The more cells present, the more severe your infection may be. Under a microscope, pus cells look like round cells with irregular borders. They may appear swollen or granular. As the infection worsens, the number of these cells in your urine increases.

Pus cells in urine can sometimes be a false positive and not indicate an infection. Other possible causes include kidney inflammation, kidney stones, or a sexually transmitted infection. To confirm an infection, your doctor will analyze your urine sample and may order a urine culture to check for bacteria.

What Are Pus Cells in Urine (Pyuria)?

Pus cells, known medically as pyuria, refer to white blood cells found in the urine. Pyuria is a disorder in which your urine contains a high concentration of white blood cells (leukocytes) or pus. Normally, urine does not contain any white blood cells. When they are present, it usually indicates inflammation or infection somewhere in the urinary tract.

What are the Causes of Pus Cells in Urine?

Urinary tract infections (UTIs) are one of the most common causes of pus cells in urine. Bacteria enter the urinary tract and urethra, infecting the bladder and kidneys. Kidney stones or bladder stones can also lead to pus cell formation. These hard masses irritate the urinary tract lining, causing inflammation and pus.

Sexually transmitted infections (STIs) like chlamydia and gonorrhea infect the urinary tract, leading to pus cell production. Cancer of the urinary tract or reproductive organs is another possible cause of pyuria. Tumors or abnormal cell growth in the kidneys, ureters or urethra can become infected or block urine flow.

An enlarged prostate, known as benign prostatic hyperplasia (BPH), can also trigger pus cell formation by blocking urine flow from the bladder. Interstitial cystitis, an inflammation of the bladder wall, produces pus cells in urine. Autoimmune disorders like lupus involve inflammation and pus formation in the kidneys.

Kidney inflammation (nephritis) from an autoimmune reaction or infection leads to pus in urine. Use of a urinary catheter for an extended time often introduces bacteria into the urinary tract, causing infection and pyuria. Certain medications like cyclophosphamide can irritate the urinary tract and increase susceptibility to infection.

Is the Presence of Pus Cells in Urine Normal?

Having some pus cells in your urine is typically nothing to worry about and can be considered normal. Small amounts of pus, usually less than 5 cells per high-power field, are commonly seen on urinalysis and are not a cause for concern. However, larger amounts of pus cells, especially when accompanied by symptoms like pain or burning during urination, fever or chills, or cloudy or foul-smelling urine, can indicate an infection in the urinary tract.

What is the Normal Range of Pus Cells in Urine?

For a healthy individual, the normal range of pus cells in urine is 0 to 5 cells per high power field. If the pus cell count in your urine sample is higher than this normal range, it indicates you may have an infection in the urinary tract like bladder infection or kidney infection.

The number of pus cells can increase up to 15-20 or even more per high power field depending on the severity of the infection. The higher the pus cell count, the more severe the infection is. Pus cells are nothing but white blood cells, especially neutrophils, that have moved into the urinary tract in response to an infection. They help fight the infection by engulfing the disease-causing microbes.

Symptoms Associated With Pus Cells in Urine

The most common symptoms associated with pus cells in urine are:

1. Cloudy or murky urine: The presence of pus cells can make the urine appear cloudy or murky. Normally, urine is clear and light yellow in color.
2. Strong-smelling urine: Urine containing pus cells may have a foul, strong smell due to the presence of bacteria.
3. Burning sensation: You may experience a burning sensation while urinating due to inflammation of the urinary tract.
4. Increased urge to urinate: The inflammation caused by the infection can irritate the bladder and increase the frequency and urge to urinate.
5. Pelvic pain: You may experience pain in the lower abdomen or pelvic area, especially in women. The pain may be dull or intense.
6. Blood in urine: In some cases, blood may be present in the urine, causing it to appear pink or red. This indicates inflammation or damage to the urinary tract.
7. Fever or chills: If the infection spreads to the kidneys, it can cause a fever, often accompanied by chills and body aches.
8. Nausea or vomiting: A kidney infection may also cause nausea, vomiting, and loss of appetite in some people.

See a doctor right away if you notice pus cells in urine along with symptoms like high fever, chills, nausea, or flank pain. Early diagnosis and treatment of the underlying condition is important to prevent complications.

Who is affected by Pyuria?

Pyuria can affect people of any age or gender. However, some groups are more prone to developing this condition.

• Infants and young children are susceptible to urinary tract infections that can lead to pus in the urine. As children get older, the risk decreases but females remain more likely to experience pyuria during their lifetime due to a shorter urethra.
• Pregnant women also have an increased risk of pyuria and urinary tract infections because of changes in the urinary tract during pregnancy.
• Individuals with a weakened immune system, such as from diabetes or HIV, face a higher chance of developing infections that result in pyuria.

Kidney stones or other urinary tract obstructions can trap urine in the body and raise the risk of infection leading to pus cells in the urine. In many cases, pyuria causes no symptoms and is detected during a routine urinalysis. However, some people may experience symptoms like frequent or painful urination, back pain, fever or chills. If you experience symptoms of pyuria or a suspected urinary tract infection, see your doctor for an accurate diagnosis and treatment. A course of antibiotics can typically clear up pyuria and any underlying infections.

Diagnosis for Pus cells in Urine

To diagnose pyuria, your doctor will review your medical history and symptoms, and conduct tests to determine the underlying cause of the excess pus cells. The most common test is a urinalysis, where a urine sample is examined for pus cells and bacteria. Your doctor may also order a urine culture to check for infection and determine appropriate treatment.

Additional tests that may be performed include:

• Blood tests to check for signs of infection or other abnormalities.
• Imaging scans like CT scans or ultrasounds to check for structural problems in the urinary tract.
• Cystoscopy to directly view the urethra and bladder.
• Kidney function tests to check how well your kidneys are working.

Once the diagnosis is made, your doctor can determine the appropriate treatment based on the underlying cause of your symptoms. The good news is pyuria is often easily treated once properly diagnosed.

Diagnostic Tests for Pus Cells

To determine the underlying cause of pyuria, your doctor may order some diagnostic tests. A urine culture test can detect the presence of bacteria in the urine. This involves collecting a urine sample to be examined for bacterial growth. If bacteria are detected, an antibiotic sensitivity test may also be done to determine the best treatment.

Blood tests can also provide clues to the cause of pus cells in urine. A complete blood count (CBC) can detect signs of infection like an increased white blood cell count. Kidney function tests check for damage to the kidneys. Imaging scans such as an abdominal ultrasound, CT scan or MRI may be ordered to visualize the urinary tract and kidneys.

Imaging tests like ultrasounds or CT scans locate the source of the infection in the urinary tract. They can detect structural abnormalities or kidney stones that may be causing pyuria.

Cystoscopy is a procedure that uses a long, thin tube with a camera to examine the urethra and bladder. This can help detect inflammation, tumors or other abnormalities in the urinary system that may be linked to pus cell formation. In some cases, a urine cytology test or urine biopsy may also be recommended for a microscopic examination of the cells to check for other causes like cancer.

A complete urinalysis analyzes several components of urine like protein, blood, pH and specific gravity. Abnormal results point to possible causes of pus cells in urine like infection, kidney disease or bladder stones.

The specific tests your doctor recommends will depend on your symptoms, medical history and a physical exam. These diagnostic tests help determine the underlying cause of pyuria so appropriate treatment can be prescribed to clear the infection, reduce inflammation and prevent complications. Follow-up testing may be needed to monitor your condition and response to treatment.

Treatment Options for Pus Cells in Urine

These are some if the treatment options for pyruaris:

Antibiotic therapy

Antibiotics are used to treat the underlying bacterial infection causing the high pus cell count. The specific antibiotic depends on the bacteria involved. A urine culture helps determine which antibiotic will be most effective.

Increase fluid intake

Drinking extra fluids helps flush out the urinary tract and reduces pus cell count. Aim for 8-10 glasses of water per day.

Get rest

Extra rest allows your body to focus its energy on fighting the infection. Lack of sleep can weaken your immunity.

Use a heating pad

Applying a heating pad to your lower back or abdomen can help relieve discomfort from the infection causing the pus cells. Use as directed.

Cranberry products

Cranberry juice and cranberry supplements may help prevent and relieve urinary tract infections. Cranberry works by preventing bacteria from sticking to the urinary tract.

Urinary alkalinizers

Medications like potassium citrate or sodium bicarbonate can be used to make the urine less acidic. This makes the environment less favorable for bacteria growth.

Follow up tests

Your doctor may order repeat urine tests after treatment to ensure the pus cell count has decreased and the infection has cleared. Further imaging or procedures may be needed in some cases.

Pus Cells in Urine Treatment at Home

To treat pus cells in urine at home, focus on staying hydrated, urinating frequently, and taking over-the-counter medications to relieve discomfort.

Drink plenty of water and other clear fluids like herbal tea to flush out your urinary tract. Aim for 8-10 glasses a day. Urinating more often, about every 2-3 hours, can also help remove pus and bacteria from your system.

Take an OTC pain reliever like ibuprofen to ease any pain from inflammation. An antispasmodic drug can help relax your urinary tract muscles. Apply a warm compress to your lower abdomen to relieve pressure and cramps.

Cranberry juice contains compounds that may help prevent bacteria from adhering to the urinary tract. Drink 1-2 glasses a day of unsweetened cranberry juice. Probiotics introduce good bacteria to maintain a healthy balance in the urinary tract. Take an oral probiotic capsule daily.

Get extra rest so your body can focus on fighting the infection. Avoid alcohol, caffeine, and acidic foods like tomatoes that can irritate your urinary tract.

Making some simple lifestyle changes and trying natural home remedies can help relieve discomfort from pus cells in your urine. Staying hydrated, urinating frequently, and taking OTC medications are effective ways to start feeling better fast. See your doctor right away for an antibiotic if your symptoms become severe or last more than a few days.

When to See a Doctor For Pyuria

If you notice blood in your urine, increased urge to urinate, pain or burning during urination, you should consult your doctor right away. These can be signs of a urinary tract infection (UTI) or other issues that require prompt diagnosis and treatment.

Your doctor will review your symptoms, medical history, and may order urine tests to check for signs of infection or other abnormalities. A urine culture can detect the bacteria causing an infection. Other tests like cystoscopy or imaging scans may be needed to check for kidney stones, tumors or other problems.

Treatment will depend on the cause of your symptoms. Antibiotics are usually prescribed for UTIs. Hospitalization may be required for severe or persistent infections. Kidney stones often pass on their own, but pain medication and medical procedures can help. Tumors or other abnormalities may require further testing and treatment.

It’s best to get checked out rather than ignore symptoms or try to self-treat. Early diagnosis of any urinary or kidney problems is key to preventing complications and permanent damage. Your doctor can determine the appropriate course of action to relieve your symptoms, treat any underlying conditions, and help you maintain good urinary and kidney health.

Conclusion

Pus cells in your pee can be a sign of something more serious going on in your urinary tract. Don’t freak out if you see a few here and there. But if it becomes a regular thing or you have other symptoms, get checked out. See your doc, provide a urine sample, and get to the bottom of it. Treatments vary but the goal is to get rid of the infection or inflammation causing the problem in the first place. Drink lots of fluids, take your meds as prescribed, and you’ll be back to pain-free peeing in no time. In the end, listen to your body. It’s got a lot of smarts. Pay attention to what it’s trying to tell you through symptoms like pus cells in your urine.