What Is The Normal Range Of Pus Cells In Urine?

It is common to see a few pus cells in the urine, but when there are more than a few of these cells, it is called Pyuria. It indicates that there is either an infection or inflammation somewhere in the urinary tract. This will lead to further investigations to find out why there are more than normal pus cells in urine. 

A urine routine is a test commonly done for people who have complaints like a burning sensation while urinating, flank pain, frothy urine, etc, or even as a part of a routine checkup. If a higher-than-normal range of pus cells in urine is detected, then further testing is done, which may include a urine culture, CBC, ultrasound, etc. 

This blog makes it easier for you to understand what these pus cells are, what can cause pus cells to appear in a urine test, what the potential treatments are, and what the complications of untreated Pyuria are. 

What are pus cells in urine?

One of the components of our blood is white blood cells, or WBCs, which play a role in fighting infection, overall immunity, and inflammation. 

When there is an infection or inflammation in our body, white blood cells migrate to that area as a protective mechanism. They do so to fight off any invading microorganisms, foreign substances, and the like. White blood cells thus gather in that area, and some cells will also die. 

Pus is a collection of these white blood cells, some dead cells, bacteria and other substances that are a result of our body's immune response. 

Be it a pus-filled pimple, a pus oozing wound, or pus cells seen in urine, it is a sign that our body is fighting an infection or inflammation. 

There are normal pus cells in urine due to many everyday factors. When pus cells are within the normal range in urine, these are due to factors like mild irritation, sexual activity, hormonal changes, etc. Sometimes, a few bacteria may reach the urethra from the surrounding region. 

The body's natural response to any invasion or irritation does result in a few pus cells. It usually originates from the lower urinary tract. But when the number of pus cells in urine is above the normal range, then it needs to be properly investigated and treated. 

Normal range of pus cells in urine

It is normal for urine to show pus cells between 0-5/HPF, which stands for high power field. 

The range for normal pus cells in urine(female) is 0-5/HPF.

The range for normal pus cells in urine(male) is also 0-5/HPF.

The normal range of pus cells in urine for a child or a baby may be slightly higher.

These ranges may vary slightly for age, sex, and other parameters, which is why only a healthcare provider must interpret your results. 

It would help if you were even more cautious for babies, children, older adults, and immunocompromised patients. 

When pus cells in urine are above the normal range

Anything above the normal range is considered Pyuria. 

If the numbers are above 10/HPF, it strongly indicates an infection. Some hormonal issues may also cause deviations from the normal numbers. 

There are two types of Pyuria:

1. Sterile Pyuria

When you look at a routine urine test report, you see many parameters like urine colour, specific gravity, protein, sugar, bacteria, pus cells, and others. When there are more than normal pus cells in urine but without any detectable bacteria, then it is called sterile Pyuria.

2. Non-Sterile Pyuria

This means that bacteria are also detected in the urine sample along with pus cells. This is a clear indication of an active infection. A doctor may immediately start the treatment or wait for other tests like culture, sensitivity, etc. 

Cause of Pus Cells in Urine

There are many causes of Pyuria, which is more than normal pus cells in urine. One of the most common causes is a UTI or a urinary tract infection. Apart from this, some medical conditions can also be behind this problem. 

Here are some causes of an above-normal range of pus cells in urine:

• UTI - A UTI can be due to a bacterial, fungal, or viral infection. Infection can reach your urinary tract:
•  During sex
• Due to some changes during pregnancy
•  Urine retention due to any reason like prostate enlargement 
•  Obstruction to the flow of urine, like with a kidney stone or a growth
•  Due to a catheter
•  When genital hygiene is not maintained
•  Due to a weakened immune system 
•  In diabetics
• Injury/inflammation due to a kidney stone
•  Pyelonephritis (infection affecting kidneys)
•  Sexually transmitted diseases
•  Viral infections 
•  Sepsis
•  Tuberculosis 
•  Inflammation due to autoimmune diseases
•  Certain medications
•  Interstitial cystitis 

Signs of pus cells in the urine

Specific signs of a urine infection or pus cells may not always be there. Some people may have non-specific signs like fever, shivering, etc only. Others, especially older adults or immunocompromised people, may not show any signs till the infection or the underlying cause progresses. 

These are some of the signs you should be aware of:

• Pain when urinating or straining
•  Urgency and frequency
•  Burning sensation during and after peeing
•  Swelling or tenderness in the pelvic region
•  Foul-smelling urine
•  Cloudy urine
•  Blood or debris in the urine
•  Fever
•  Shivering
•  Headaches 
•  Low back pain
•  Nausea and loss of appetite 
•  When infection progresses, one may have delirium 

What are the tests for pus cells in urine?

The first test is a routine urine test or urinalysis. In this test, a urine sample is collected in a sterile container. This sample is then analysed under a microscope. The number of pus cells seen under the high power field is counted. 

When pus cells, bacteria, casts or RBCs are seen in routine urine tests, the doctor may further recommend:

• CBC
•  Urine culture and sensitivity test
•  ESR
•  Ultrasound

O-Lab in Jammu is the best lab to get all your blood tests. Timely reporting can help you get early treatment and avoid all the complications. Reach out to us for accurate reporting with a quick turnaround time, along with the home collection facility. 

Who should get a routine urine test to detect pus cells in urine?

Anyone who has the signs and symptoms of a urine infection should get it done as soon as possible.

People who have any obstruction in the urinary tract due to a kidney stone or a growth should get the test done.

People who have urinary retention may be asked to get urinalysis a few times a year. It most commonly occurs in old age due to prostate enlargement or other factors. 

Older adults may not show severe and specific symptoms of a urinary tract infection. A urinalysis can detect if there are normal pus cells in urine per HPF or more. Early intervention in case of infection reduces morbidity and mortality in the elderly population. 

People who have a catheter need to be regularly tested to check for pus cells in urine. 

People with diabetes or any condition that makes them immunocompromised should also include urinalysis in their regular health checkups. 

*O-Lab offers many health checkup packages at economical prices to help you monitor your health. 

Anyone pregnant who is about to undergo surgery and people on certain medications also need frequent urinalysis. 

Treatment for pus in the urine

It is important to treat the underlying cause to reduce pus cells in urine. 

If there is a bacterial or fungal infection, you will be given appropriate antibiotics or antifungal medicines. You may also be given medicines for symptoms like pain, burning, fever, etc. 

Sexually transmitted diseases need to be treated promptly, and all due precautions need to be taken.

If there is an autoimmune disease or other inflammatory causes, those are treated with appropriate medicines. 

If there is an obstruction, then treatment may include surgery. If kidney stones are causing obstruction, many will pass without surgery. Anti-inflammatory properties, antibiotics, and alpha-blockers (as they relax the muscles in the ureter) may be given. 

Drinking plenty of fluids is important unless fluids are restricted due to a medical condition.

Some supplements may also be given.

Each case is different, and treatment depends on the cause and severity of symptoms. Self-medication should be avoided. 

Complications due to pus cells in urine

When left untreated, the presence of pus in your urine can lead to certain complications. 

These complications include:

• Sepsis, which is the spread of infection to the blood
•  Complications during childbirth, low-weight baby or preterm labour in pregnancy
•  Recurrent UTI
•  Kidney damage or kidney failure

Sometimes, people delay getting treatment for pus in the urine. At other times, one may not realise there is pus in urine. When the cause is benign or non-threatening, a little delay may not do as much harm as in other cases. However, treatment is required, and it is quite easy in most cases. 

See your doctor at the earliest for any sign of pus or infection in urine. Do get your regular checkups when necessary for your health status and age. 

Home remedies for pus cells in urine

Since infection from the urinary tract can reach kidneys and blood, it is very important that a medical professional promptly treats all urinary tract infections. 

Home remedies can be an adjunct to medical treatment. These can also be used by people who get frequent UTIs to avoid infections and reduce pus cells in urine. 

These are some of the home remedies:

• Always stay well hydrated because this helps you urinate more, which can flush out toxins.
•  Maintaining genital hygiene, washing from front to back after defecating, and wearing clean undergarments can help prevent infections.
•  Some studies have found cranberry extract and products to be beneficial for preventing urinary tract infections. These can prevent bacteria from adhering to the lining of the urinary tract. You can ask your doctor or dietitian for the dosage and methods. 
•  Ayurvedic and homoeopathic remedies, only when prescribed by a registered practitioner, can be taken along with your medicines. Some of these are said to help shorten the duration of the infection.
•  Probiotics can be helpful both for your gut health and your urinary tract health. The probiotics play a role in maintaining healthy bacterial balance. Some studies hint at their role in preventing UTIs and treating UTIs. 
•  Avoid female hygiene products as they are not needed and may irritate your urinary tract and genital area.

These are some things you should not do when there is pus in your urine:

• First and foremost, don't delay treatment.
•  Only add a few spices to the food. Don't drink too much coffee and tea, don't drink alcohol, etc. Avoiding these things helps, as they are all irritants. 
•  Do not self-medicate, as treatment will be based on the underlying cause. Your health status and age may also play a role in deciding the best course of treatment.
•  Do not hold your urine.
•  Do not wear diapers or sanitary pads for longer than recommended. Change these every few hours to avoid infection.

Always inform your doctor about the home remedies, supplements, and alternative medicines that you may be taking.

Conclusion

Whenever the number of pus cells deviates from the normal pus cell range in urine, it can be an indicator of a health issue or an infection. Women are generally more prone to infections of the urinary tract because of the shorter length of the urethra. Women are also more prone to frequent UTIs. 

It is important to find the cause of pus in urine because if there is an infection, it can spread to the kidney, prostate in men, or blood, causing serious complications. There may be less serious causes of Pyuria as well. A medical professional can make the correct diagnosis. They can assess if and what treatment may be needed. More often than not, it is easy to treat the underlying cause. 

Home remedies and alternative therapies can complement conventional medical treatment. A healthy lifestyle, good hygiene, a balanced diet, and proper hydration can be good for your health and the urinary tract.