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What do the levels of pus cells in urine indicate?

Thursday, 24 May 2007
Answered by: Dr. Rajesh Ahlawat
Director, Urology and Renal Transplantation
Fortis Hospitals
New Delhi
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Q. The pus cells in my urine are 20-25%. What is the cause and treatment for the same?

A.  I think you mean 20-25 pus cells/hpf (high power field of microscope), the usual term, and not %. Normal numbers of pus cells are up to 5 in males and may be up to 10 in females. The presence of pus cells in urine is also called pyuria, and is defined as >10 pus cells / microlitre of urine. Increased number of pus cells may reveal some destructive or healing process in the urinary tract, anywhere from kidney to the bladder. It usually is taken as indicative of an infection. Acute infections are most common cause of increased pus cells and get back to normal after couple of days of treatment. Persistently high pus cells in absence of a positive culture demand a search for a chronic infection like tuberculosis. There are non infective causes of high number of pus cells, like presence of stones or following any surgery on the urinary passage (high number of pus cells may persist for months after prostate surgery even in absence of infection). Thus, pus cells in urine by themselves are not a disease, but have to be seen in the right context and investigated.

A.  I think you mean 20-25 pus cells/hpf (high power field of microscope), the usual term, and not %. Normal numbers of pus cells are up to 5 in males and may be up to 10 in females. The presence of pus cells in urine is also called pyuria, and is defined as >10 pus cells / microlitre of urine. Increased number of pus cells may reveal some destructive or healing process in the urinary tract, anywhere from kidney to the bladder. It usually is taken as indicative of an infection. Acute infections are most common cause of increased pus cells and get back to normal after couple of days of treatment. Persistently high pus cells in absence of a positive culture demand a search for a chronic infection like tuberculosis. There are non infective causes of high number of pus cells, like presence of stones or following any surgery on the urinary passage (high number of pus cells may persist for months after prostate surgery even in absence of infection). Thus, pus cells in urine by themselves are not a disease, but have to be seen in the right context and investigated.

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