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What does the presence of pus cells in urine signify?

Monday, 18 August 2008
Answered by: Dr. Rajesh Ahlawat
Director, Urology and Renal Transplantation
Fortis Hospitals
New Delhi
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Q. My pus cell count is 15-20/hpf, what does it mean?

A.  Pyuria signifies abnormal numbers of white blood cells (WBCs) in the urine, usually detected under microscope in an unspun sample. Everybody's urine would contain these cells in certain amount, up to 5 WBCs in males and up to 10 in females are considered normal. Any irritation of urinary system lining will cause an increase in number of these cells. Acute urinary tract infection is the most common cause and is associated with urinary symptoms, and a positive urine culture. Varied infective pathologies in other associated urinary organs like prostate, or in adjoining areas like pelvic abscess, may also cause pyuria. There is a significant other group of diseases which cause pyuria even in absence of an acute infection, or a positive urine culture. The phenomenon is called sterile pyuria. While infections with organisms, which cannot be grown on normal culture plates (like tuberculosis) forms one group, the other group is of non-infective origin. Common non-infective causes are urinary stones and non-infective inflammations like interstitial cystitis. Rarely, some cancers like carcinoma-in-situ also lead to pyuria and need to be excluded in cases with persistent pyuria.

A.  Pyuria signifies abnormal numbers of white blood cells (WBCs) in the urine, usually detected under microscope in an unspun sample. Everybody's urine would contain these cells in certain amount, up to 5 WBCs in males and up to 10 in females are considered normal. Any irritation of urinary system lining will cause an increase in number of these cells. Acute urinary tract infection is the most common cause and is associated with urinary symptoms, and a positive urine culture. Varied infective pathologies in other associated urinary organs like prostate, or in adjoining areas like pelvic abscess, may also cause pyuria. There is a significant other group of diseases which cause pyuria even in absence of an acute infection, or a positive urine culture. The phenomenon is called sterile pyuria. While infections with organisms, which cannot be grown on normal culture plates (like tuberculosis) forms one group, the other group is of non-infective origin. Common non-infective causes are urinary stones and non-infective inflammations like interstitial cystitis. Rarely, some cancers like carcinoma-in-situ also lead to pyuria and need to be excluded in cases with persistent pyuria.

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