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Why do I have high pus cells in my urine?

Q: I am a 21 year old girl having more than 100 pus cells/high power field (HPF) in my urine and pain in the lower abdomen too. What is the cause of this problem? I had the same problem last year too. Please advise.

A:Pyuria signifies abnormal numbers of white blood cells (WBCs) in the urine, usually detected under microscope in an unspun sample. Everybodys 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 urinary culture. It is not uncommon to continue with pyuria for some days even after an acute infection has settled with treatment, though culture at this time may be negative. There is a significant other group of diseases, which cause persistent 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. Your urologist after proper examination and investigations would be able to reach proper diagnosis and would guide you for appropriate steps.

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