Pus Cells in Urine (Pyuria): Symptoms, Causes, Normal Range & Treatment

Urine is one of the key indicators of health concerns, and the composition of urine reveals much about what is happening inside the body. One indicator in urine is the presence of pus cells, also referred to as pyuria. Having a few pus cells in the urine is normal, but too many pus cells can indicate an infection or inflammation in the urinary tract. This article describes the causes, symptoms, diagnosis, treatment, and prevention of pyuria. 

What Is Pyuria?

Pyuria is an abnormal number of white blood cells (WBC) or pus cells in the urine. These cells are present when the body is fighting inflammation or an infection, usually in the urinary tract (kidneys, bladder, ureters, and urethra). In this condition, the urine also contains bacteria and dead tissues apart from the white blood cells. If you have Pyuria, your urine might have a strong odor of ammonia. Consulting with a doctor in this situation is the best option. 

What are the Normal Ranges of Pus Cells in Urine?

Having a small number of pus cells in your urine is mostly normal. When you have a urine sample examined under a microscope:

• 0–5 pus cells per high power field (HPF) is usually considered normal.
• 5–10 pus cells/HPF could signify borderline or mildly increased.
• >10 pus cells/HPF typically indicates pyuria and should be evaluated further.

When there are increased pus cells present in your urine, the urine will look visibly altered in colour, in that it will appear cloudy and thicker. Please speak to your doctor right away if you see this type of change in your urine.

Who Does Pyuria Affect? 

Pyuria can occur in anyone, irrespective of age and gender. But there are specific groups that are at higher risk:

• Women - Women with shorter urethra have a higher risk of UTIs.
• Older adults – Particularly older adults with catheters, or immune systems decreased, or with UTIs.
• People with diabetes - People with diabetes may have recurrent infections in the urinary tract.
• People with kidney stones or urinary tract blockages.
• Pregnant women - Due to hormonal and anatomical changes in pregnancy

Causes of Pyuria

The presence of pus cells in urine can be triggered by various reasons, from kidney stones to Sexually Transmitted Infections (STIs). Here are some of the causes you should stay aware of: 

• Urinary Tract Infections (UTIs) - the most usual cause.
• Kidney Infections (Pyelonephritis).
• Bladder Infections (Cystitis).
• Sexually Transmitted Infections (STIs) - i.e. chlamydia or gonorrhea.
• Tuberculosis of the urinary tract.
• Kidney stones- which may cause irritation and inflammation.
• Interstitial cystitis - a bladder condition.
• Autoimmune diseases - for example, lupus.
• Catheter use or personal hygiene.
• Urinary tract cancer (uncommon).

Symptoms of Pyuria

Pyuria itself represents an unidentified condition. It often presents with symptoms, especially if associated with UTI. Some of the common symptoms include:

• Cloudy urine or smelly urine
• Pain or burning while urinating
• An increase in frequency of urination
• Lower abdominal or back pain
• Fever and chills (if infection has progressed)
• Blood in urine (hematuria)
• Nausea or vomiting (in cases of severe kidney infections)

Diagnosis 

The cases of Pyuria are mainly diagnosed by Urine analysis. Its done by taking your urine sample and checking for while blood cells and bacteria. In order to evaluate pyuria and its underlying cause, a physician may suggest:

• Urinalysis—In order to determine the presence of pus cells, bacteria, blood, or protein in urine. 
• Urine culture—in order to determine which type of bacteria is causing an infection.
• Complete blood count (CBC)—In order to assess the presence of infection or inflammation.
• Imaging tests—For example, ultrasound, CT scan, or MRI, in order to check for structural abnormalities. 
• Cystoscopy—In order to visually examine the interior of the bladder if the evaluation is chronic or unclear.

Treatment Options 

Your healthcare provider determine the management by the underlying cause for your condition. Here are some common treatment options. 

• Bacterial infections:  Treated with antibiotics such as nitrofurantoin, ciprofloxacin, or trimethoprim-sulfamethoxazole.
• Sexually transmitted infections (STIs): Require specific antibiotics to target the believed infectious organism (bacteria, virus, or parasite). 
• Kidney stones: In general, treatment may include pain relief, hydration, and/or surgical intervention.
• Autoimmune disorders: In general, management will include corticosteroids or immunosuppressants.
• Catheter-associated infections: In general, management may require removal or replacement of the catheter and identification of appropriate antibiotics.

It is important to complete the prescribing course of medication to reduce the risk of exacerbation of pyuria. If you left it untreated, further complications might follow including blood poisoning and even organ failure. 

Home Remedies for Pyuria

Home remedies are not substitutes for medical treatment. However, they can help with recovery by speeding it up. Here are some home remedies for Pyuria that can help you to a significant extent: 

• Stay Hydrated – Drink water to help flush out bacteria.
• Cranberry Juice - May prevent bacteria from sticking to the walls of the urinary tract. 
• Warm Compress – May relieve pelvic pain or discomfort.
• Good Hygiene – Wipe the area from front to back after urinating (especially women).
• Avoid Irritants – Such as caffeine, alcohol, and spicy foods during an infection.

Always talk to your doctor before using home remedies as they often interfere with the prescribed medications ot treatment process.

Preventive Measures

Pyuria can be prevented if you focus on preventing UTIs and STIs. Here are daily measures you can consider for preventing Pyuria. 

• Practice good personal hygiene
• Regularly urinate, and do not hold it for extended time periods. 
• Drink during the day.
• Urinate after sexual activity in order to wash away any bacteria.
• Don't overuse perfumed products pertained to the genital area.
• Manage chronic diseases such as diabetes.

Conclusion

Pyuria, or pus cells in urine, mainly indicates some infections or inflammation. While it is understandable and almost always a treatable condition, it should not be taken lightly if accompanied by signs of pain, fever, or blood in the urine. With appropriate diagnosis, treatment, and preventive care, the majority of cases can be appropriately treated with no lasting sequelae.

FAQs

1. Can pyuria be present without symptoms?

Yes. Asymptomatic pyuria is the term often used in these cases, and can be a byproduct of routine urine testing, especially in older adults or pregnant women.

2. Can drinking water cure pyuria?

Drinking lots of water may help flush out bacteria, which contributes to healing, but on its own drinking water will not cure an infection. Appropriate antibiotics must be prescribed for successful treatment.

3. Is pus cells in urine normal?

A few pus cells are normal. However, if the number increases it can be harmful for your overall health.