We find out why white blood cells in the urine are elevated, what are the reasons for women. Urine, or urine, is inherently an ultrafiltrate of blood plasma. Urinalysis is a general clinical research method, since with its help you can navigate the functioning of the urinary system.
If there are pathological impurities in the urine, which can be hematogenous and non-hematogenous cells, salts, microorganisms, the pathology of the kidneys, ureter, bladder or urethra should be suspected. The most common pathological finding in the general analysis is an increased content of leukocytes in the urine.
Where do the white blood cells come from?
The basis of the urinary tract are 2 types of cells: various epithelial and muscle. Their livelihoods are supported by capillary blood, which brings oxygen and nutrients. The blood also contains immunity cells - white blood cells. They “bypass” the urinary tract by checking the “identification marks” - antigens — displayed on each cell, with a kind of “list” of such “authorized” molecules.
When leukocytes see antigens of bacteria, viruses or fungi, as well as “signs” of cancer cells, they rush to a “compromised” place and begin to destroy foreign agents. After performing their function, they enter the urine, where they are detected using laboratory tests:
- general (general clinical) analysis - The usual portion of urine collected in the morning. This analysis is the simplest to perform, and it is from it that they usually find out that the content of leukocytes is increased (this is called leukocyturia),
- samples by Nechiporenko - An average portion of morning urine. It is considered more informative for determining the number of white blood cells, as well as red blood cells and cylinders in the urine. It better clarifies the number of these cells, which helps in the diagnosis of various inflammatory diseases of the urinary tract,
- Amburge samples. This analysis is performed from 10 ml of urine taken from dishes where urine collected in 3 hours,
- Addis-Kakovsky tests - counting urinary cells in urine collected 24 hours.
Recent tests are needed to detect latent leukocyturia (when in the general analysis the leukocytes are normal) or when the leukocytes are elevated, then normal with multiple studies. They will help not to miss, but to detect a disease in a person even at the stage when ultrasound does not show anything.
White blood cell function
Many are faced with the need to take a blood test. It describes in detail the percentage of various components, such as red blood cells, platelets, white blood cells. Each of the cells performs certain functions in the body, therefore, their decrease or increase makes it possible to learn about the threat to human health.
- Acceleration of blood coagulation with its various loss caused by bruises, injuries, injuries. Neutrophils are involved in this function - a type of white blood cells formed in the bone marrow,
- The absorption of certain substances, moving them to the desired place of use. This function is transport and it is performed by a number of enzymes (diastases, proteases, deoxyribonucleases and others) contained in leukocytes,
- The ability to synthesize gamma globulin, proteins, phospholipids, glycogens, due to which leukocytes have a high rate of RNA (ribonucleic acid) renewal. This function of white blood cells is called metabolic,
- The process of the formation of new cells, the healing of tissues with various injuries. This is the regenerative function of white blood cells,
- The capture and poisoning of foreign bodies, the destruction of microbes and the formation of antibodies, antitumor and anthelmintic effects, participation in the formation and support of immunity are the most important and valuable protective function of all white blood cells.
These white blood cells are valued and characterized for their unique antiviral and antibacterial actions, serve as support and support for a healthy body.
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What are white blood cells?
White blood cells are elements of the cellular component of the blood whose main function is the immune.
White blood cells form in the red bone marrow from multipotent, or stem cells. Subsequently, these cells differentiate and form different populations of leukocytes. Classically, these cells are divided into granulocytes, since their cytoplasm contains granules visualized by microscopic examination, and agranulocytes that do not have granules.
In turn, depending on the reaction to histological stains of acidic or basic nature, granulocytes are divided into:
Agranulocytes are divided into:
Different stages of the immune response are divided between the corresponding leukocyte populations:
- Neutrophils provide an immune response for mycoses (infectious diseases caused by fungi) and for bacterial infections.
- Eosinophils regulate the reactivity of the immune system, in particular allergic reactions, and also participate in antiparasitic immunity.
- Basophils are modulators of inflammation.
- Lymphocytes are involved in the antiviral and antitumor response.
- Monocytes differentiate into macrophages, whose function is phagocytosis and immune regulation.
The reasons for the appointment of tests to determine the level of white blood cells
White blood cells (from Greek λευκός - colorless) among other human blood cells stand out for their large size and ability to amoeboid movement. Their main function is to recognize and destroy foreign inclusions, from molecules to whole cells, which is true both for pathogens and allergens, and their own dead or diseased cells. By determining the level of white blood cells in the blood, one can judge the body's resistance.
The leukocyte upward jump in both blood and urine tests is possible in the following cases:
- inflammation and suppuration, sepsis,
- infection with viruses, bacteria, fungi,
- the development of certain types of malignant tumors,
- ingestion of allergens,
- myocardial infarction
- pregnancy, breastfeeding,
- increased physical activity.
With a noticeable decrease in the level of leukocytes, it is necessary to check the lymphatic system and the red bone marrow, since they produce these blood cells. The number of white blood cells can also be reduced with radiation sickness, various types of typhoid, while taking certain medications.
Most often, blood and urine tests are used to determine the level of leukocytes. In case of problems of a gynecological nature, a vaginal smear analysis can be prescribed. With severe inflammation of the gastrointestinal tract, when an analysis of feces is prescribed, white blood cells can be detected in it. However, in this case, this is a non-specific indicator, and it must be considered in conjunction with the patient's complaints.
White blood cell count
Normally, there may be several immune cells in the urine: these are the "sentinels" who checked the organs for infection or cancer. In women, a little more of these cells is allowed: in them, those white blood cells that “check” the genitals can also get into the urine.
- So, the norm of leukocytes in urine (according to a general clinical analysis of urine):
- in women: 0-6 in sight,
- in men: 0-3 in the field of view.
- If we talk about the test according to Nechiporenko, then a level higher than 2000 cells per 1 ml will be considered as increased white blood cells (in women, up to 4000 cells are allowed).
- Amburge's sample rate is also up to 2000 leukocytes.
- According to Addis-Kakovsky, the norm is considered to be above 2 million leukocytes in daily urine.
So what does “elevated white blood cells” mean? Depending on which urinalysis they are determined, these are:
- or more than 3 in men and 6 in women (according to general analysis),
- or more than 2000 (according to Amburge and Nechiporenko),
- or more than 2 million (according to Addis-Kakovsky).
What does it mean "increased white blood cells in urine in an adult"?
According to The Merck Manual Online Medical Library, the presence of white blood cells in the urine is a sign of inflammation and infection.
A laboratory symptom, when there is an increased number of leukocytes in the urine, is called leukocyturia.
The issue of the normal number of white blood cells is controversial. It is generally recognized that the presence of more than one white blood cell in the field of view is an abnormality, although some experts believe that five or more cells indicate pathological leukocyturia.
The rate of leukocytes in the urine of women and men is slightly different - this is due to the anatomical features of the urinary and reproductive systems in different sexes. A certain role in the penetration of leukocytes into urine is played by the fact of the proximity of the external opening of the urethra, the entrance to the vagina and the anus. And because women have a wider and shorter urethra, they have a higher risk of urinary tract infections. Therefore, leukocytes in the urine in men without any pathology are much less common.
Theoretically, any cellular element that is in the blood can be present in urine sediment. Most often neutrophils are found there, however, the presence of lymphocytes and eosinophils is of great clinical importance, therefore they should be determined separately, if possible. Additional stains or phase contrast microscopy are used to differentiate blood elements.
Urinalysis: white blood cell count in women
To determine the amount of these cells and check the norm of their content in a woman's body, a urine test is performed. In this case, mainly its correct collection is:
- do not consume medications (activated carbon, acetylsalicylic acid) and vitamins, tinctures of herbs and vegetables that can change the color of urine during the day before taking the analysis
- washing the genitals well using hygienic soap, gel and thoroughly rinsing it, wipe it dry,
- at the first urination in the morning, preferably immediately after sleep, without a few first and last drops,
- use clean and dry collection dishes or a sterile container purchased at a pharmacy kiosk,
- if it is not possible to take the test immediately, store in the refrigerator, having consulted about the terms with a doctor, laboratory assistant.
With the correct fulfillment of all requirements for urine collection, as well as the absence of inflammatory processes and diseases of the genital organs, the standard level of white blood cells in women is in the range from zero to six "in sight" and up to four thousand per 1 ml according to the detailed analysis by Nechiporenko.
This indicates good health and unnecessary unnecessary worries.
White blood cell count
First of all, it should be clarified that the normal level of leukocytes in the general blood test does not mean that the patient is healthy. White blood cells are of different types: some are involved in the capture and "eating" of foreign microorganisms directly, while others produce antibodies. In some cases, to clarify the clinical picture, it is necessary to determine the leukocyte formula, which will show the percentage ratio of different types of leukocytes.Thus, for example, you can determine the nature of the rash: it is an infection or an allergic reaction of the body.
White blood cells in urine in women - table of norms by age
In childhood, the allowable number of leukocytes in urine is slightly higher than in adults.
|Age||The norm of white blood cells in urine in girls, women|
|16 and older||0—5|
If we talk about adulthood among women, then there is no fundamental difference in the optimal indicators of cellular elements of urine. The norm of white blood cells in urine in women after 50 years old does not differ much from 30-year-olds, however, with age, the risk of developing a disease accompanied by leukocyturia is much higher.
White blood cells in the urine of women: normal and abnormalities
In women, due to the special anatomical structure - the vaginal opening is located not far from the urethra - bacteria and inflammatory cells can move without obstacles, which leads to a change in the analysis and the appearance of deviations from the norm of white blood cells.
To decrypt this analysis, you need to know the quantitative indicators of the norm and deviations of the leukocyte content in the composition of urine “in sight”:
- from 0 to 6, in extreme cases, not exceeding 10 - the figure on the analysis indicates the patient’s good health or a dubious result that needs to be repeated,
- from 10 to 50 - is considered a slight deviation, but indicates a pathological process that should not occur in the urinary organs,
- more than 50 cells - reports the presence of inflammation of the genitourinary system, requires close attention and determination of the disease,
- the huge content of white blood cells is characterized by severe inflammation, called pyuria or purulent urine, which requires immediate medical intervention.
In the analysis itself, attention is also paid to other indicators of the quantitative content of bacteria, red blood cells, epithelial cells, and only after that a medical report is made.
How to prepare for the procedure and what is it?
Blood is taken from the cushion of the ring finger of the left hand by puncture with a sterile disposable scarifier, which is printed in the presence of the patient, or using a needle from a vein. Venous blood is a better biomaterial for analysis, therefore, when it comes to an adult patient, this option is always preferable. Children are often afraid of syringes, so they take blood from their fingers.
Blood is usually (but not necessarily) taken early in the morning on an empty stomach. If this is not possible, then at least four hours should have passed since the last meal. The day before the delivery of the biomaterial, you should refrain from taking alcohol and drugs, exercise, overheating. Physiotherapeutic, x-ray, massage procedures prescribed the day before the blood donation must be postponed for later. For repeated blood donation, it is advisable to choose the same watch as before. Before entering the treatment room, you should sit quietly in the lobby for 10-15 minutes and relax.
The result of the analysis can be obtained on hand within a day or two.
In the laboratory, the number of leukocytes is determined using special robotic analyzers or a microscope. Microscopic examination is traditional, however, more time-consuming. Therefore, it is used either when it is impossible to equip the laboratory with a modern analyzer, or as an additional research method - for example, if you need to consider a stained blood preparation to detect abnormal inclusions.
Causes of leukocyturia in women
In the analysis of urine, white blood cells are detected only in small quantities. Their high content is signs of an infectious lesion, inflammatory processes, cancer, or physiological characteristics of a woman's body.
In infections, the immune system begins to produce more protective cells than usual to combat pathogens. In this regard, an excessive amount of white cells is not able to be completely absorbed in the process of urine formation and its filtration. Therefore, in this case, urine will contain white blood cells. Their volume will depend on the degree of damage and the type of infection.
A similar excess will be with the inflammatory nature of the violation. With inflammation of any organ or system, an appropriate immune response occurs, aimed at healing the disease. White blood cells in this case act as healing cells. A very slight excess of the norm is due to improper collection of urine, errors in nutrition, saturated with salt, as well as poor hygiene.
Pyuria can be the result of such diseases:
- Pyelonephritis is a purulent inflammation of the kidneys.
- Urethritis is an inflammation of the urinary canal.
- Glomerulonephritis - damage to the glomeruli of the kidneys.
- Urolithiasis disease.
- Cystitis is an inflammation of the bladder.
In addition to these diagnoses, a urinalysis can show leukocyturia in the case of an allergic reaction of the body, systemic inflammatory diseases, previous surgery and sexually transmitted diseases.
Urinalysis may be abnormal during pregnancy. This condition of a woman causes many changes in the normal functioning of the body. The pregnant fetus affects metabolism, the physiological location of organs in the abdominal cavity, as well as changes in blood and urine tests.
The reason for this feature is the woman’s immune system. The fetus of the expectant mother is regarded by him as a foreign body, therefore, the active production of white blood cells occurs. A similar reaction is considered absolutely normal, especially in the first months of pregnancy. In some cases, even in the last trimester, white blood cells are found in the urine, and sometimes after childbirth. The number of white blood cells in such cases reaches 3-6 units.
If leukocyturia persists after pregnancy for a long time, then you should pay attention to this. The attending physician should conduct a thorough study of the urinalysis and prescribe an additional blood test. After pregnancy and childbirth, kidney diseases may appear, and in this condition, women are more susceptible to attack by fungal infections.
A normal white blood cell count is an ideal indicator of any study, however, white blood cell count is not always the result of a complex pathology. It is very important in such cases to quickly respond and prevent the development of pyuria.
Deciphering the results
So, you have received an analysis form with some results. It is useful to know the norm indicators if the analysis is planned. Then in case of deviations you will not delay the visit to the doctor. If the study was ordered due to any of your health complaints, you should not try to make a diagnosis - this is still a specialist’s business.
- The white blood cell count in the analysis . Over the course of a life, norm indicators vary greatly, so the patient's age should be taken into account. Sex is not that important. It is generally accepted that in women the level of leukocytes is slightly higher than in men. However, in general, the norm for adults varies widely enough, therefore, gender differences can be neglected.
|Age||Norm in sight|
|in boys||in girls|
|up to 28 days of life||5-7||8-10|
|up to a year||5-6||8-9|
|1 to 18 and older||0-5||0-6|
Thus, the less white blood cells in urine, the better. Some practicing urologists are of the opinion that if in the urine of a child of any age, more than 3 leukocytes in the field of vision are determined by the general clinical method, then it should already be examined according to the algorithm in the section “What to do with an increase in leukocytes in the urine”.
Causes of increased indicators and methods of complex therapy
White blood cells are important blood elements that perform a comprehensive protective function throughout the body. They are able to actively move and pass through the walls of the capillaries, be extracted into the intercellular space, absorb and decompose any foreign particles by phagocytosis. In addition to blood, white blood cells are also present in urine, although in a small amount.
In which cases in women this indicator will be higher than normal? When can they prescribe an analysis to determine the level of leukocytes in urine? What are the main causes of leukocyturia? You will read about this and much more in our article.
White blood cells in urine as such do not give any symptoms - their presence there is a manifestation of the underlying disease. Therefore, the symptoms will depend on the severity of the inflammatory process and on its localization.
The classic clinical picture in patients with acute pyelonephritis is as follows:
- fever (not always present when it is, the temperature reaches 39.4 ° C),
- bone-vertebral, often unilateral pain of varying severity, which may accompany muscle tension in the side,
- nausea and / or vomiting - they vary in frequency and intensity, from absence to severe, is also common in patients with acute anorexia pyelonephritis - lack of appetite.
If the patient has cystitis accompanied by leukocyturia, he will have the following symptoms:
- dysuria, or urination disorder (rapid, false desires, imperative desires),
- a feeling of fullness of the bladder or discomfort in the lower abdomen,
- suprapubic tension
- rarely - fever, chills, and malaise.
What is the norm of white blood cells in urine in pregnant women
The immunity of a pregnant woman decreases for the proper development of the fetus, and, therefore, the number of white blood cells fluctuates and rises.
This change is natural and should not cause great concern if the level does not exceed a value of up to 10-15 units, but an increase can be the beginning of the development of diseases such as pyelonephritis, cystitis, nephritis, urethritis or indicate the presence of stones in the urinary system.
All disturbing indications in the urine tests of pregnant women lead to additional submission of these analyzes again. Only then can a medical report be made correctly.
Types of leukocyturia
By origin, leukocyturia is:
- truewhen the causes of elevated white blood cells in the urine are diseases of the urinary system,
- falsewhen white blood cells enter the urine from the genital tract (to determine inflammation in the genitals, white blood cells are determined in a smear from them). This can occur in both men and women of any age. The cause of this condition can be both poor hygiene of the genitals before analysis, and inflammation of the external genitalia in women (vulvovaginitis) or the skin of the penis and its head (balanoposthitis).
There is another classification that takes into account the sterility of urine, in which a large number of white blood cells are found. In this case, leukocyturia is:
- infectious. Caused by inflammation of the urinary tract.In case of bacterial seeding or PCR examination of urine, some kind of microbe is determined.
- non-infectious (aseptic) It is caused either by non-infectious processes (for example, autoimmune glomerulonephritis or allergic cystitis), or inflammation occurring in organs adjacent to the urinary tract, or by taking the drugs listed below.
Depending on the quantitative results that a general urinalysis shows, leukocyturia happens:
- insignificant: 7-40 leukocytes in sight,
- moderate: 41-100 cells in the field of view,
- pronounced (it is also called pyuria, that is, “pus in the urine”), when it is determined more than 100 cells per point of view.
Depending on what leukocytes prevail in the field of view (leukocytes are a collective concept for several types of cells), leukocyturia can be neutrophilic, lymphocytic, eosinophilic and mononuclear. Each of them is characteristic of certain diseases. To determine the type of leukocyturia, an additional urine test is required: this indicator is not determined by standard general clinical analysis.
Indications for taking a urine test
There are several types and diagnostics of the biomaterial described above, differing in the methodology and procedure for calculating the final result. Regardless of the type of study, whether it is a general urinalysis, a test according to Nechiporenko or Zimnitsky, it can be prescribed in the following situations:
- Regular examination of the patient as part of basic preventive measures or during pregnancy,
- Suspected urinary tract pathologygastrointestinal tract and other organs, both infectious and non-infectious in nature,
- Objective complaints of the patient about the appearance of various negative symptoms, in particular, frequent acts of urination, itching, pain in the groin and abdomen and other syndromes,
- General monitoring of vital signs as part of the treatment of a wide range of diseases, as well as monitoring the condition of a woman before and after complex medical procedures, including surgical intervention.
Abroad, a popular method for determining leukocyte esterase using strips with indicators. In our country, the most common method for determining white blood cells in urine is a general urinalysis, where these cells are determined using light microscopy.
Urine tests according to Addis-Kakovsky and Nechiporenko are sometimes used. When analyzing urine according to Addis-Kakovsky, the entire volume of daily urine is used, in relation to which the cellular elements are determined in it - here the white blood cells should be less than 2 million in 1 ml. The essence of the analysis of urine according to Nechiporenko is to study the average portion of morning urine - leukocytes should be no more than 2000 per 1 ml.
Causes of an increase in white blood cells in urine in women
The number of white blood cells in the urine of women can range from many causes. It could be:
- increased physical activity,
- intake of healthy vitamins and minerals with food,
- emotional stress
- overheating and hypothermia of the body,
- on time or before the period of menstruation,
- during pregnancy
- with ovulation,
- depending on the time of day.
Consultation with a doctor and the correct diagnosis can identify diseases of the kidneys and urinary system in women, such as:
- urethritis (inflammation of the urinary tract),
- cystitis (bladder disease)
- nephrosis (degenerative damage to the kidneys),
- pyelitis (inflammation of the renal pelvis),
- pyelonephritis (pathological processes in the kidneys),
- formation of kidney stones, ureter,
- violation of metabolic processes.
- vaginitis (inflammation of the external genital organs),
- oncological diseases,
- vulvovaginitis (inflammation of the mucous membrane of the vulva and vagina),
- venereal diseases.
Timely detection of excess white blood cell counts using urine tests can help prevent the further development of many diseases and prescribe the right treatment.
Preparation for research and collection of biomaterial
Regardless of the type of urine study, prior preparation is required before the event. Recommended actions usually include:
- Compliance with the diet. In most cases, it is recommended that you follow a diet at least three days before taking the biomaterial. The daily diet excludes all fried, spicy and salty foods, products that cause fermentation and increased gas formation, as well as individual products that additionally burden the gastrointestinal tract, changing the parameters of urine, including its color, texture, smell, and volume. You need to eat in small portions up to 6 times a day, while it is advisable to eat dishes warm, and steam cook, boil or bake. In addition to the correction of classic home cooking, you should refuse to use any type of fast food, convenience foods, sweet soda, coffee and any form of alcoholic beverages,
- Medicines 4 days before urine collection, it is necessary to stop the use of any drugs, including local action. If it is impossible to refuse the use of medicines due to the presence of serious chronic pathologies that require regular correction by conservative treatment methods, it is worth reporting this fact to the specialist who referred the patient for diagnosis, indicating the names and active substances of the drugs, dosage regimens, dosage and other necessary parameters,
- Life style. For the period of preparatory activities for 2 days, it is necessary to minimize physical activity, and also try to avoid any stresses and worries. In addition, it is advisable to fully walk in the fresh air, follow the general rules of hygiene, including the intimate spectrum.
Direct urine collection for general clinical tests and Nechiporenko test is carried out in the morning on an empty stomach. Prepare in advance a sterile container for collection, which can be purchased at any pharmacy.
With the beginning of the first act of urination, the initial portion of the biomaterial should be lowered into the toilet within a few seconds, then substitute the available vessel and fill it with biological fluid up to half, close the lid tightly and deliver the sample to the laboratory for 2 hours. If there is no possibility of immediate delivery, the container with biomaterial can be placed in the refrigerator, where it is stored for a maximum of 4 hours.
Urine Collection Rules
In order to avoid false-positive results, it is necessary to adhere to certain rules in preparing for the analysis of urine.
- Before collecting urine, you must purchase a sterile container for delivery of urine.
- It is best to use morning urine.
- Before collecting urine, it is necessary to conduct a toilet of the external genital organs — high leukocytes in the urine of women are sometimes caused by banal insufficient hygiene.
- It is best to collect the middle part of the urine - a few seconds after the start of the act of urination.
- The container should be transported to the laboratory as quickly as possible.
How to normalize the level of leukocytes contained in urine in women
To normalize a high degree of white blood cells in the urine of women, it is possible only after the correct diagnosis of the disease.
Also, with the correct definition of some diseases, there are ways of non-traditional and non-drug treatment. In the case of an increase in these blood cells in the urine with such common and known diseases as cystitis, pyelonephritis and other inflammations of the urinary and renal system - apply:
- boiled and boiled corn stigmas,
- a diet based on reducing water and salt intake,
- tincture of flaxseeds, hop cones, dioica nettle,
- sea buckthorn berries
- bearberry leaves
- salad or juice from flowers or leaves of nasturtium.
Any remedies are good for treatment, but only after a mandatory consultation with a doctor, since even infusions and decoctions from herbs can enhance the course of inflammatory processes in a woman’s body, which will lead to an even greater increase in white blood cell count.
With cystitis - acute and chronic
It is difficult to miss an acute disease: it manifests itself as intense pain in the lower abdomen, strong urge to urinate and its pain (especially at the end), sometimes even blood in the urine and fever. And chronic cystitis can be asymptomatic, only in some cases letting you know about yourself with frequent urination and a little discomfort with it. In chronic cystitis, exacerbations periodically occur, which are manifested by the symptoms of an acute process.
How to lower white blood cell count in urine
Leukocyturia is a laboratory symptom, not a disease. It follows that leukocyturia is not treated - therapeutic tactics are not aimed at reducing the number of leukocytes in the urine.
At the same time, urine is examined in dynamics in order to monitor how much leukocyturia has decreased depending on certain medical measures.
In bacterial cystitis, empirical therapy with an oral antibiotic is performed, which is effective against gram-negative aerobic bacteria (for example, Escherichia coli). The first drugs for the treatment of uncomplicated acute cystitis in women are as follows:
- nitrofurantoin monohydrate ®,
- sulfamethoxazole-trimethoprim ®,
- fosfomycin ®.
For complicated cystitis, fluoroquinolones are used.
For the treatment of acute pyelonephritis, antibiotic therapy is needed, which prevents the progression of the infection. Bacteriological analysis of urine and sensitivity testing should be performed. Empirical therapy should be adapted to the uropathogen.
Patients with moderate acute pyelonephritis are prescribed a single dose of a parenteral antibiotic, followed by oral therapy and monitoring during the first 48 hours.
In severe pyelonephritis, patients are shown inpatient treatment. It consists in monitoring the general analysis of urine and blood, acid-base balance, electrolytes. Intravenous antibiotics are prescribed before recovery and a significant improvement in the clinical picture. In some cases, anti-inflammatory, analgesic, detoxification therapy is appropriate.
Acceptable antibiotic regimens for acute pyelonephritis may include:
With urethritis - acute and chronic
Acute inflammation is manifested by pain, especially severe at the beginning of urination, its rapidity and clouding of urine. In chronic urethritis, these symptoms occur only occasionally, after hypothermia, taking large amounts of alcohol and sexual intercourse. The rest of the time, the disease may not show any symptoms.
Reasons for increased rates
Modern medicine knows a fairly large number of potential reasons why the concentration of leukocytes in the urine exceeds the norm. In addition to the physiological justifications given above, there are also pathological circumstances. The most typical of them:
- Cystitis. It is an acute inflammatory process in the bladder. According to official medical statistics, it is the most common pathology associated with the work of the urinary tract in women of reproductive age. The disease often proceeds with an increase in body temperature, frequent acts of urination, as well as pain in the pubic area.Additional provoking factors are sometimes severe hypothermia, stress, as well as uncontrolled and excess normal long-term use of drugs,
- Urethritis. Urethral inflammation in women is less common than in men, but it often accompanies complex infections of the genital tract. Pathology is sometimes asymptomatic, or expressed in a slight burning sensation when urinating. In the absence of treatment, it can provoke the development of complications,
- Vulvovaginitis. A sufficiently significant percentage of reported cases of leukocyturia is not associated with pathologies of the urinary tract. First of all, we are talking about vulvovaginitis. In this case, in the presence of active inflammation in the vagina and adjacent departments, trace amounts of vaginal secretion enter the urine, which is reflected in the results of the analysis by an increase in the levels of white blood cells, proteins and bacteria,
- Pyelonephritis. They are less common than the other pathologies described above, however, it is one of the most severe infectious and inflammatory pathologies of the urinary tract. The inflammatory process in the kidneys is accompanied by an active pathological symptom complex in the acute course of the problem, as well as certain blurred manifestations in the case of its chronic nature. Pyelonephritis, even with timely and adequate treatment, often provokes the development of complications, such as gestosis,
- Tumor. In some cases, an increase in white blood cells in the urine is caused by the formation of benign or malignant tumors in the genitourinary system. If a similar reason is suspected, the woman will be sent for additional procedures for passing tests and instrumental research methods, on the basis of which a final diagnosis can be made.
Adult Leukocyturia Prevention
For the prevention of leukocyturia as a false-positive result of a general urinalysis, it is necessary to adhere to all the rules of preparation for the analysis.
To prevent the diseases themselves that cause leukocyturia, you should:
- adhere to the rules of personal hygiene - conduct daily toilet of the external genital organs, change underwear,
- reduce the amount of synthetic underwear, as well as one that does not perform a hygienic function,
- avoid prolonged exposure to low temperatures without proper clothing,
- adhere to an optimal diet, as well as ensure a healthy sleep, to avoid immunosuppression.
Causes of white blood cells in the urine
Their excess is most likely the result of inflammatory processes (the number of white blood cells that are needed to fight various viruses, fungi, bacteria increases during infection). But there are other reasons for abnormal levels of white blood cells in the urine of women - even, for example, cardiovascular failure. The main reasons are considered:
- inflammation of the appendages, ovaries or fallopian tubes,
- kidney infections
- urinary tract obstruction,
- stagnation of urine
- some medications (therefore, if you are taking any medications, inform your doctor about this).
In addition to the main reasons, there are others, such as:
- hard work,
- chronic heart failure
- inflammation of adjacent organs of the urinary system,
- the presence of foreign bodies (catheter in the bladder, etc.).
Did you know?It is believed that the use of one's own urine reduces the risk of cancer, since it contains antigens, which, when ingested, supposedly enhance its immunity. There is no scientific confirmation of this today.
With pyelonephritis and pyelitis, which are acute and chronic, have the same manifestations. Acute inflammation of the kidney tissue is characterized by high fever, intoxication symptoms and lower back pain.Chronic pyelonephritis can manifest itself only faster fatigue, periodic headaches and rises in temperature to numbers below 38 ° C. Faster freezing of the lower back may also be felt.
What to do when high values are detected?
It should be understood that an excess of white blood cell count relative to established norms is not a disease. This is just a clear symptom, indicating individual physiological aspects of the female body or pathology of an infectious or non-infectious nature.
Modern medicine does not recommend manually normalizing the level of leukocytes in urine or blood, and immediately consult a specialist who will refer the patient to a comprehensive diagnosis, which includes in addition to passing tests, ultrasound, colposcopy and other procedures as necessary.
With the accurate detection and confirmation of the presence of pathology, a woman will be prescribed individual therapy taking into account the characteristics of the body, the current state of kidney disease and other factors.
As part of complex treatment, antibiotics, antifungal agents, antispasmodics, cytostatics, anti-inflammatory complexes, corticosteroids, probiotics and prebiotics, and other drugs as necessary can be used. It is forbidden to engage in self-medication in this situation, since in the best case a woman will only disappear part of her symptoms (which will complicate the search for the true cause of the problem), in another, her health condition will significantly worsen.
White blood cells can be detected when blood enters the urine (it contains all the blood cells), which happens with urolithiasis (when the stone injures the urinary tract), after a kidney injury or descending urinary tract, with a tumor in the kidneys, prostate, or descending urinary tract . And if urolithiasis is usually manifested by symptoms of renal colic (sharp and intense pain in the lower back, giving to the genitals), and the fact of the injury is difficult to forget, then tumors of the genitourinary system for a long time have no symptoms.
How to prepare urine for research?
For the most accurate result, an analysis should be prepared. Stick to these simple rules:
- The day before collection, do not eat foods that can change the color of biomaterial (carrots, beets, bright berries and fruits, smoked meats, sweets, etc.).
- Do not drink alcohol, coffee, mineral water.
- Do not take diuretics, vitamins, dietary supplements. If you constantly drink some medicine, notify your doctor in advance.
- It is also not recommended to take urine for analysis within a week after cystoscopy - examination of the inner surface of the bladder.
- Avoid large physical activities, visiting the baths, saunas.
- Do not give urine during an infectious disease with fever and high blood pressure.
- Before collecting biomaterial, be sure to forget about hygiene procedures.
- Immediately during collection, first start urinating and only after 2-3 seconds substitute a container under the stream.
Important!It is not recommended to give women urine for analysis during menstruation! You should not neglect this rule, since you will still get a distorted result with a deviation from the norm - an excess of white blood cells, bacteria, mucus will appear. And the procedure will have to be repeated.
Norms and causes of deviations of white blood cells in urine during pregnancy
According to modern regulatory standards of gynecological monitoring of a pregnant woman, urine is regularly taken from her for analysis of basic parameters, including leukocytes. Moreover, quite often tests show an excess of the norms of this component in urine. With what it can be connected?
As modern clinical practice shows, the causes of leukocyturia are both physiological and pathological. In the first case, the problem is due to the active physical and hormonal changes in the body of a woman during pregnancy.
Some experts believe that indicators of up to 20 units of red blood cells in the field of vision in women bearing a child can be considered a variation in the norm.
In the second case, the most typical pathologies are:
- Various kidney diseases. These include chlorenonephritis, pyelonephritis, renal tuberculosis, carbuncles, abnormalities in the position of individual parts of the organ, hydronephrosis, and so on.
- Nonrenal diseases. Often associated with negative conditions regarding the urethra, bladder and ureters. The most commonly diagnosed are fistulas, phimoses, strictures, urethritis, diverticula, cystitis, urolithiasis, and so on.
- Pathology of bearing. In the presence of even slight bleeding due to various negative conditions regarding the attachment of the placenta, the condition of the uterus, and so on, part of the biomaterial from this organ regularly enters the urine and gives a positive result for white blood cells,
- Neoplasms. In the localization of the genitourinary system, various volume formations can be present - from cysts to malignant tumors.
The presence of any of the above pathologies can pose a threat not only to the health of the woman, but also to the life of the unborn child.
In the vast majority of cases, a pregnant woman is hospitalized in a hospital for preservation with the implementation of complex measures of conservative therapy, physiotherapy and other measures as necessary.
What substances are in the urine, and what do they indicate?
Normal urine is clear, with a fuzzy odor, straw yellow. Dark urine happens when you consume insufficient water. In the renal fluid, the following indicators are considered:
- Protein. Its indicator is not lower than 0.033 g / l. An increase in the amount of protein indicates dysfunctions of the filter - the main mechanism responsible for the removal of toxic substances from the body. Most often, this condition occurs with glomerulonephritis, less often with pyelonephritis in patients older than 60 years.
- Glucose - normally not detected. If it appears, this indicates the development of diabetic pathology. Excess blood sugar is excreted by the kidneys, and this requires a large amount of fluid.
- There are no ketone bodies. Their presence is detected with acetonemic syndrome.
- Hemoglobin is absent. Its presence indicates hidden bleeding.
- Red blood cells are absent. Several red blood cells are allowed in the visual field of the microscope.
- Epithelial cells - count up to 5 in the visual field. Doctors secrete flat, renal and transitional epithelium.
- Bacteria - normally not detected.
- White blood cells - up to 6 in the field of view.
There are several types of leukocytes found in urine:
- Neutrophils. They are most of all, because they are responsible for the defenses of the body. Pus is an accumulation of dead white blood cells. The stronger the inflammatory process, the more neutrophils are in urine.
- Lymphocytes Protect the body from viruses. The presence of these cells in the urine indicates the progression of a viral or autoimmune pathology.
- Monocytes. Most active in phagocytosis. These cells are most common with interstitial nephritis.
- Eosinophils. Appear with the active development of an allergic reaction. An increase in the level of eosinophils occurs with a prolonged infectious process.
With glomerulonephritis, that is, inflammation of the renal glomeruli, which does not occur as a result of infection of the renal tissue (as with pyelonephritis), but with a strongly “active” immune response to the microbial inflammation present in the body.Glomerulonephritis can also have an autoimmune character when cells of their own immunity begin to attack the glomeruli of their own kidneys. Acute glomerulonephritis is manifested by fever, weakness, decreased appetite, nausea, and the appearance of edema on the face, which is more in the morning and less in the evening. In some cases, blood appears in the urine, which gives it a brown, black or dark brown color.
Reasons for deviation from the norm
The increase in the number of white blood cells and other elements indicates the development of pathological processes in the body. Information about what is the norm of white blood cells in urine in women and what it means to increase them is of crucial diagnostic value.
The number of leukocytes is growing for such reasons:
- increased physical or emotional activity,
- vitamin deficiency
- excessive emotional stress,
- hypothermia or, conversely, overheating of the body in conditions of changing weather,
- Times of Day,
- chronic heart failure.
An increase in the number of red blood cells in urine by more than 10 units. indicates an infection. An increase in the relative density of urine indicates the development of edema in women and diabetes.
During pregnancy, a slight excess of the norm of white blood cells is possible. This phenomenon is due to changes in metabolism and hormonal levels.
Other causes of increased rates during pregnancy:
- urinary tract infection
- decreased bladder tone
- bacteriuria without attaching the symptoms of this disease,
- contamination of test samples with vaginal discharge.
During gestation, a woman needs to be periodically checked for the presence of white blood cells and other cells in the urine. This is required for the early diagnosis of dangerous diseases.
The most common cause of an increase in white blood cells in women after 50 years is a malfunction of the immune system and kidneys. Passing a comprehensive diagnostic examination contributes to the early detection of dangerous diseases.
Norms by Nechiporenko
Urinalysis according to Nechiporenko is prescribed when pathological changes are detected during a general analysis to confirm or exclude them. The norm of white blood cells in urine in women according to Nechiporenko are the following indicators:
- Leukocyte cells - up to 2000 leukocytes in 1 ml of urine.
- Red blood cells - up to 1000 red blood cells in 1 ml of urine.
- Cylindrical elements - up to 20 hyaline cylinders.
How to normalize the level of leukocytes and other indicators contained in the urine of women?
It is possible to improve the level of leukocytes in the urine after proper diagnosis of the state of the body. To reduce their number, therapy of the underlying disease is prescribed. Most often it is caused by the introduction of pathogens.
Symptoms and signs of menopause in women at 40
Taking antibiotics helps to gradually reduce the number of bacteria and, as a result, the number of leukocytes. After 60 years, it is important for women to carefully follow the regimen of treatment and nutrition, work and rest.
Treatment of increased indicators is aimed at combating infectious pathologies. Before a doctor is recommended to drink more fluid. Cranberry juice is indicated: it has pronounced antibacterial properties. It is useful to drink tea or a decoction of blackcurrant leaves. If necessary, the doctor prescribes additional diagnostic methods:
- bacteriological culture of urine,
- ultrasound examination of the kidneys,
- a study using radiopaque substances.
To strengthen the immune system, taking decoctions and tinctures of lemongrass, aloe, ginseng is indicated. The use of these drugs is long, in some cases it can take several months.
When red blood cells appear in the urine, drugs are taken to relieve the inflammatory process in the kidneys. The use of drugs that dissolve stones is indicated.
Patients drink a sufficient amount of water and, if necessary, take antibacterial, hemostatic agents. Correction of the diet with the exception of salted, fried, pickled is shown.
With the development of infection, antibacterial drugs are used.
Leukocyturia refers to an increased number of white blood cells in the urine. In order to examine and confirm this diagnosis in more detail, there are two types of samples - Amburge and Addis - Kakovsky.
For the first sample, biomaterial is collected 3-4 hours. During this period, urination must be restrained (children are allowed to not observe this rule), and after the specified time, urine is collected for examination. The norm is 2000 leukocytes (allocated per minute).
For the second test, urine is collected throughout the day. Here the norm is 2 million units.
Important!When confirming leukocyturia, the Sternheimer-Malbin leukocytes are of no small importance. If during the study they are detected in an amount of more than 10-15%, there is a real probability of pathology.
Possible diseases and pathologies with deviation
The main reasons for the deviation have already been discussed above. Now let us dwell on this moment in more detail. This deviation may indicate:
- infectious mononucleosis,
- renal failure
- inflammatory processes of the vagina,
- pelvic injuries
- urolithiasis, inflammation of the genitourinary system, stagnation of urine,
- acute and chronic pyelonephritis, glomerulonephritis, hemorrhagic cystitis,
- sexually transmitted diseases
- the presence of parasitic worms.
Did you know?Countless white blood cells are located on the intestinal mucosa.
With renal amyloidosis
This disease is characterized by the deposition of a special protein - amyloid - first between the main "working elements" of the kidney, and then with the replacement of these structures. As a result of this pathology, normal renal tissue is mostly replaced by a non-working pink shiny tissue. The disease occurs due to hereditary disorders of certain genes. It also develops in chronic infections, tumors, autoimmune diseases.
Renal amyloidosis for some time (3 years or more) does not manifest itself, then protein, red blood cells and white blood cells begin to be lost in the urine, as a result, edema appears, the skin becomes pale. At the next stage, protein is lost even more, because of this, edema on the body also increases, ceases to respond to diuretics. Blood pressure may be increased, normal, or decreased. Shortness of breath, dizziness, weakness develop, heart function is disturbed, the amount of urine decreases.
With tuberculosis of the kidneys
It can develop as a complication of pulmonary tuberculosis or without changes in the lungs. Manifested by weakness of varying degrees, fever to low numbers, back pain, clouding of urine, in which blood is sometimes visible to the naked eye. If kidney tuberculosis is complicated by bladder tuberculosis, the same symptoms are observed as with non-tuberculous cystitis.
What are white blood cells and their function
As a rule, women do not know that there is a norm of white blood cells in the urine of women. And the name itself - a white blood cell, is not entirely familiar. If we understand in detail what leukocytes mean, then we can say the following - these are white bodies that represent a certain group of cells. They differ from their other brethren in that they have no color.
In the human body, they perform a very important function - they protect the body from pathogenic factors. They often enter into an unequal battle, as a result of which they die and, accordingly, are excreted in the urine.
For different age categories, the level of leukocytes in urine is completely different.If, with a certain age category in a woman, the level of leukocytes shows increased results, this means that health is not entirely all right, and an urgent diagnosis of the body should be carried out.
In any case, this factor cannot be ignored, sometimes a deviation from the norm may indicate oncological tumors. Therefore, each person should take tests and check the number of white bodies in the body. Yes, and it is advisable to know the norm of white bodies in the urine.
In what cases is it prescribed to take an analysis for white blood cells
At the first sign of ill health, a person goes to the doctor, and he, in turn, appoints to take various tests to identify the cause of the disease. One such test is a general urine test. It allows you to determine the number of white blood cells in the urine.
And the doctor can prescribe treatment based on the results. So, there are many reasons for checking white blood cells, and these factors include:
- Inflammatory processes in the body.
- Suppurations and abscesses.
- The defeat of the body by viruses and bacteria.
- The development of oncological tumors.
- Myocardial infarction.
- Excessive exercise.
Based on the results, the doctor prescribes treatment or continues to examine the patient. This directly depends on whether the white blood cells in the urine are increased or decreased. If the level is significantly reduced, then the doctor recommends checking the entire lymphatic system and the red brain, since they produce blood cells.
What does the presence of white blood cells in urine mean?
White blood cells are white blood cells. Their main function is to provide the body with immune defense. They are synthesized in the bone marrow and peripheral lymph nodes.
Five main types of white blood cells are distinguished.
The increase in each of these species will talk about individual processes:
- Neutrophilic white blood cells (neutrophils) - this is the main, most numerous class of white blood cells. They are responsible for protecting our body from bacterial and fungal agents, as well as from simple microorganisms. These cells are always present in the focus of inflammation. Dead neutrophils are pus. Accordingly, their number increases in the urine with any inflammatory processes of the urinary system, and, importantly, only bacterial or fungal in nature. This can be pyelonephritis (inflammation of the pyelocaliceal system of the kidneys), cystitis (inflammation of the mucous membrane of the bladder), acute stage of glomerulonephritis (autoimmune-inflammatory lesion of the renal glomeruli).
- Lymphocytes - they also provide a protective reaction of the body, only from viruses, and not from bacteria. Therefore, lymphocytes in the urine will be observed with viral lesions of the urinary system or autoimmune processes.
- Monocytes - they are most active in the processes of phagocytosis (absorption) of pathogenic bacteria and foreign cells. Monocytosis in the urine will be observed with a disease such as interstitial nephritis (inflammation of the interstitium of the kidneys).
- Eosinophils - are the main indicator of allergic processes in the body. Moreover, an increase in eosinophils is most often observed in chronic allergic processes. It can also be with cystitis and non-bacterial glomerulonephritis.
- Basophils - they are responsible for the development of inflammatory mediators (substances that provide a complete clinical picture of the inflammatory process), play an important role in blood coagulation, increase vascular permeability and participate only in immediate allergic reactions.
The excretion of leukocytes in the urine is called leukocyturia. If the number of leukocytes exceeds 100 cells in the field of view, then this phenomenon is called pyuria - pus in the urine.
How to prepare for analysis
In order to collect urine, you need to properly prepare. For this, women should conduct personal hygiene, and for a more informative and reliable analysis, it is worth following simple rules:
- For 12 hours, exclude sweets, alcohol, spicy and smoked foods from the diet.
- Do not take vegetables and fruits, as they affect the color of urine.
- Do not use multivitamins.
- Stop taking medications.
- During the menstrual cycle, urine can not be collected.
- A day before the collection of the analysis, it is desirable to avoid physical exertion.
How is bacteriosis on microflora
Urine for examination is collected in the morning, in clean containers with a lid. Such containers are sold in pharmacies. Before proceeding with the collection, a woman must tidy up her genitals. Rinse the genitourinary sphere to avoid unnecessary elements entering the urine that will affect the result.
More about leukocyturia
By origin, leukocyturia can be true and false. True is observed when white blood cells themselves are formed directly in the urinary organs, and false - that they entered the urine due to insufficient cleansing of the external genital organs. That is why before collecting urine, it is very important to thoroughly wash and urinate only in a sterile container, purchased at a pharmacy.
Also, leukocyturia is divided into bacterial (that is, associated with the presence of infection) and non-bacterial (it is also called sterile). With sterile leukocyturia, white blood cells are present in the urine, but there are absolutely no bacteria.
Depending on the number of leukocytes, insignificant, moderate and significant leukocyturia is secreted. With an insignificant number of cells does not exceed 40 in the field of view, with a moderate one - no more than 100, and with a significant one there is pyuria (or “white blood cells”).
So, what could be causing leukocyturia.
The causes of pathological deviations can be a large number. Among them, the main ones are the following:
- interstitial nephritis,
- renal transplant rejection,
- kidney tuberculosis,
- urolithiasis disease,
- malignant tumors of the kidneys, bladder,
- inflammation of the uterus and other diseases of the female reproductive system (vaginitis, candidiasis, vulvovaginitis),
- parasitic infections
- heart failure.
We should not forget that the norm of white blood cells in urine in women is from 0 to 6, or single in the field of view. In pregnant women, it can increase to 10.
In women after 50 years old, numbers up to 4-6 are considered the norm of white blood cells in the urine, since in old age kidney stones and hormonal imbalances are often observed.
With appendicitis, when the inflamed appendix lies on the bladder, leading to reactive inflammation of the latter. By the way, appendicitis is not always acute, which is very difficult not to notice. In some cases, the disease takes a chronic course, manifested by periodic pains in the lower abdomen and on the right, which are aggravated by physical exertion, nausea, bloating, constipation or diarrhea.
For allergic diseases
With allergies caused, among other things, by the vital products of parasites. Changes similar to those observed from the skin (urticaria) or nasopharynx (allergic rhinitis), with severe allergies appear in the intestines and urinary tract. As a result, the mucous membrane of the urinary tract inflamed under the influence of histamine becomes a source of white blood cells.
What to do if urine contains a lot of white blood cells?
If a large number of leukocytes was found in the analysis of urine, then it is urgent to consult a doctor, as this may mean the development of serious inflammation in the body.
The doctor will conduct the correct decryption of the analysis, and may also prescribe additional studies to clarify the diagnosis. For example, this may be a urinalysis according to Nechiporenko.
Urinalysis according to Nechiporenko is prescribed to determine the number of formed elements in 1 ml of urine.
Normally, the number of shaped elements has the following meanings:
- White blood cells - up to 2000 / ml.
- Red blood cells - up to 1000 / ml.
- Cylinders - up to 20 / ml.
With the correct assessment of the test results and diagnosis, the doctor is likely to prescribe treatment.
If this is an inflammatory process, then you will have to take antibacterial drugs (antibiotics) for the speedy destruction of pathogenic bacteria in the urinary tract.
With diabetic nephropathy
If a person has diabetes, he needs to control not only the level of glucose in the blood, but also a general urine test. The appearance of leukocytes here indicates that due to the long-term maintenance of a high concentration of sugar, the vessels that feed the kidneys were damaged, which causes tissue damage. This is diabetic nephropathy.
White blood cells are almost colorless, less numerous than red blood cells and have the ability to move. Two types are found in peripheral blood:
Agranulocytes make up approximately 60% of the leukocyte formula. These include units such as monocytes and lymphocytes. The percentage of monocytes is about 2-9%, which allows you to stimulate the antigens of the immune system. Lymphocytes include B cells and T cells.
The former produce antibodies that are used to attack invading pathogens and toxins. Others destroy their own structural compounds that have been affected by harmful microorganisms.
Granulocytes consist of three types - neutrophils, eosinophils and basophils. They contribute to the killing of fungi, bacteria and other pathogenic microorganisms. Eosinophils allow you to attack all types of parasites, they also play a role in allergic reactions. The goal of neutrophils is bacteria and fungi, while basophils are released during allergic reactions and asthma. The following distribution of granulocytes: 50-60% of neutrophils, 1-4% of eosinophils, less than 2% of basophils - this is the norm of white blood cells in urine in women.
Interpretation of tests: the norm of white blood cells in urine in women and possible causes of deviations
Urinalysis is one of the most common studies in laboratory diagnostics.
Along with the UAC, which is increasingly carried out using automated systems, clinicians use various tests and provocative tests.
A study of urinary sediment reveals changes in the urinary system. Many kidney diseases are accompanied by leukocyturia. The norm of white blood cells in urine in women and children differs from that in men, but the excess of these values is often associated with the same pathological processes.
With systemic lupus erythematosus, then this complication is called lupus nephritis
Systemic lupus erythematosus can be suspected by the appearance of characteristic redness in the face of the cheeks and nose bridge (resembles a butterfly), “strange” temperature rises, muscle and headaches, hair loss in areas, and brittle nails. The fact that nephritis has developed is indicated by edema that appears on the face, legs and feet, the appearance of lower back pain, and an increase in blood pressure.
Analysis of the urinary sample provides the general numbers and differentials of the leukocyte formula, as well as qualitative and quantitative changes. It indicates the concentration of neutrophils, segmented lymphocytes, monocytes, eosinophils and basophils that are present in the blood.
The following factors affect the concentration of the leukocyte group:
- sample collection time
- bad habits like smoking
- taking medications
The reference norm of white blood cells in urine in women facilitates the interpretation of laboratory tests of urinary fluid. An absolute score is a more important indicator than a relative value (%) from a clinical point of view.
A small density of white blood cells in urine is a normal indicator, as they age and collapse, and then are excreted with urine. But with UTI or more serious illnesses such as cancer, studies show higher concentrations of segmental units in urine.
White blood cells can be seen under the microscope, examining the prepared slide of a urine sample. They are also considered using the high power of the device in a 40-fold approximation. The normal leukogram in excretions should be a small volume, it is determined in the following ways:
- 0-5 under a microscope or 0-10 in a centrifuge,
- per 1 mm 3 of fresh sample - 8-10,
- 1 mm 3 daily urine - 2-5.
If the analysis showed an increase in the leukocyte formula, the doctor instructs the patient to undergo additional testing to diagnose some hidden processes, as well as to make sure that the treatment is correct. The norm of white blood cells in urine in women according to the Nechiporenko method should be no more than 2000 / ml.
How are the calculations made?
To determine the number of cellular elements using microscopy of urine sediment deposited on a Goryaev chamber with a volume of 0.9 μl or Fuchs-Rosenthal mesh containing 3.2 μl.
The researcher takes a certain amount of biological substrate, centrifuges it, removes the supernatant and drips the resulting material onto the surface of a special device.
First, a fresh drug is surveyed, then an accurate count of the number of specific cellular elements is performed. The simplest way to determine apparent leukocyturia is to evaluate a general urine test (OAM). The laboratory technician examines the sediment under a microscope and, when leukocytes are detected, indicates their detected amount (from units in the field of view to massive pyuria).
There are rapid tests, auto and semi-automated urine analyzers that simplify the study. Classical methods for laboratory diagnosis of urinary tract diseases are considered tests according to Nechiporenko, Amburge, Kakovsky-Addis.
Research is carried out, if necessary:
- exclude / confirm the inflammatory process of the urinary system in the absence of an increased content of leukocytes in the clinical analysis of urine,
- compare the quantitative ratio of leukocyte and hematuria,
- dynamic monitoring of renal pathology.
Each analysis is carried out with some features. A study by Nechiporenko suggests taking an average portion of morning urine.
The patient is asked to first urinate past the jar, collect the main part in the dishes and complete the act of urination in the toilet. For research on Amburge, urine is taken for 3 hours. A test is performed to temporarily evaluate leukocyturia and hematuria (in one minute).
The number of leukocytes in 1 μl of urine is determined by adding the result to the numerator (A): x = A / 0.9 or x = A / 3.2 (using the Goryaev or Fuchs-Rosenthal camera, respectively). Then calculate the number of cellular elements per day, either contained in a milliliter of urine, or excreted per minute.
Optimal would be the initial placement at the bottom of the vessel of substances that preserve the quality of the biological fluid (a few drops of formalin or up to three crystals of thymol crystal).
In the laboratory, the resulting volume is measured, mixed. To directly calculate the number of cell units, take part of the urine excreted in 12 minutes.
After routine manipulations, the concentration of leukocytes in a microliter is determined and daily leukocyturia is calculated.The resulting content of the shaped elements is multiplied by the volume taken for direct counting (500 or 1000 μl), and time factors (5 * 24).
It is possible to determine false results with an underestimation of the number of leukocytes. Alkaline environment contributes to the rapid decay of immune cells. Before passing the test, the patient is recommended to switch to a meat diet with fluid restriction. Such a diet promotes acidification of the pH of urine.
Reference standard for pregnant women
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In order to constantly monitor the changes at each appointment with the gynecologist, the expectant mother necessarily passes an analysis of excretion, which is a prominent indicator of health.
The norm of leukocytes in the urine of pregnant women is 10,000 cells per μl or 0-5 units. in sight. Sometimes in urine, the concentration of biological components of the immune system is up to 30,000 units. per μl and this is not considered a pathology.
If the analysis showed an increased number of white cells, there are several reasons for this:
- Urinary tract infections are the most common medical problem during pregnancy. Expectant mothers have an increased volume of the bladder and its reduced tone due to the weight of the child. Complete emptying of the bladder becomes difficult, which leads to the growth and reproduction of bacteria.
- A kidney infection, also known as pyelonephritis, occurs when you ignore UTI. Sometimes accompanied by fever, pain in the side, nausea and vomiting.
- Asymptomatic bacteriuria - the development of bacteria in the urinary tract without symptoms.
- Other pathologies are contaminated samples with vaginal secretions.
Analysis of urine and white blood cells: the norm in women (table)
White blood cells as representatives of the immune defense under normal conditions constantly “monitor” various organs and systems for the presence of foreign antigens. This property justifies the possible entry of white blood cells into the urine. In women, the normal values of leukocytes in OAM are slightly higher than men's indicators.
You can find out what is the norm of white blood cells in urine in women from this table:
|Study||WBC reference values|
|Clinical analysis of urine (general)||up to 5-6 leukocytes in the field of view|
|Test according to Kakovsky-Addis||less than 2 * 106 units / day|
|Sample by Nechiporenko||less than 2 * 103 units / ml (according to some guidelines up to 2.5 thousand cells)|
|Amburge test||less than 2 * 103 units / min (according to some guidelines up to 2.5 thousand cells)|
Exceeding the normal values of urine white blood cells is of varying severity:
- insignificant (7-40 in the field of view),
- moderate (41-100 in sight),
- pronounced / pyuria (more than 100 cells).
The presence of a clinic of a urinary tract infection without manifestations of leukocyturia becomes the reason for provocative tests. The patient undergoes a urinalysis, after which Prednisolone is administered to the patient in physiological saline and urine is taken three times on the same day.
The next day, OAM is repeated. An increase in leukocytes in two or more times in at least one serving, in comparison with the control results, indicates the presence of inflammation of the urinary tract.
Women should remember that the result of the study depends on the quality of preparation and collection of urine. The entry of leukocytes from the vagina can give a picture of false leukocyturia. The distortion of the results is facilitated by the administration of Aspirin, Allopurinol, Kanamycin, Methicillin, Ampicillin and saline preparations of iron.
Minor leukocyturia may be a physiological response to increased physical activity. Such changes in OAM are considered as a variant of the norm.
Indicators in women older than 50 years
The norm of white blood cells in urine in women after 50 years is 6 units.1 μl when examining the sample under a microscope. Their number is written in the form of the designations "small", "some", "moderate" or "large number".
Since there should not be any impurities in urine, therefore, the presence of white cells is considered pathological. They often indicate urinary tract infections.
The norm of leukocytes for women in the analysis of urine is shown in the table.
Components of the immune system may be present in the contents of the bladder, only in small quantities. When they increase, it indicates inflammation of the urinary tract, kidneys, or other serious diseases. In any case, it is necessary to undergo examinations to identify the reasons for the increase in their density.
What threatens deviation from the norm?
The appearance of an increased content of leukocytes in the urine corresponds to the activity of inflammatory processes from the urinary system. Common diseases accompanied by leukocyturia are cystitis, urethritis, and kidney damage. White blood cells are represented by various groups.
The increase in certain leukocyte elements largely corresponds to a specific pathological process:
Any of these conditions can eventually lead to a decrease in functionally active kidney tissue and the development of renal failure.
The most favorable course is acute cystitis and urethritis, which are quickly diagnosed and, as a rule, are successfully treated with antibiotics.
The remaining nosological units are prone to chronic course.
To determine the topics of the inflammatory process, they can resort to a two- or three-glass sample.
The essence of the analysis is to collect urine in one act of urination in several jars. An increase in leukocytes from the biomaterial of the first portion at normal values from the rest indicates urethral pathology. Isolated leukocyturia in the third glass is a sign of bladder damage.
Total changes in all urine tests indicate inflammation of the kidneys or ureters.
The appointment and interpretation of the results of OAM is performed by the attending physician. The patient is required to comply with all recommendations, pre-rinse the genitals with running water before collecting urine, do not take an analysis at the time of menstruation.
The quality of the laboratory test largely depends on the correct approach of the subject.
Examination of the urinary residue to detect leukocyturia is a relatively simple and affordable diagnostic method that helps to detect urinary tract disease in a timely manner and begin treatment.
Elevated white blood cells in urine in women
Additionally, leukocyturia in women develops as a result of “false” reasons, that is, not associated with the kidneys and not with the body as a whole, but with diseases of the female genital organs. It:
- Vulvovaginitis (inflammation of the vagina and external genital organs), including candida origin. It is usually manifested by discomfort in the vulva and vagina, sometimes itching, discharge from the vagina of various colors and character, which depends on the pathogen. So, with candidal lesion (thrush), this is usually curdled whitewash.
- Bartholinitis (inflammation of the bartholin gland at the entrance to the vagina). The acute process is manifested by the appearance of edema and pain in the genital area, which intensifies when sitting, walking, having sexual intercourse, visiting the toilet, it becomes extremely painful to touch one large labia. Also, with acute bartholinitis, body temperature rises to high numbers, weakness and chills appear. In chronic bartholinitis, periods of remission without symptoms are replaced by the appearance of a painful, densified area in the region of the labia majora, which is accompanied by pain during movement. Body temperature may rise, but - to low numbers.
- Adnexitis - This is an inflammation of the uterine appendages, which can be either unilateral or bilateral. It is difficult not to notice acute adnexitis. This is pain on one side of the abdomen, radiating to the rectum and sacrum, fever, weakness, the appearance of purulent or copious mucous discharge from the vagina. If the disease is not treated, it becomes chronic. Then, menstrual irregularities come to the fore, periodically the same symptoms appear as in the acute process, but less pronounced.
An increase in white blood cells in urine during pregnancy above 9-10 cells in the visual field cannot be a sign of normal. It suggests that a woman has one of the pathological processes that are discussed above. Most often, pregnant women may develop cystitis (chronic cystitis often worsens) or pyelonephritis. Both of these pathologies are associated with the fact that the urinary tract is squeezed by the growing uterus, and urinary stagnation occurs in them.
White blood cells in urine during pregnancy can also increase due to thrush of the genitals, which often worries a woman because of a decrease in immunity, which is natural for pregnancy. But the most formidable reason for such a change in the general analysis of urine is gestosis of 2 half of pregnancy, when the kidneys suffer from the fact that the body perceives the fetus as a foreign organism. In this case, not only leukocyturia is necessarily observed, but also an increase in protein in the urine. In this case, hospitalization in an obstetric hospital for further diagnosis and treatment is mandatory, since gestosis is dangerous for the life of both the mother and the child.
Elevated white blood cells in urine in men
If a man has more leukocytes in his urine than necessary, then in addition to the reasons listed above, characteristic of both sexes, this may be:
- Prostatitis. When this is an acute process, it manifests itself as painful urination, while the pains are localized in the sacrum and perineum, intensified by bowel movements. The temperature rises, and with a far advanced process, urine outflow is difficult, erectile function suffers. In chronic prostatitis, only slight discomfort or slight pain during urination can be felt, the temperature periodically rises to very low numbers. More often the disease proceeds without symptoms.
- Phimosis - fusion of the opening of the foreskin - it is difficult not to notice: in the erect state, the head is not fully exposed or cannot be exposed at all. In a severe stage, urination is also disturbed: urine first inflates the adhering foreskin, and then, dropwise, flows from the formed "bag".
- Balanoposthitis - inflammation of the skin covering the penis, usually passing to the head. It manifests itself as painful sensations in this area, itching and burning, fever, the appearance of secretions, increased libido due to irritation of the head, high body temperature.
- Prostate adenoma It does not appear for a long time - until the prostate enlarges enough to begin to block the outflow of urine. Later, its symptoms are a decrease and intermittent urine stream, forced tension at the beginning of urination, which is later replaced by pain. When, due to compression of the enlarged prostate, the bladder stops completely empty, the man is worried about frequent and strong urination, you have to get up to the toilet several times even at night. If complications join, blood appears in the urine, either urinary incontinence develops, or its complete retention.
- Prostate cancer the symptoms do not differ from prostate adenoma. If a man does not undergo planned examinations by a urologist or ultrasound, and the cancer reaches the stage where metastases appear, pain in the bones or spine, cough (if metastases in the lungs), weakness and icteric staining of the skin (if metastases in the liver).
The taxonomic position of leukocytes in the general analysis of urine
White blood cells are colorless (otherwise white) blood cells whose task is to protect the body from the penetration of foreign agents (viruses, bacteria, parasites, allergens).
The leukocyte formula is represented by several types of cells (neutrophils, lymphocytes, monocytes, eosinophils, basophils), each of which is responsible for the differentiation and destruction of one or another agent (antigen).
These processes affect all body systems, including the urinary system. The presence of colorless blood cells in the urine is explained by the fact that leukocytes conduct a kind of check of the urinary organs for invasion of the genitourinary system of infections, bacteria and viruses.
For such control, an insignificant number of leukocytes corresponding to accepted laboratory standards is sufficient. In the presence of antigens, mobilization occurs, and a significant increase in the number of leukocytes trying to eliminate the threat.
Thus, an excess of the norm of leukocyte cells, otherwise leukocyturia, indicates the development of the inflammatory process.
Other uniform elements examined during urinal microscopy include:
- glucose (sugar) - normal ≤ 0.8 mmol / l,
- protein - the maximum value of 0.033 g / l, ideally - is not detected,
- erythrocytes (red blood cells) - ⩽ 3,
- hyaline cylinders (elements formed from primary urine protein) - in urine sediment no more than 20.
The rest of the analyzed biological substances, bilirubin, ketone bodies, cylinders (granular, erythrocyte, epithelial, waxy), salts, bacteria and fungi are not detected in healthy urine.
Elevated white blood cells in urine in children
When a child has more leukocytes in her urine than normal, these may be the same reasons as in adults, with the exception of processes such as prostatitis, adenoma and prostate cancer in boys. Rare for childhood are amyloidosis, tumors (benign and malignant) and urinary tract cysts.
Each age of the child is characterized by a different set of diseases accompanied by leukocyturia:
- Up to a year some severe congenital malformations of the urinary tract begin to appear, drug damage to the kidneys, vesicoureteral reflux (urine reflux from the bladder to the ureters). Leukocyturia can occur with diaper rash, as well as in the case when the child has diathesis (in children with diathesis, the white blood cell count in the urine is 2 cells higher than in peers without this allergic disease). In girls at this age, vulvitis can already take place, then even with the naked eye parents can notice redness and swelling in the labia minora and vestibule of the vagina.
- When a child is one year old, leukocytes speak of enterobiosis (pinworms), inflammation in the urinary tract: urethritis, cystitis, vesicoureteral reflux, less commonly glomerulonephritis. In girls, this may be a sign of vulvitis.
- Up to 3 years the main causes of leukocyturia are: enterobiosis, kidney injury, vesicoureteral reflux, urinary tract infections, including pyelonephritis. They, manifesting for the first time at this age, often acquire a chronic course, and with improper treatment can be complicated by pyonephrosis. In boys at this age, phimosis debuts.
- From 3 to 5 years leukocyturia can indicate enterobiosis, urolithiasis, urethritis or cystitis (more often), pyelonephritis (less often), kidney injury, glomerulonephritis. Girls have vulvitis, boys have balanoposthitis.
- Age from 5 to 11 years typical for urolithiasis, urinary tract infections, acute appendicitis, kidney injuries, glomerulonephritis. If there was a bladder-ureter reflux of a mild course, then at 6-7 years, on the contrary, it can be cured independently.At this age, enterobiosis can also occur, becoming the cause of leukocyturia.
- In children over 12 years old the causes of leukocyturia can be all those diseases that are characteristic of adults. As already mentioned, with the exception of tumor diseases, diabetic nephropathy, amyloidosis.
Varieties of urine research and white blood cell count
What norm of leukocyte cells corresponds to the female body depends on the method of urine examination. The main study is a general clinical analysis of urine. According to indications, the doctor may prescribe:
- sample according to Nechiporenko. A study of urine sediment, designed to detect leukocyturia, hematuria (high red blood cell count in urine), cylindruria (presence of cylinders). Microscopy reveals chronic, acute and latent ongoing inflammation of the urinary system. For analysis, it is necessary to collect the average
- test of Addis-Kakovsky. Determines the number of shaped blood cells (white blood cells, red blood cells) and cylinders. Effective for the diagnosis of pathologies of the renal apparatus. Urine is collected overnight in a 3-liter container (jar), then mixed. 60 ml of biofluid are sent for research.
- Amburge test. Performed to evaluate kidney function. For analysis, 10 ml of urine (of the total volume) collected over three hours should be taken.
Table of normal values of leukocytes in urine in women by study type
|Analysis||By Nechiporenko||Test Addis-Kakovsky||Sample Amburge|
|norm indicators||2000-4000 cells / ml||2 * 106 cells / ml||2000 cells / ml|
The reference values of leukocyte cells in urine in women for a general analysis are from 0 to 6 in the field of view (in men, from 0 to 3). Doubled female norm indicators, relative to male values, are due to the anatomical structure of the genital organs. The leukocytes contained in the vaginal discharge often fall into the short and wide female urethra (urethra).
If the results of the analysis fit within the normal range, this indicates the absence of infectious, bacterial, viral and fungal infections. In case of exceeding indicators, leukocyturia of the general analysis of urine is classified as follows:
- up to 50 white blood cells - a slight deviation, the presence of pathogens that cause inflammation.
- up to 100 leukocytes - moderate, the presence of an inflammatory process,
- up to 250 units - pronounced, indicates acute and chronic pathologies,
- over 250 cells - pyuria caused by purulent-inflammatory diseases of the urinary system.
Important! All elements of urine studied during the analysis are correlated with each other. An objective assessment of leukocyturia is possible only by comparing the results of other microscopy parameters (red blood cells, cylinders, protein, etc.) with their reference values.
In female infants, white blood cells in the general urine analysis are normally 8–9 units in the field of view. This is due to the imperfect development of the immune system, when blood cells do not yet work at full strength, and more are needed to protect the body.
In the perinatal period, the number of white blood cells in the urine can increase to 15 units, which is not a pathology. A change in indicators is usually associated with a decrease in immunity during pregnancy.
A slight increase in white blood cells during pregnancy occurs in seven out of ten cases
What is the function of white blood cells
The rate of leukocytes in the urine of women, men and children is different from each other. But the function of these substances or bodies is one and the same. They serve as an indicator of health or a defensive reaction of the body. You can even say that, in this way, immunity reports on its activities. You can identify or find such a “report” in the collected morning urine.For this, they pass a general analysis. Naturally, such an examination, if necessary, is carried out at any time of the day, but for greater fidelity, the information obtained will be dubbed using the morning collection of material.
The norm of leukocytes in the urine in women, men and children is different from each other
The generation of white bodies, this is what leukocytes are called, occurs due to the bone marrow and lymph nodes. If nothing threatens human health, and viruses and bacteria are absent, then the norm and number of leukocytes in the urine will be either insignificant or even absent. To determine the norm, use the table. After carrying out and removing all substances, they look at the result. The urine of a healthy person, regardless of gender and age should be:
|Salts and bacteria||Are absent|
|Cylinders and hemoglobin||Are absent|
|Epithelial cells||Present in the field of view in an amount of not more than 5|
|red blood cells|
|white blood cells|
But the best indicators are in sight, i.e. from 0 to 3
|Bilirubin and ketone bodies||Not valid|
|Glucose||May reach 0.7-0.8 mmol|
|Protein||The best option if it is absent, but if in the amount of 0, 03, then it is also allowed as non-deviation|
|General characteristics||The urine of a healthy person can be light yellow or straw yellow. Transparent and without sediment. You can always notice violations of general indicators yourself|
Important! It’s worth going to the hospital to identify inflammatory processes or other disorders in the body after changing the color of the urine. But consider some of the nuances. For example, eating affects color and sometimes smell. This is very clearly seen after eating beetroot or salted fish. But the norm of leukocytes in the urine of a man or woman will not change from this.
What to do with an increase in white blood cells in urine
There is a special algorithm of actions that must be followed in order to establish the cause of leukocyturia:
- Have a thorough toilet of the external genitalia as described in the section below, and only then pass a general urine test again.
- If the second analysis is normal, doctors recommend not to calm down, but, by prior agreement with a nephrologist or urologist (especially if it concerns a child), collect urine during the day for Addis-Kakovsky's test. Only if there is a norm, you can do nothing further.
- If in the second urinalysis the leukocyte count is again increased, even if it is a 3-5-cell number, 2 tests are needed: bacterial inoculation of urine (for this urine must be given after genital hygiene and necessarily in a sterile jar) and a three-glass sample. According to the data of bacterial seeding, it is possible to determine which pathogen caused inflammation, and according to the three-glass sample, its localization can be established.
A three-glass test is most often performed in a hospital, in order to avoid errors, but can also be performed at home. For it you need 3 identical clean containers, which are numbered accordingly: “1”, “2”, “3”. After genital hygiene, you need to start urinating, but make it so that very little urine (1/5) gets into the first glass, the maximum amount (3/5) in the second, and the last few drops (1/5 of the volume) in the third .
Then 3 glasses are sent to the laboratory, where in each of them the number of leukocytes is counted. Further reasoning is as follows:
- if the maximum number of these cells is in bank No. 1, then it is urethritis, vaginitis or enterobiosis,
- if the maximum number of leukocytes is in sample No. 3, then this indicates prostatitis or inflammation of deeper tissues in the small pelvis,
- if there are many cells in all three samples, then inflammation is either in the kidneys or in the bladder.
- If the leukocytes are enlarged in all samples during a three-glass test, an ultrasound of the kidneys and bladder is performed. Next, determine in which organ inflammation. If, according to ultrasound, this is the bladder, an x-ray cystography is performed. If, according to ultrasound data, this is the bladder, you need to do urography or renoscintigraphy.
- If when conducting a three-glassed sample, the maximum number of leukocytes is in the first portion, the following tests are needed: an imprint on enterobiosis in both sexes, in men - a smear from the urethra, and in women - a smear from the vagina. Both smear should be sent to a bacteriological laboratory.
- During a three-glass test or a separate study, it is necessary to determine the shape of the white blood cells:
- if most white blood cells are neutrophils, it says: pyelonephritis, cystitis, urethritis, acute glomerulonephritis, or an exacerbation of chronic glomerulonephritis. A special staining with genzialviolet and saffronin will partly help to distinguish pathologies. It can detect Sternheimer-Malbin cells (active white blood cells). If there are a lot of them, this speaks in favor of pyelonephritis,
- if most are mononuclear cells. They are determined in the later stages of glomerulonephritis, as well as with instertial nephritis,
- when a lot of eosinophils, then with negative urine culture, this is an excellent help to the doctor. So he learns that the cause of leukocyturia is allergic diseases,
- if most cells are lymphocytes, this indicates lupus or rheumatoid nephritis, glomerulonephritis.
Before all these studies, you should not self-medicate: both antibiotics and alternative methods can be used only on the basis of an established diagnosis.
How to pass urine
In order for leukocytes from the genital tract not to get into the urine, whether it be a child or an adult, he needs to prepare for the study. To do this, you need to buy a sterile jar for urine in the pharmacy, and for the baby - also an urinal, which is glued to the genitals (they are different for boys and girls).
The day before the test, exclude sorrel, game, chocolate from the diet, red wine for adults. You also need to consult a doctor if Prednisolone, Dexamethasone, other hormonal or antibacterial drugs can be canceled 2-3 days before this laboratory test.
Immediately after waking up, you need to wash yourself with soap, and wash everything: inguinal folds, genitals, external anal sphincter with movements directed from front to back. Next, carefully open the lid of the can and collect urine there. For a general analysis, not an average, but a full portion of urine is needed: at least 5 ml (in infants) and not more than 150 ml in adults.
What you should know about the norm of the substance
White blood cells the norm for women in the urine and male will vary depending on the following phenomena and factors:
- Excess even by one leukocyte serves as a signal for additional studies. According to immunologists, such scouts serve as an indicator that there are minor problems. But their immune system is able to solve itself. They give a signal when an infection occurs and contribute to the production of antigen.
- Mandatory look at the state of permeability of blood vessels and their walls. The fact is that white bodies can penetrate from the blood, but they do not affect the state of health.
Exceeding even one leukocyte in the urine in women is a signal for additional studies
How many leukocytes should be in urine? For each gender, these indicators are changed. So in the female half of humanity, up to 6 pieces are normal when taking material. But for men, this figure will be considered a deviation. The maximum allowable figure in the analysis of strong representatives reaches three.
If we talk about children, then they also look at sexual characteristics:
- girls - maximum 10,
- boys - 7.
Why are there such differences? The fact is that how much normal white blood cells are in the urine directly depends on the anatomy. The female structure of the genitourinary system and the male is different. So the urogenital system of women is hidden completely in the abdominal cavity. Therefore, the organs are all nearby and any bacterium is able to migrate through them. Because of this, there is an increase in all indicators, including white blood cells.
Often you have to retake research material due to improper collection of urine
Often you have to retake material for research due to improper collection of urine. It will not be possible to hide negligence, since the indicators of white bodies increase immediately and can reach the level of 10. It is worse if the entire collection procedure was carried out correctly and a repeated examination shows the same result. This indicates a clear pathology. Most often, such indicators indicate violations that have occurred in the kidneys. The urologist or gynecologist, having received such results, sends the patient for further examination:
- ultrasound examination of the abdominal cavity,
- study of the kidneys by various methods,
- Bakseeding. For this, urine is again used, but studies are already being carried out according to different methods,
- epithelial scraping.
How does age affect the rate of white bodies
The norm of white blood cells in urine in women after 50 years and, say, pregnant women will vary. Plus, in adolescence, they are significantly changed. That is why when issuing a referral to the laboratory, the doctor indicates the age and gender of the patient. This is necessary to get reliable results.
The rate of white blood cells in urine in women after 50 years and, say, pregnant women will vary
It is worth considering all the possible options that may occur during the examination.
According to the table, it is clear that the maximum level of white Taurus can reach the level of 6. Better, of course, is generally zero. There is one distinguishing feature that only women take into account - critical days or bleeding. Once in the blood material, dramatically changes performance, and distorts the result. The level immediately rises. In any case, it will be necessary to re-examine the material.
In the body of a pregnant woman, not only hormonal change occurs. All organs begin to function differently. Accordingly, the indicators of all substances will be changed. In any case, this fact is taken into account when examining urine. So in the normal state of a woman, an amount reaching 10 is a deviation. And during pregnancy - the norm. Exceeding this mark is evidence of ongoing inflammatory processes. Immediately carry out additional tests. Most often this is an ultrasound and smear. Such an increase can cause candidiasis, cystitis, colpitis, and kidney or urinary stones. But the woman herself notices the appearance of discomfort.
50+ or older women
The norm of white blood cells in urine in women after 60 years old ranges from 4, but does not exceed 6 units. Any slight deviation indicates kidney stones and salt deposition. Unfortunately, indicators at this age are always overestimated, since the presence of these diseases in people of advanced age is constant.
The stronger sex has a completely different structure, there are no such hormonal bursts as women in different periods of life. Hence the reason for such a norm as the complete absence of white blood cells or a maximum of 2 units. Towards the age mark of 50+, this figure is increasing to 4, and by age 60 it will become 6 units.
Analysis of urine for white blood cells: what do the indicators mean
Suspecting a disease, doctors often send the patient for urine analysis. This type of laboratory research allows specialists to diagnose the state of the immune, cardiovascular systems, kidneys and other organs. If a large number of white blood cells in the urine is detected, it is worth being wary. Find out why.
What is white blood cells in urine?
So-called white blood cells, whose task is to suppress infections, protect the body from harmful microorganisms. The photo shows that these large blood elements are not colored, differ in structure, purpose, are the main elements of the immune system. Cells are able to pass into all organs, tissues, can move independently thanks to pseudopods.
If a person increases the number of bacteria, viruses, foreign particles, white blood cells destroy them, die themselves and are excreted in large volumes in the urine. According to the analysis, the doctor diagnoses the inflammatory process. The presence of white blood cells in the urine is not a pathology if the norm is not exceeded (according to the table). You should sound an alarm if a certain threshold is exceeded.
Indications for the study
A general urine test for women is prescribed:
- according to symptomatic complaints of the patient,
- in the framework of medical examination, examination, etc.,
- when registering for pregnancy,
- to monitor ongoing therapy,
- for preventive purposes.
Indications for the test for Nechiporenko, Addis-Kakovsky, Amburge are:
- unsatisfactory results of the general analysis (increased white blood cell concentration, protein detection),
- chronic diseases of the genitourinary system.
A study on Nechiporenko is conducted during pregnancy to evaluate the functioning of the urinary and urinary organs.
How to take a urine test
This type of diagnostic study is very important, it is prescribed for suspected a variety of diseases, as well as to monitor the effectiveness of treatment. If the white blood cells in the analysis of urine are elevated, there is a high probability of the presence of pathology, the inflammatory process. To get reliable results, you should not go to the doctor if the temperature is elevated, menstruation is on, blood pressure is increased. Recommendations for passing the analysis:
- The day before the delivery of the biomaterial, you should avoid food that can affect the color of the fluid secreted by the kidneys: beets, brightly colored fruits, marinades. It is not recommended to drink coffee, dietary supplements, alcohol.
- It is advisable not to visit a sauna or bath, to exclude strong physical exertion.
- Before delivery, it is necessary to conduct hygiene procedures, take a shower.
- If the collection of biomaterial will occur at home, you should buy a disposable container in advance. The fluid must be collected a few seconds after the start of urination, brought to the laboratory for a maximum of 2 hours.
- The procedure is done in the morning, before meals.
- When collecting the container should not touch the skin, genitals.
General Analysis Preparation Rules
To obtain objective results two days before collecting urine, the simple preparation conditions should be observed:
- eliminate urine-staining products from the diet (beets, rhubarb, carrots, blackberries, asparagus),
- exclude the use of alcoholic and carbonated drinks,
- refuse to take medicines of the diuretic group (diuretics), as well as multivitamins that change the smell and color of urine,
- do not use vaginal contraceptives and therapeutic suppositories,
- to limit sports and other physical activity,
- refrain from visiting the sauna, baths.
- purchase a sterile container for urine.
It is not recommended to take a urine test:
- in the first seven days of the follicular phase of the menstrual cycle (period of blood discharge),
- within 5–7 days after instrumental diagnosis of the state of the urinary tract and bladder (cystography, cystoscopy).
Immediately before collecting urine in a container, it is necessary to carry out the procedure of genital hygiene, without using soap or gel. For research, it is necessary to collect a morning dose of urine.
Urination begins in the toilet, after a couple of seconds they substitute the container.
You should collect 2/3 of the volume, tightly close the container with a lid, and deliver to the medical institution no later than two hours later.
Urine collection rules for general clinical analysis
The child has
Doctors regularly issue directions for urine tests to infants and children in order to identify problems in time and prevent the development of inflammatory processes and pathologies. An ideal general analysis should show a white blood cell count close to zero. A single excess is permissible depending on the age of the child, the baby. For example, the norm of leukocytes in urine in male children can vary at the level of 0-7 leukocytes, in girls - from 0 to 10. The more white bodies are found, the more acute the disease occurs in infants.
Causes of an increase in white blood cell count in urine
First of all, white blood cells in the urine of women (men and children) increase against the background of the development of inflammatory diseases. At the initial treatment with complaints of pain during urination and pain in the lower abdomen, accompanied by hyperthermia (fever), the following diagnoses are suggested:
How to take a urine test according to Nechiporenko?
- Cystitis - inflammation of the walls of the bladder and purulent cystitis - infectious-purulent inflammation of the walls of the bladder (in the latter case, pyuria is recorded in the analysis).
- Urethritis is a bacterial inflammation of the wall of the urethra.
- Pyelonephritis is an inflammatory pathology of the pyelocaliceal system of the renal apparatus and kidney tissue.
- Paranephritis and pyonephrosis are complications associated with pyelonephritis.
- Glomerulonephritis - an inflammatory lesion of glomeruli (renal glomeruli). The disease can also have an autoimmune nature of origin, when glomeruli are damaged by cells of their own immune system.
Leukocyturia accompanies the following diseases:
- nephrolithiasis - the formation of calculi (stones) in the kidneys,
- urolithiasis - deposition of calculi in the urinary tract,
- renal cyst - a hollow formation of connective tissue filled with fluid,
- renal amyloidosis - the deposition of amyloid (protein) between nephrons (kidney cells), followed by their replacement,
- nephrotuberculosis - an infectious lesion of the kidneys with a Koch stick,
- diabetic nephropathy - a complication of diabetes mellitus on the renal vascular system,
- lupus nephritis - a complication of SLE (systemic lupus erythematosus), an autoimmune disease characterized by damage to the connective tissue and blood vessels,
- renal infarction - the death of renal tissue caused by the closure of the lumen of the arteries,
- rheumatoid arthritis - pathology of connective tissue in small joints,
- intoxication of the body, accompanied by dehydration,
- infectious diseases, with a severe course (pneumonia, helminthiasis, leptospirosis, etc.).
An increase in the concentration of leukocytes in urine is observed in diseases of the female genital organs (classified as false leukocyturia, not associated with pathologies of the renal apparatus and urinary organs):
- salpingoophoritis (otherwise adnexitis) - inflammation of the ovaries and fallopian (uterine) tubes,
- bartholinitis - an infectious and inflammatory disease of the bartholin (large) glands located at the entrance to the vagina,
- vulvovaginitis is a non-infectious or infectious pathology of an inflammatory nature that affects the vulva (vulvitis) and the vaginal mucosa (vaginitis).
- STIs (sexually transmitted infections).
An increase in leukocyte cells in urine can be observed for reasons not related to acute and chronic diseases. A change in the chemical composition of urine causes an incorrect intake of medicines of the following groups:
- immunosuppressants (drugs that suppress immunity),
- anti-TB drugs
- NSAIDs (non-steroidal anti-inflammatory drugs).
With a correlation increase in the number of red blood cells and white blood cells, and the appearance of cylinders, we can assume the development of chronic renal failure (chronic renal failure) or nephrotic symptom complex (severe complications of chronic renal disease).
CRF is characterized by a violation of the filtration and excretory functions of the kidneys. Pathology is irreversible
Important! A single urine test is not enough to confirm the diagnosis. The doctor prescribes an additional examination, according to the results of which the tactics of therapy are determined.
White blood cells are white blood cells that are responsible for the protective reactions of the immune system to infect infections, viruses, bacteria, etc. In healthy urine, the minimum number of white blood cells is fixed. According to a general urinalysis, the norm for women is from 0 to 6 (in sight).
Depending on how much their number is exceeded, the stage of inflammatory diseases of the urinary system (cystitis, pyelonephritis, urethritis, etc.) is determined.
Leukocyturia also accompanies chronic kidney disease and diseases of the female genital organs.
To determine the level of leukocytes, one of four urine tests is prescribed (general clinical or Nechiporenko, Amburge, Addis-Kakovsky tests).
White blood cells in the urine during pregnancy
Women who are expecting a baby are assigned a regular diagnostic test of urine, a procedure is mandatory. The purpose of the analysis is to see and fix possible malfunctions and failures in time. As a rule, in the first trimester, the study is prescribed once every 3-4 weeks, in the second - with a frequency of 2 weeks, at a later date - even more often. The level of white cells in pregnant women is initially high. The reason is the increased protective properties of the body due to antigenic load. The norm of white blood cells in urine during pregnancy is from 0 to 3 units.
If the white blood cells are normal, in women the indicator is not higher than 6 units. If leukocyturia has a pronounced degree, this can be seen visually: the liquid released becomes cloudy, includes lumps, mucus, and various threads. An increased number of white blood cells may indicate inflammatory processes in the genitals, kidneys, and urinary tract. To get an accurate diagnosis, the doctor can prescribe a re-analysis, while the fluid is taken from the bladder.
It is considered normal if a urine test for white blood cells shows up to 3 cells in the field of view. If the indicator is higher, we are talking about the excess and the presence of any pathology. The cause of a poor analysis may be inflammation of the urethra, infections of the genitourinary system, the presence of kidney stones, ureter, connective tissue pathology, tumor diseases, and so on.
If the general analysis shows an increased number of blood cells, the doctor may prescribe an analysis according to Nechiporenko to clarify the diagnosis. The method helps to identify the amount of protein, red blood cells, white blood cells, cylinders. In a healthy person, white blood cells in urine according to Nechiporenko should not exceed 2000 in 1 ml. If there are more of them, comparing all the information received, the doctor will be able to identify diseases of the kidneys, urinary tract.
How to lower white blood cells in urine
It is useful to change the diet, lifestyle, if the increase in white blood cells is negligible. It is recommended to avoid excessive loads, overwork, take a small amount of food evenly throughout the day. It is important to exclude dehydration, to refuse heavy meals. You can try traditional methods of treatment, for example, a month to drink a decoction of horsetail or drink linden tea more often.
How to reduce white blood cells in the urine, if they have a pathological origin? The method is selected individually, depending on the cause of leukocytosis, a specific case, the patient's age. The treatment options for adults and children may vary. Typically, the following methods are assigned:
- taking antibiotics if the disease is associated with bacteria, infections,
- taking non-steroidal drugs to eliminate foci of inflammation,
- the use of complex therapy for pathologies of internal organs,
- the appointment of antihistamines, if increased rates are due to allergies,
- chemotherapy, surgery for oncological manifestations,
- drug withdrawal if leukocytosis is caused by their intake,
- if very high rates, leukapheresis is used - transfusion of purified blood.
White blood cells in the urine are elevated
Attention! The information presented in the article is for guidance only. Materials of the article do not call for independent treatment. Only a qualified doctor can make a diagnosis and give recommendations for treatment based on the individual characteristics of a particular patient.
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Article updated: 06/18/2019
What does this mean analysis by A.Z. Nechiporenko, how many white cells should be
The body is protected from viruses, bacteria and other pathogenic agents by the human immune system. The main "executors" of the protective function of the immune system are white blood cells - shaped elements of the cellular composition of the blood, also called white cells, or bodies.
To maintain the normal immune status of the body, the content of white bodies in the blood should adhere to reference (normal) values. Why white bodies appear in the urine and what is the norm of white blood cells in the urine of women - this is worth reading.
Normal value table and interpretation
During a laboratory study, which is carried out with a diagnostic purpose for the needs of clinical practice, several types of urinalysis are performed:
The study of organized urinary sediment allows you to detect and count the number of leukocytes in the sample falling into the field of view under the microscope and compare it with reference values. The norm of white cells in adults does not change with age, but slightly differs for representatives of different sexes.
The maximum allowable level is 10 leukocytes, although an indicator of 7-10 is considered suspicious in both men and women and requires a more in-depth analysis.
Consider the norm in the table for adults over the age of 18 years and children.
|Study groups||White blood cell norm in sight|
|Children||Less than 10 units|
|Men||Up to 5 units|
|Women||Up to 7 (maximum - 10)|
|Pregnant women||Maximum 10-15|
The table shows the norms in the analysis of urine according to the general indicator. It has great diagnostic value, but if serious deviations from the norm are observed, other studies (for example, ultrasound), the symptomatic picture and the patient’s history should serve as an additional information link in determining the pathology.
Today, the question of the norm in determining such conditions as leukocyturia (high white blood cell count in urine) and pyuria (the presence of a huge amount of this fraction in urine) still remains a moot point. Most nephrologists believe that 3-5 leukocytes in the field of view is the amount that should be normal, others consider this indicator to be elevated.
Leukocyturia in women is usually associated with urinary tract infections (UTI). But a significant excess of the norm of white bodies can be caused by other diseases.
The condition when the number of leukocytes in the urine does not exceed 200 units is called microleukocyturia, if there are more than 200 of them in the field of view, it is pyuria.
What does this mean, the doctor must figure it out in each case. To clarify the diagnosis, a woman may need additional studies - vaginal smears, in-depth urine tests, and others.
Analysis by A.Z.Nechiporenko
If an increased content of leukocytes in the urine is detected during a biochemical study, the need for a deeper and more accurate analysis of the quantitative content of this fraction often arises. There are several options for in-depth urine tests, one of which is a relatively simple and fairly accurate Nechiporenko analysis.
Methodology for urine analysis according to Nechiporenko
What it is?
Urinalysis according to Nechiporenko is a comprehensive study of a urine sample to quantify the most important formed elements of the blood - red blood cells, white blood cells and special cells called cylinders. The technique proposed by the Soviet scientist and doctor A.Z. Nechiporenko, has been widely used in clinical practice due to the high information content and ease of implementation. Indications for the purpose of this analysis are:
- severe symptoms of UTI in the absence of abnormalities in urine tests,
- detection of deviations from the norm in the general clinical analysis of urine - to clarify the situation,
- history of inflammatory disease of the urinary system.
For analysis, morning urine should be collected according to special preparation rules.
- On the eve of the analysis, one should refrain from excessive physical or emotional stress, sexual intercourse, cystoscopic examinations.
- Before collecting urine, the external genitalia should be thoroughly washed.
- To begin urination should not be in the collection tank, but in the toilet (about 1 second) to collect the average portion.
- Keep collected urine (at least 100 ml) in a tightly closed container.
It makes no sense to describe the procedure of laboratory analysis, since what it is, it will be clear only to medical professionals. We only clarify that a separate calculation of the formed elements in this case is carried out according to the formula with recalculation of 1 milliliter of urinary sediment.
Types of possible urine tests
How many leukocytes should be?
Since the analysis according to Nechiporenko counts for 1 ml of a urine sample, the norm in this case is very different from the norms of a microscopic examination. The white blood cell norm for this method is Useful video
A gynecologist will talk about the causes of poor urine tests in women: