Are there cells in urine

Since the number of elements found in each field may vary considerably from one field to another, several fields are averaged. Next, examination is carried out at high power to identify crystals, cells, and bacteria.

The various types of cells are usually described as the number of each type found per average high power field HPF. Hematuria is the presence of abnormal numbers of red cells in urine due to: glomerular damage, tumors which erode the urinary tract anywhere along its length, kidney trauma, urinary tract stones, renal infarcts, acute tubular necrosis, upper and lower uri urinary tract infections, nephrotoxins, and physical stress. Red cells may also contaminate the urine from the vagina in menstruating women or from trauma produced by bladder catherization.

Theoretically, no red cells should be found, but some find their way into the urine even in very healthy individuals. However, if one or more red cells can be found in every high power field, and if contamination can be ruled out, the specimen is probably abnormal. RBC's may appear normally shaped, swollen by dilute urine in fact, only cell ghosts and free hemoglobin may remain , or crenated by concentrated urine.

In addition, red cell ghosts may simulate yeast. The presence of dysmorphic RBC's in urine suggests a glomerular disease such as a glomerulonephritis. Dysmorphic RBC's have odd shapes as a consequence of being distorted via passage through the abnormal glomerular structure. Pyuria refers to the presence of abnormal numbers of leukocytes that may appear with infection in either the upper or lower urinary tract or with acute glomerulonephritis.

Usually, the WBC's are granulocytes. White cells from the vagina, especially in the presence of vaginal and cervical infections, or the external urethral meatus in men and women may contaminate the urine. If two or more leukocytes per each high power field appear in non-contaminated urine, the specimen is probably abnormal.

Leukocytes have lobed nuclei and granular cytoplasm. Renal tubular epithelial cells, usually larger than granulocytes, contain a large round or oval nucleus and normally slough into the urine in small numbers. However, with nephrotic syndrome and in conditions leading to tubular degeneration, the number sloughed is increased.

When lipiduria occurs, these cells contain endogenous fats. When filled with numerous fat droplets, such cells are called oval fat bodies. Oval fat bodies exhibit a "Maltese cross" configuration by polarized light microscopy. Oval fat bodies in urine, with polarized light Transitional epithelial cells from the renal pelvis, ureter, or bladder have more regular cell borders, larger nuclei, and smaller overall size than squamous epithelium.

Renal tubular epithelial cells are smaller and rounder than transitional epithelium, and their nucleus occupies more of the total cell volume. Their significance is that they represent possible contamination of the specimen with skin flora. Urinary casts are formed only in the distal convoluted tubule DCT or the collecting duct distal nephron. The proximal convoluted tubule PCT and loop of Henle are not locations for cast formation. Hyaline casts are composed primarily of a mucoprotein Tamm-Horsfall protein secreted by tubule cells.

The Tamm-Horsfall protein secretion green dots is illustrated in the diagram below, forming a hyaline cast in the collecting duct:. Even with glomerular injury causing increased glomerular permeability to plasma proteins with resulting proteinuria, most matrix or "glue" that cements urinary casts together is Tamm-Horsfall mucoprotein, although albumin and some globulins are also incorporated.

An example of glomerular inflammation with leakage of RBC's to produce a red blood cell cast is shown in the diagram below:. The factors which favor protein cast formation are low flow rate, high salt concentration, and low pH, all of which favor protein denaturation and precipitation, particularly that of the Tamm-Horsfall protein. Protein casts with long, thin tails formed at the junction of Henle's loop and the distal convoluted tubule are called cylindroids.

Hyaline casts can be seen even in healthy patients. Red blood cells may stick together and form red blood cell casts. Such casts are indicative of glomerulonephritis, with leakage of RBC's from glomeruli, or severe tubular damage. White blood cell casts are most typical for acute pyelonephritis, but they may also be present with glomerulonephritis.

Their presence indicates inflammation of the kidney, because such casts will not form except in the kidney. Bacteria usually enter the urethra and then travel up to the bladder, leading to the cystitis, which is an infection of the bladder.

Women have a bit shorter urethras compared to the men, thus making the women to be more prone to the infections. In men, infection can begin in the prostate and then move up into the bladder, leading to the cystitis.

Symptoms of UTI are the urinary frequency, urgency to urinate after every few minutes and also the pain that is just above the pubic bone. Antibiotics are usually used in treatment of the UTIs. People suffering from STDs such as the gonorrhea, chlamydia, etc. It can also lead to swelling of the genitals. Pregnancy can as well result in white blood cells contamination, which increases the count of leukocytes. Unlike the UTI, interstitial cystitis is not brought about by infection.

White blood cells that are in the urine are brought about by inflammation of the bladder wall. This condition is much common in women than in men, and leads to urinary urgency, frequency as well as the pelvic pain.

This condition is brought about by bacterial or viral infections, and is usually treated by use of antibiotics. Pyelonephritis also affects people of all ages, but is very much common amongst the women. The infection begins from urinary tract, and spreads towards the kidneys. As indicated, kidneys are very much responsible for filtering of the blood, and never allows the white blood cells to enter the urine. Thus, if the kidneys are not functioning as expected and are much affected by any kind of infection, this will provide a way for the white blood cells to pass through the kidneys into the urine.

Pyelonephritis is very much common amongst the women than men. Kidney stones prevents the passage of urine that is in the urethra. Therefore, urine stagnates, therefore increasing the risk of the bacterial infection. Irritation of urethra from the stones can also lead to the white blood cells in urine.

Kidney stones lead to severe pain that can come in waves, making it very much difficult for you to stay in a single position. If the stone is blocking the passage of urethra, it can be very much difficult to urinate or you can urinate only in very small amounts at one given time. Bladder spasms and also the pain during urination may also happen.

People who have had a kidney stone are likely to experience more. If the stones are very large to pass through the urinary tract, they can be broken up using the ultrasound or even surgically removed. Interstitial cystitis happens because of the inflammation of bladder but it is not brought about by an infection. The white blood cells is able to appear in the urine when the bladder is much inflamed because of other causes other than an infection.

Interstitial cystitis happens more amongst the women than men. It leads to an individual to have a pelvic pain and urinary urgency. Most of the women can be familiar with the problems of frequent urinary tract infections, or even apparent symptoms for which no given bacterial infection is able to be found.

Urine contains DNA but only in small amounts, and it deteriorates quickly. This makes extraction difficult and test results unreliable. Learn more…. Health Conditions Discover Plan Connect. Mental Health. Medically reviewed by Debra Sullivan, Ph.

There are two types of hematuria: Gross hematuria means blood is visible in your urine. Microscopic hematuria involves RBCs that can only be seen under a microscope.

How are RBCs in urine detected? What causes RBCs in urine? What are the next steps after finding RBCs in urine? The bottom line. Read this next. Medically reviewed by Deborah Weatherspoon, Ph. Medically reviewed by Elaine K. If certain medications caused the high presence of red blood cells in urine, they should be stopped right away.

As for the other causes, your doctor will prescribe the appropriate treatment regime which you should follow to the letter. It is important not to self treat as this may cause more harm than good. Your email address will not be published. Skip to content The presence of red blood cells in urine is a very common condition. Normal Results Values of up to 4 red blood cells present per high power field indicate that nothing is wrong.