The level of white blood cells in the urine - an occasion for a full examination of the patient

In most cases, elevated levels of white blood cells White blood cells as the basis of immunity   in urine is expected, for example if a patient is suspected renal disease or urinary tract. But sometimes a large number of white blood cells in the urine is a random finding, which requires a re-analysis and clarify the diagnosis.

Norma leukocytes in the urinalysis

In general, the analysis of urine may be small amounts of white blood cells. In men, there should be no more than three in sight, and women no more than six. What do these numbers mean? The number of leukocytes in the urine (as well as other cell elements - erythrocytes, epithelial, platelets) is determined after centrifugation and separation of the precipitate. The precipitate was examined under a microscope and find the average number of leukocytes in the same field of view. If the analysis is carried out using a special analyzer, it is considered the number of leukocytes in 1 l, normally it should be no more than ten.

Normally, urine should be transparent, with the appearance of a large number of white blood cells urine becomes cloudy and unpleasant smell.

Elevated levels in urine

First of all, the doctor correlates data urinalysis results to the general condition of the patient. If he has signs of acute or chronic kidney disease and urinary tract infections, the patient is treated by controlling the treatment process using urine tests.

In order to clarify the status of the patient, it is usually prescribed repeated urinalysis, and then quantitative analysis of urine at ADDIS Kakovskomu or Nechiporenko. In the first case, the number of blood cells counted in the daily urine, and the second - in one ml of midstream morning urine. Norms of these tests: for Addis Kakovskomu - 2 x 10 to the sixth power per day, according to Nechiporenko - 2-4 x 10 to the third power in one ml.

If repeated studies in the urine there is any change, the patient is completely examined, ultrasound and X-ray of the kidneys and ureters Cystoscopy (study of the bladder mucosa Urinary bladder - structure and function   using an optical instrument cystoscope), cystography (radiography of the urinary bladder), if necessary - a narrow x-ray, CT and MRI.

What is Reflux

Often in the survey apparently healthy person identified various congenital and acquired anatomical changes - obstacles to urine flow, which may contribute to its backflow - reflux. Refluxes junction can be kidney, ureteral and renal pelvis, vesicoureteral. Reflux contributes to stagnation of urine, as well as urine is a good breeding ground for various microorganisms that may enter therein from the intestine, genital organs, or with blood from any other organ inflammation begins. Inflammation in the kidney can occur unnoticed, however, it will contribute to the reduction in kidney function.

Often in the background structure of urinary system defects develop very severe secondary pyelonephritis, which can only be cured by eliminating reflux using surgery.

Genital infections

It is possible that white blood cells in urine were in infectious and inflammatory processes in the genital area - vulvovaginitis in women and balanoposthitis in men. In this case, re-analysis of urine, taken all the necessary precautions (catheter directly from the bladder), it will be normal.

But after infection vulvovaginitis and balanoposthitis can go to the urethra (usually men) and bladder (mostly women). In this case, the repeated analysis also shows the presence of large amounts of leukocytes in urine. Such a patient should be treated for a urinary tract infection.

The right to collect urine

Urine should be collected in accordance with certain rules:

• the overall analysis is going to morning urine immediately after sleep Dreams: how to understand our dreams ;
• before collecting urine genitals should be washed with soap or shower gel;
• Urine is collected in a clean dry the dishes washed and covered with a lid;
• if the analysis is impossible to carry out immediately, the urine is stored in the refrigerator.
• The level of white blood cells in the urine may become a pretext for a full examination of the patient.

The normal white blood cell count in urine - how to interpret the results

The normal number of white blood cells in the urine depends on the age and sex .  Furthermore, the number of leukocytes may vary depending on a number of factors (for example, under the influence of certain physiological processes in the body, when taking certain medications), which in itself does not indicate the presence of infection .  Normal leukocytes in urine is generally from zero to six cells in the field of view for women (in the investigation of urine samples under a microscope), and from zero to three cells in the field of view - Men .  This figure depends on the type of executable analizma urine: for example, the analysis of urine on Nechiporenko norm is up to four thousand white blood cells per milliliter of fluid .  The excess of the normal number of white blood cells in the urine is called leukocyturia .  If the number of white blood cells in urine is significantly higher than normal, a condition called pyuria - in this case the presence of leukocytes in urine is already possible to determine without a microscope, because a large number of white blood cells alters the texture and color of the liquid .

Determine the number of white blood cells in the urine after centrifugation, resulting in separated urine sediment. The precipitate look under a microscope and determining the presence of leukocytes therein. Under the microscope, white blood cells are represented by small round cells with sharply defined and refract light nucleus. Often they are glued together to form a group or a handful. In recent years, such studies do not often manually, using special equipment.

White blood cells in the urine as a sign of the disease

The presence of white blood cells in the urine, indicating any inflammatory disease, determined by standard urine tests, running in the diagnosis of various diseases and, above all, in the diagnosis of diseases of the genitourinary system .  For determination of leukocytes in urine could be analyzed urine leukocyte esterase - an enzyme produced by leucocytes and urine was determined in the presence of white blood cells .  Furthermore, the presence and the exact number of leukocytes in the urine can be determined by examining the urine samples under a microscope .  In a very small number of white blood cells in the urine may be present all the time, so even some exceeding standards for levels of white blood cells in the urine itself in some cases still is not a basis to confirm the diagnosis .  Generally, for the diagnosis of various types of urinary tract infections, bladder or kidney, in addition to the analysis of leukocytes in urine, an additional analysis of urine nitrite, which also indicate the presence of infection .

The increase in the number of leukocytes (leukocyturia) indicates inflammation in the kidneys, urinary tract and genitals. Thus, when pelvic inflammatory disease is detected in the urine of a huge number of white blood cells, therefore, to clarify the diagnosis by repeated measurements of urine, taken this time with a catheter directly from the bladder Urinary bladder - structure and function .

During acute inflammatory leukocytes renal origin generally have a single core, while leukocytes deriving from the urinary tract, have multiple cores. When the exchange (dystrophic) kidney disorders are often found in leukocytes fat inclusion.

Most white blood cells of renal origin is found in inflammatory diseases of the kidneys (pyelonephritis), much less their in infectious allergic diseases of the kidneys (glomerulonephritis), which dominates the other symptoms. The fact that the process has an allergic nature and occurrence of said large number of eosinophils (one type of leukocytes, which accompanies an allergic reaction).

Establishing the source leukocyturia

To identify the source of large numbers of white blood cells, the following samples:

• dvuhstakannaya test: the patient must urinate in two glass jars without interrupting the stream of urine; leykotsituriya detected if the first portion - this indicates the presence of inflammation in the lower part of the urinary tract (urethra, prostate), and the second - an inflammation of the urinary bladder, ureters and kidneys;
• trehstakannaya test: before collecting urine urologist massages the prostate; continuous stream of urine is divided into three parts, the predominance of leukocytes in the first portion indicates inflammation of the urethra or prostate, uniform distribution of leukocytes in all portions with high probability could indicate renal disease.

To reveal hidden leukocyturia sometimes make prednisolone trial: patient examined in the morning the first urine, then intravenous prednisolone Prednisolone - against inflammation, allergy and pain, but with complications Then examined three urine samples collected at hourly intervals; in the presence of a hidden leukocyturia number of white blood cells in the urine should be increased two or more times.

Quantitative methods of urine

Quantitative methods of determination of formed elements in urine can determine the exact number of erythrocytes, leukocytes and cylinders isolated from urine. It reveals hidden pyuria, which is frequently observed in chronic inflammatory diseases of the kidney, as well as to clarify the nature of the inflammatory process.

For example, in chronic pyelonephritis Pyelonephritis - kidney disease   WBC count is usually predominates over the number of erythrocytes and chronic glomerulonephritis Glomerulonephritis - a severe infection of the kidneys   and renal arteriosclerosis contrast, the number of erythrocytes more than leukocytes. Quantitative research methods include methods of urine Nechiporenko, Addis Kakovskogo and Amburzhe. Most often used the most wait Nechiporenko method: counting the cellular elements in 1 ml of medium morning urine.

How to collect urine

In order to avoid errors in the evaluation of urine test, it is necessary to properly collect. For a general analysis of urine is enough to collect the first morning urine in a clean bowl of clear glass with a flat bottom and close the lid. Before collecting urine should carefully wash the external genitals with soap and water. If the study for any reason can not be made shortly after the urine collection, it is best to store it in a cool place.