You have received a urine test form showing white blood cells above the normal range. This is not yet a diagnosis but a signal: there is inflammation or irritation in the urinary tract. Let us explain what the numbers on the form mean and in which cases a conversation with a doctor should not be delayed.
What white blood cells in urine are and what their normal range is
White blood cells are blood cells that are the first to arrive at the site of inflammation. When they are found in urine, this is called leukocyturia. The normal range in a single sample: in men, 0–2 white blood cells per field of view; in women, up to 5. The difference is anatomical: in women, the urethra is shorter than in men.
By quantity, a distinction is made between microleukocyturia — fewer than 200 white blood cells per field of view — and pyuria — more than 200 white blood cells per field of view.
When to see a doctor
High white blood cells without symptoms is a reason to show the form to a doctor, but not a reason to panic. People should see a doctor promptly if they have fever, chills, pain in the lower abdomen or in the back under the ribs, or blood in the urine. Separately: people aged 65 and older, children under 15, men, pregnant women, people with diabetes, people with a catheter, and people with weakened immunity — they should not wait. Another reason is if symptoms do not ease within 48 hours or infections recur: two in 6 months, three in 12.
An elevated white blood cell count in urine by itself is not a reason to call an ambulance. 103/112 — if the person is confused, drowsy, or has difficulty speaking.
If it feels awkward to talk about burning, odor, and frequent trips to the toilet, remember: the doctor looks at the form and the symptoms, there is no need to be embarrassed.
White blood cells in urine: what it means
Not only the number but also the type of cells matters. Neutrophils point to infection: pyelonephritis, tuberculosis. Mononuclear cells — to glomerulonephritis and interstitial nephritis. Lymphocytes — to systemic diseases: lupus erythematosus, rheumatoid arthritis. Eosinophils — to an allergic reaction.
The second reference point is the source of the cells. White blood cells from the bladder indicate cystitis or stones, from the urethra — urethritis, from the calyces and renal pelvis — pyelonephritis. A distinction is also made between bacterial and abacterial leukocyturia: abacterial is associated with an interstitial process in the kidney tissue.
Causes of elevated white blood cells in urine
One cause is urinary tract infection: bacteria from the stool enter the urethra and ascend higher. The risk is higher during pregnancy, when wiping from back to front, with kidney stones, and with conditions that prevent complete emptying of the bladder — prostate adenoma in men, constipation in children. A catheter, weakened immunity, menopause, spermicides in contraception, and lack of fluid add to the risk.
Inflammation can also occur without bacteria: glomerulonephritis, interstitial nephritis, allergic conditions, systemic diseases. With infection, the picture usually looks like this:
- Pain or burning during urination, frequent and sudden urges, including at night.
- Cloudy, dark urine or a strong odor.
- Blood in the urine.
- Pain in the lower abdomen or in the back under the ribs.
- High fever, chills, weakness; in older adults — confusion and incontinence worse than usual.
White blood cells and red blood cells in urine at the same time
Blood in the urine is one of the symptoms of urinary tract infection: the urine may be bright pink, red, or dark brown. If there is blood in the urine, you need to see a doctor urgently.
What is checked in a urine test
A general analysis describes color, transparency, odor, acidity, the presence of blood, protein, glucose, ketones, bilirubin, cells, crystals, casts, and bacteria. If white blood cells and bacteria are present, the doctor may order a urine culture — it will show which bacteria grew. Further examination is prescribed by the doctor.
The material is for reference: it helps to read the form but does not replace a doctor's consultation.
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This content is for reference and does not replace a doctor's consultation. Medical disclaimer