Norm of leukocytes in urine in women, breakdown by age

Leukocytes in urine in women: normal indicators Urinalysis is one of the most common tests in laboratory diagnostics.

Along with CBC, which is increasingly performed using automated systems, clinicians use various tests and provocative tests.

Studying urinary sediment allows us to identify changes in the urinary system. Many kidney diseases are accompanied by leukocyturia. The norm of leukocytes in the urine in women and children differs from those in men, but exceeding these values ​​is often associated with the same type of pathological processes.

Where do leukocytes come from?

The basis of the urinary tract is made up of 2 types of cells: various epithelial and muscle. Their vital activity is supported by capillary blood, bringing oxygen and nutrients. The blood also contains immune cells - leukocytes. They “look around” the urinary tract, checking the “identification marks” displayed on each cell - antigens - with a kind of “list” of such “allowed” molecules.

When white blood cells see the antigens of bacteria, viruses or fungi, as well as the “signs” of cancer cells, they rush to the “compromised” place and begin to destroy foreign agents. After performing their function, they are released into the urine, where they are detected using laboratory tests:

• general (general clinical) analysis - a regular portion of urine taken in the morning. This analysis is the simplest to perform, and it is from it that they usually find out that the white blood cell count is increased (this is called leukocyturia);
• Nechiporenko's test - an average portion of morning urine. It is considered more informative for determining the number of leukocytes, as well as red blood cells and casts in the urine. It better clarifies the number of these cells, which helps in the diagnosis of various inflammatory diseases of the urinary tract;
• Amburger samples. This analysis is performed from 10 ml of urine taken from a container where urine was collected over a 3-hour period;
• Addis-Kakowski test - counting urinary cells in urine collected for 24 hours.

The latter tests are needed to detect hidden leukocyturia (when in a general analysis the leukocytes are normal) or when, after repeated studies, the leukocytes are either elevated or normal. They will help not to miss, but to detect a person’s disease at a stage when an ultrasound will not show anything.

General information about white blood cells

Leukocytes are white nucleated cells because they do not have pigment, and they perform several functions at once, the main one being the fight against infection in the body. Let's look at them in more detail:

1. Protective. It consists of destroying microorganisms of all types, since the cells have bactericidal, antitumor, antitoxic, anthelmintic, and antiallergic effects.
2. Regenerative. Consists in the release of specific factors that accelerate tissue healing.
3. Regulatory. Involves the formation of cytokines, growth and other elements that are actively involved in the formation, development and maturation of blood components, as well as immune reactions

Leukocytes have a memory function, that is, they remember all the harmful agents that have affected the human body throughout his life. Some “knowledge” is inherited through information molecules from mother to child.

They also have the ability to enhance reproduction and self-healing, which is especially important in cancer, when after chemotherapy their number is significantly reduced. “Smart” cells control, direct and regulate the activity of their “brothers”, due to which the processes of immune defense proceed normally.

Leukocyte norm

Normally, there may be several immune cells in the urine: these are the “sentinel” cells that check the organs for infection or cancer. In women, a little more of these cells are allowed: those leukocytes that “check” the genitals can also enter their urine.

• So, the norm of leukocytes in the urine (according to general clinical urine analysis): in women: 0-6 in the field of view;
• in men: 0-3 in the field of view.

So, what does “increased white blood cells” mean? Depending on what urine test they are determined by, 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).

Normal in children

In infants, in relation to the amount of “work” performed, leukocytes are somewhat “weaker”. This means that the norm of leukocytes at the age of up to one year is different: from 1 to 8 cells/field of view. This amount in the urine of a baby may increase during periods of teething, when non-microbial inflammation of the tooth socket occurs, and many leukocytes are forced to enter the urine.

In older children, the norms approach those of adults. To assess whether your child's reading is normal, there is a table by age. You just need to compare the resulting general urine analysis with it:

Thus, the fewer leukocytes in the urine, the better. Some practicing urologists express the opinion that if more than 3 leukocytes in the field of view are determined in the urine of a child of any age by a general clinical method, then he should already be examined according to the algorithm given in the section “What to do if there is an increase in leukocytes in the urine.”

Results

Leukocytes are white blood cells responsible for the protective reactions of the immune system to the penetration of infections, viruses, bacteria, etc. into the body. In healthy urine, a minimal number of leukocyte cells is recorded. According to a general urine test, the norm for women is from 0 to 6 (in the field of view).

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 pathologies 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).

Types of leukocyturia

By origin, leukocyturia is:

• true when the causes of increased leukocytes in the urine are diseases of the urinary system;
• false, when leukocytes enter the urine from the genital tract (to determine inflammation in the genitals, leukocytes 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 either poor hygiene of the genital organs before the test, or 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 leukocytes are found. In this case, leukocyturia occurs:

1. infectious. Caused by inflammation of the urinary tract. During bacterial culture or PCR testing of urine, a microbe is identified.
2. non-infectious (aseptic). It is caused either by non-infectious processes (for example, autoimmune glomerulonephritis or allergic cystitis), or by inflammation occurring in organs adjacent to the urinary tract, or by taking the drugs listed below.

Depending on the quantitative results shown by a general urine test, leukocyturia can be:

• minor: 7-40 leukocytes per field of view;
• moderate: 41-100 cells per field of view;
• severe (it is also called pyuria, that is, “pus in the urine”), when more than 100 cells/in the field of vision are determined.

Depending on which leukocytes predominate 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 a standard general clinical analysis.

How to properly collect urine

A necessary condition for correct results of a clinical study is appropriate preparation and collection of urine. The composition and amount of chemical compounds in the urine are influenced by many factors that contribute to a false positive or false negative result, namely:

• medications (if the composition contains caffeine, ethyl alcohol, rauwolfia, glycerol trinitrate, diuretics, painkillers, antipyretics, then glucose, creatinine, etc. increase in the urine);
• alcoholic drinks, coffee, green tea, drinks and food with a high concentration of dyes;
• too salty and sweet food;
• failure to comply with hygiene standards.

Urine is collected immediately after sleep at the first urination. Immediately after waking up, it is necessary to carry out hygiene procedures using soap and sterile wipes. You should prepare a sterile container in advance, or use any thoroughly washed suitable container.

All morning urine is conventionally divided into three portions, each of which may indicate the presence of inflammatory processes in the upper and lower urinary tracts. Depending on this, there are two options for collecting morning urine:

• collection of average urine - the first milliliters of urine must be passed, and then the liquid must be collected in a prepared container;
• collection of general urine - the entire volume is released into a wide container, then the liquid must be mixed and the required amount poured into a prepared container.

Causes of increased leukocytes in urine

An increased level of leukocytes can be determined not only during illness. This can be due to insufficient genital hygiene (read how to properly prepare for urine donation, below), as well as due to taking certain medications. The latter include:

• diuretics;
• antituberculosis drugs;
• some antibiotics;
• drugs that suppress the immune system (used in the treatment of autoimmune diseases, tumors, and also after organ transplantation);
• non-steroidal anti-inflammatory drugs, which are usually used to treat pain syndromes of various localizations.

Let's consider when more than 6 leukocytes appear in the urine in the field of view in people of both sexes:

For cystitis - acute and chronic

An acute disease is difficult to miss: it is manifested by intense pain in the lower abdomen, a strong urge to urinate and its pain (especially at the end), sometimes also the release of blood in the urine and an increase in temperature. But chronic cystitis can be asymptomatic, only in some cases making itself known by frequent urination and slight discomfort with it. With chronic cystitis, exacerbations periodically occur, which manifest themselves as symptoms of an acute process.

For urethritis - acute and chronic

Acute inflammation is manifested by pain, especially severe at the beginning of urination, increased frequency and cloudiness of the urine. With chronic urethritis, these symptoms appear only occasionally, after hypothermia, drinking large amounts of alcohol and sexual intercourse. The rest of the time, the disease may not show any symptoms.

Pyelonephritis, pyelitis

For pyelonephritis and pyelitis, which are acute and chronic; have the same manifestations. Acute inflammation of the kidney tissue is characterized by high fever, symptoms of intoxication and lower back pain. Chronic pyelonephritis can only manifest itself as faster fatigue, periodic headaches and fevers below 38°C. Your lower back may also feel like your lower back is freezing faster.

Urolithiasis, tumors

Leukocytes can be detected when blood enters the urine (it contains all the blood cells), which happens with urolithiasis (when a stone injures the urinary tract), after injury to the kidneys or descending urinary tract, when there is a tumor in the kidneys, prostate or descending urinary tract . And if urolithiasis usually manifests itself with symptoms of renal colic (sharp and intense pain in the lower back, radiating to the genital organs), and the fact of injury itself is difficult to forget, then tumors of the genitourinary system do not have any symptoms for a long time.

Glomerunonephritis

With glomerulonephritis, that is, inflammation of the renal glomeruli, which does not occur due to infection of the kidney tissue (as with pyelonephritis), but with a strongly “active” immune response to the microbial inflammation present in the body. Glomerulonephritis can also be autoimmune in nature, when the cells of one's own immunity begin to attack the glomeruli of one's own kidneys. Acute glomerulonephritis is manifested by increased temperature, weakness, decreased appetite, nausea, and the appearance of swelling on the face, which is greater 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.

With pyonephrosis

This is the name given to the melting of kidney tissue when an abscess forms; is a complication of pyelonephritis. Manifested by weakness, sleep disturbance, increased sweating, pain in the lumbar region.

With paranephritis - inflammation of the perinephric tissue

It is a complication of pyelonephritis, bacterial inflammation of the colon, which comes into contact with this fiber, as well as purulent pathologies of other organs, from where bacteria are spread throughout the body through the blood. Manifested by increased temperature, pain in the lower back and half of the abdomen.

For renal cysts

For a long time, until the cyst disrupts the flow of urine, they do not manifest themselves in anything. As soon as urine flows poorly, it begins to stagnate in the kidney, and a bacterial infection occurs here. This is manifested by fever, lower back pain, and weakness.

For renal amyloidosis

This is a disease 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 kidney tissue is largely replaced by non-functioning pink shiny tissue. The disease occurs due to hereditary disorders of certain genes. It also develops with chronic infections, tumors, and autoimmune diseases.

Renal amyloidosis does not manifest itself for some time (3 years or more), then protein, red blood cells and white blood cells begin to be lost in the urine, resulting in swelling and the skin becoming pale. At the next stage, even more protein is lost, because of this, swelling on the body also increases and stops responding to diuretics. Blood pressure may be increased, normal, or decreased. Shortness of breath, dizziness, weakness develop; the heart function is disrupted, the amount of urine decreases.

For kidney tuberculosis

It can develop as a complication of pulmonary tuberculosis or without changes in the lungs. It manifests itself as weakness of varying degrees, an increase in temperature to low numbers, pain in the lower back, cloudy 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.

Appendicitis

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 to miss. In some cases, the disease takes a chronic course, manifested by periodic pain in the lower abdomen and on the right, which intensifies with physical activity; nausea, bloating; constipation or diarrhea.

For allergic diseases

For allergies caused, among other things, by waste products of parasites. Changes similar to those observed in 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 leukocytes.

For diabetic nephropathy

If a person has diabetes, he needs to monitor not only the level of glucose in the blood, but also a general urine test. The appearance of leukocytes here indicates that due to long-term maintenance of a high sugar concentration, the vessels feeding the kidneys have been damaged, which is why the tissue of the latter suffers. This is diabetic nephropathy.

With systemic lupus erythematosus, then this complication is called lupus nephritis

Systemic lupus erythematosus can be suspected by the appearance of characteristic redness on the face in the area of ​​the cheeks and bridge of the nose (reminiscent of a butterfly), “strange” rises in temperature, muscle and headaches, hair loss in patches, and brittle nails. The fact that nephritis has developed is indicated by swelling that appears on the face, legs and feet, the appearance of lower back pain, and increased blood pressure.

For rheumatoid arthritis

In this case, the joints are the first to be affected in varying numbers and combinations. The joints in the hands are almost always affected. Kidney damage is manifested by swelling of the face and legs, a decrease in the amount of urine, and an increase in temperature.

When dehydrated

Then there is either excessive sweating (including at high body temperature), or diarrhea, or blood loss, or the discharge of large quantities of urine.

For diseases accompanied by severe intoxication

These are mainly infectious diseases: severe sore throat, pneumonia, leptospirosis.

Correct collection of urine for testing for leukocytes

In order for the study to show the most accurate picture, you need to follow certain recommendations for preparing for it:

• Physical activity and sudden temperature changes (visiting a bathhouse or sauna) are excluded.
• The day before the test, do not take antibacterial and anti-inflammatory drugs. This prohibition also applies to diuretics.
• Drink fluids in moderation, not exceeding the daily norm.
• Reduce your intake of high protein foods.

Otherwise, the rules are completely the same as those given above for general urine collection. They must be followed impeccably, otherwise the dynamics will turn out to be incorrect. If the result of the initial study remains unchanged after this addition, the disease is confirmed.

Elevated leukocytes in urine in women

Additionally, leukocyturia in women develops due to “false” reasons, that is, associated not with the kidneys or with the body as a whole, but with diseases of the female genital organs. This:

• Vulvovaginitis (inflammation of the vagina and external genitalia), including candidiasis. It usually manifests itself as discomfort in the vulva and vagina, sometimes with itching; Discharge of different colors and characters appears from the vagina, depending on the pathogen. So, with candidiasis (thrush) it is usually curdled leucorrhoea.
• Bartholinitis (inflammation of the Bartholin gland at the entrance to the vagina). The acute process is manifested by the appearance of swelling and pain in the genital area, which intensifies when sitting, walking, sexual intercourse, or visiting the toilet; one labia majora becomes extremely painful to touch. Also, with acute bartholinitis, body temperature rises to high levels, weakness and chills appear. With chronic bartholinitis, periods of remission without symptoms are replaced by the appearance of a painful, compacted area in the labia majora, which is accompanied by pain when moving. Body temperature may rise, but to low levels.
• Adnexitis is an inflammation of the uterine appendages, which can be either unilateral or bilateral. Acute adnexitis is difficult to miss. This is pain on one side of the abdomen, radiating to the rectum and sacrum, fever, weakness, and the appearance of purulent or copious mucous discharge from the vagina. If the disease is not treated, it becomes chronic. Then menstrual cycle disorders come to the fore, and periodically the same symptoms appear as during an acute process, but less pronounced.

An increase in leukocytes in the urine during pregnancy above 9-10 cells in the field of view cannot be a sign of normality. It indicates that one of the pathological processes discussed above has appeared in the woman’s body. 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 compressed by the growing uterus, and urine stagnation occurs in it.

Leukocytes in urine during pregnancy can also increase due to thrush of the genital organs, which often worries a woman due to a decrease in immunity that is natural during pregnancy. But the most dangerous reason for such a change in the general urine test is gestosis in the 2nd 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 noted, 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 life-threatening for both mother and child.

What to do if high values ​​are detected?

It should be understood that an excess of leukocyte levels relative to established norms is not a disease. This is just a clear symptom indicating certain physiological aspects of the female body or pathologies of an infectious or non-infectious nature.

Modern medicine does not recommend manually normalizing the level of leukocytes in urine or blood , but immediately contacting a specialized specialist who will refer the patient for a comprehensive diagnosis, which, in addition to tests, also includes ultrasound, colposcopy and other procedures as necessary.

If the presence of pathology is accurately detected and confirmed, the 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, antifungals, antispasmodics, cytostatics, anti-inflammatory complexes, corticosteroids, probiotics and prebiotics, and other drugs as necessary can be used. Self-medication in this situation is prohibited, since in the best case, the woman’s symptoms will only disappear (which will make it difficult to find the true cause of the problem), but in another case, her health will worsen significantly.

Elevated leukocytes in urine in men

If a man has more leukocytes in his urine than necessary, then in addition to the reasons listed above, which are characteristic of both sexes, this may be:

• Prostatitis. When this is an acute process, it manifests itself as painful urination, while the pain is localized in the sacrum and perineum and intensifies during defecation. The temperature rises, and when the process is far advanced, the outflow of urine becomes difficult, and erectile function suffers. With chronic prostatitis, only slight discomfort or mild pain may be felt when urinating; The temperature periodically rises to very low numbers. More often the disease occurs without symptoms.
• Phimosis - fusion of the opening of the foreskin - is difficult not to notice: in an erect state, the head is not completely exposed or cannot be exposed at all. In the severe stage, urination is also impaired: urine first swells the sticky foreskin, and then flows out drop by drop from the resulting “bag”.
• Balanoposthitis is an inflammation of the skin covering the penis, usually spreading to the head. It manifests itself as painful sensations in this area, itching and burning, increased temperature, the appearance of discharge, increased libido due to irritation of the head, high body temperature.
• Prostate adenoma does not appear for a long time - until the prostate enlarges so much that it begins to block the outflow of urine. Later, its symptoms include a decrease and intermittency of the urine stream, forced strain at the beginning of urination, which is later replaced by pain. When, due to compression by an enlarged prostate, the bladder stops emptying completely, a man is bothered by a frequent and strong urge to urinate; I have to get up to go to the toilet several times even at night. If complications arise, blood appears in the urine, and either urinary incontinence or complete retention develops.
• Prostate cancer symptoms are no different from prostate adenoma. If a man does not undergo routine 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 discoloration of the skin (if metastases in the liver) appear.

Diseases of the bladder and urinary tract

An increased number of leukocytes in urine may indicate the development of an inflammatory process in the organs of the urinary system. Most often diagnosed:

1. Cystitis. The source of inflammation is located in the bladder. The disease is acute. Severe pain appears in the lower abdomen, increased urge to urinate, and body temperature may increase.
2. Urethritis. The problem is accompanied by an inflammatory process, the focus of which lies in the urethra. Because of this, a person begins to urinate more than usual, he is tormented by itching and severe burning. As the disease progresses, the pathogen can spread higher through the urinary system and lead to the development of complications.
3. Injuries. Any damage to the ureters and urinary tract is accompanied by the release of blood cells into the urine. Injury occurs as a result of a bruise, a fall, a blow, or violations of the technology of medical procedures.

The most effective is the three-glass test, in which three samples are taken. The development of urethritis is indicated by the detection of leukocytes already in the first portion of urine. If there is a problem with the ureter or bladder, blood cells are present in the second sample.

Elevated leukocytes in urine in children

When more leukocytes are detected in a child’s urine than normal, these may be for the same reasons as in adults, with the exception of processes such as prostatitis, adenoma and prostate cancer in boys. Amyloidosis, tumors (benign and malignant) and cysts of the urinary tract are rare for children.

Each child’s age is characterized by a different set of diseases accompanied by leukocyturia:

• Before one year of age, some severe congenital malformations of the urinary tract, drug-induced kidney damage, and vesicoureteral reflux (reflux of urine from the bladder into the ureters) begin to appear. Leukocyturia can also appear with diaper rash, as well as when a child has diathesis (in children with diathesis, the norm of leukocytes in the urine is 2 cells more than in peers without this allergic disease). Girls at this age may already have vulvitis, then even with the naked eye parents can notice redness and swelling in the area of ​​the labia minora and the vestibule of the vagina.
• When the child is one year old , leukocytes indicate enterobiasis (pinworms), inflammation in the urinary tract: urethritis, cystitis, vesicoureteral reflux, and, less commonly, glomerulonephritis. In girls, this may be a sign of vulvitis.
• Up to 3 years, the main causes of leukocyturia are: enterobiasis, kidney injuries, vesicoureteral reflux, urinary tract infections, including pyelonephritis. They, appearing for the first time at this age, often become chronic, and if not treated correctly can be complicated by pyonephrosis. In boys at this age, phimosis debuts.
• From 3 to 5 years, leukocyturia can indicate enterobiasis, urolithiasis, urethritis or cystitis (more often), pyelonephritis (less often), kidney injury, glomerulonephritis. Girls have vulvitis, boys have balanoposthitis.
• Age from 5 to 11 years is typical for urolithiasis, urinary tract infections, acute appendicitis, kidney injuries, glomerulonephritis. If there was mild vesicoureteral reflux, then at 6-7 years old, on the contrary, it can heal on its own. At this age, enterobiasis can also occur, causing leukocyturia.
• In children over 12 years of age, 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.

Causes of leukocyturia

An increased content of leukocytes in the urine is characteristic of the following diseases:

• pyelonephritis;
• glomerulonephritis;
• hydronephrosis;
• interstitial nephritis;
• kidney transplant rejection;
• kidney tuberculosis;
• cystitis;
• urethritis;
• urolithiasis disease;
• appendicitis;
• prostatitis;
• malignant tumors of the kidneys, bladder;
• inflammation of the uterine appendages and other diseases of the female reproductive system (vaginitis, candidiasis, vulvovaginitis);
• parasitic infections;
• intoxication;
• heart failure.

An increase in white blood cells can be caused by taking certain medications (antibiotics, diuretics, anti-tuberculosis drugs, immunosuppressants, drugs from the group of non-steroidal anti-inflammatory drugs).

With the development of an inflammatory reaction due to the destruction of tubules and cellular infiltration, conditions are created for the excessive release of leukocytes from the source of inflammation into the urine.

An increase in leukocytes in the urine of women is observed during pregnancy.

What to do if there is an increase in leukocytes in the urine

There is a special algorithm of actions that must be followed in order to establish the cause of leukocyturia:

1. Perform a thorough toileting of the external genitalia, as described in the section below, and only then take a general urine test again.
2. If the second analysis is normal, doctors recommend not to calm down, but, with prior agreement with a nephrologist or urologist (especially if it concerns a child), to collect urine during the day for the Addis-Kakovsky test. Only if it is the norm there, you can do nothing further.
3. If in the second urine test the number of leukocytes is again increased, even if it is a figure of 3-5 cells, 2 tests are needed: urine culture (for this, urine must be given after genital hygiene and always in a sterile jar) and a three-glass sample. Based on bacterial culture data, it is possible to determine which pathogen caused the inflammation, and based on the data of a three-glass sample, its localization can be established.

The three-glass test is most often performed in a hospital to avoid errors, but can also be performed at home. It requires 3 identical clean containers, which are numbered accordingly: “1”, “2”, “3”. After hygiene of the genital organs, you need to start urinating, but do it in such a way that very little urine (1/5) gets into the first glass, the maximum amount (3/5) into the second glass, and the last few drops (1/5 of the volume) into the third glass. .

Next, 3 glasses are sent to the laboratory, where the number of leukocytes in each of them is counted. Next they reason like this:

• if the maximum number of these cells is in jar No. 1, then this is urethritis, vaginitis or enterobiasis;
• if the maximum number of leukocytes is in sample No. 3, then this indicates prostatitis or inflammation of deeper tissues in the pelvis;
• if there are a lot of cells in all three samples, it means inflammation either in the kidneys or in the bladder.

Besides:

• If, during a three-glass test, leukocytes are increased in all samples, an ultrasound scan of the kidneys and bladder is performed. Next, determine which organ is inflamed. If, according to ultrasound, it is the bladder, x-ray cystography is performed. If, according to ultrasound data, it is the bladder, you need to do urography or renoscintigraphy.
• If, when conducting a three-glass test, the maximum number of leukocytes is in the first portion, the following tests are needed: imprint for enterobiasis in persons of both sexes; for men - a smear from the urethra, and for women - a smear from the vagina. Both smears must be sent to a bacteriological laboratory.
• During a three-glass test or a separate study, it is necessary to determine the shape of leukocytes: if the majority of leukocytes are neutrophils, this indicates: pyelonephritis, cystitis, urethritis, acute glomerulonephritis, or exacerbation of chronic glomerulonephritis. Special staining with gential violet and saffronin will partly help to distinguish pathologies. It can detect Sternheimer-Malbin cells (active white blood cells). If there are many of them, this speaks in favor of pyelonephritis;
• if the majority are mononuclear cells. They are determined in the later stages of glomerulonephritis, as well as in interstitial nephritis;
• when there are a lot of eosinophils, then with a negative urine culture this is an excellent help to the doctor. So he learns that the cause of leukocyturia is allergic diseases;
• if the majority of cells are lymphocytes, this indicates lupus or rheumatoid nephritis, glomerulonephritis.

Before all these studies, you should not self-medicate: both antibiotics and traditional methods can only be used on the basis of an established diagnosis.

Rules for collecting material for analysis

To prevent the study from showing distorted data, the material for analysis should be collected correctly. Before collecting urine, it is necessary to perform a thorough toilet of the genitourinary organs. This will minimize the likelihood of third-party contaminants getting into the liquid. Urine should be collected in a sterile container. For this purpose, special containers for biosamples are used.

12 hours before collecting fluid, it is necessary to avoid taking any medications that may affect the physical and chemical parameters of urine. The analysis itself should be carried out no more than 2 hours after sample collection. It is prohibited to store the container with the collected material. Microorganisms may begin to multiply in the urine. Results may not be accurate.

If you plan to conduct a general urine test, you must collect fluid in the morning. During the night, physiological accumulation of fluid occurs. This material is considered the most optimal. In this case, the research results will be as reliable as possible.

If a woman has started menstruating, she cannot give urine for analysis. If blood enters the container, the result will be unreliable.

It is recommended to flush the first portion of liquid down the toilet. Then, without interrupting the process of emptying the bladder, you need to collect a sufficient amount of urine in a container and seal it tightly. The resulting material must be immediately delivered to the laboratory.

How to donate urine correctly

In order to prevent leukocytes from the genital tract from entering the urine, whether a child or an adult, he needs to prepare for the study. To do this, you need to buy a sterile jar for urine at the pharmacy, and for infants, also a urinal, which is glued to the genitals (they are different for boys and girls).

The day before the test, exclude sorrel, game, chocolate from your diet, and red wine for adults. You also need to consult with your doctor whether it is possible to take Dexamethasone, other hormonal or antibacterial drugs for 2-3 days before this laboratory test.

Immediately after waking up, you need to wash yourself with soap, and wash everything: the inguinal folds, genitals, external anal sphincter with movements directed from front to back. Next, carefully open the lid of the jar and collect the urine there. For a general analysis, you need not an average, but a full portion of urine: at least 5 ml (in infants) and no more than 150 ml in adults.

Author:

Krivega Maria Salavatovna resuscitator

After urine test

Abnormal urine results usually require additional screening methods to adequately determine the cause. These may include:

• blood tests;
• imaging tests, such as computed tomography or MRI;
• comprehensive metabolic panel (CMP);
• urine culture;
• complete blood count (CBC);

Table of norms for general urine analysis in adults and children

Diagnostics

The main screening method used to identify pathology is a general urinalysis. During its implementation, organoleptic and physicochemical properties and cellular composition are determined. In order to identify latent leukocyturia or make a correct diagnosis, the following laboratory methods are used:

• analysis according to Nechiporenko;
• Kakovsky-Addis test;
• Amburger method;
• prednisolone test;
• technique for identifying active leukocytes.

After determining the quantitative composition of the formed elements, urine culture and a three-glass sample are carried out. These types of studies make it possible to establish the type of pathogen and the site of the pathological process. Additionally, ultrasound of the bladder and cystoscopy are performed. The woman should be examined by a gynecologist.