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What Do Leukocytes In The Urine Mean?

Leukocytes are white blood cells that are vital to immune system defenses. Leukocytes in the urine can indicate an infection or inflammation in the urinary tract.

Having leukocytes in the urine may be a sign of infection. A urinary tract infection (UTI) is often responsible for increasing leukocyte levels in the urine.

UTIs are one of the most common infections worldwide, with an estimated 404 million cases estimated to have occurred in 2019.

This article will explain what an excess of white blood cells in the urine means, as well as how to treat a UTI.

Leukocytes are white blood cells. They are heavily involved in immune responses that protect people from infection.

There are several types of white blood cells. The two main leukocytes are phagocytes and lymphocytes.

Phagocytes are produced in the bone marrow. Their job is to engulf foreign particles, such as bacteria or parasites. This means surrounding, absorbing, and destroying a particle.

Lymphocytes are the white blood cells that recognize foreign particles based on previous encounters. They contribute to "adaptive" immunity, the sophisticated ability of the immune system to remember and produce tailored and effective responses to an infection.

Lymphocytes produce antibodies. These bind to foreign particles and allow the immune system to remember them later on, should the same infection occur.

An unusually high number of leukocytes in the urine indicates inflammation or infection along the urinary tract.

These will show in a urine test. The doctor may carry out a dipstick test, in which a chemical strip detects an enzyme called leukocyte esterase that points to the presence of white blood cells, typically related to an infection. The dipstick test also highlights nitrites, which are a waste product from the breakdown of certain bacteria.

The presence of nitrites in the urine is highly specific to certain bacterial infections. Nitrites do not occur with all types of bacteria.

An absence of leukocyte esterase in the urine means that the urine is not likely to contain white blood cells, so it is not likely to be carrying infectious agents.

The doctor or laboratory technician may also perform a urine culture. This involves growing bacteria from the urine to identify the cause of the infection.

During pregnancy, women receive testing for urinary infections during their first prenatal visit, and they might need testing at other times during their pregnancy.

Indeed, UTIs are common during pregnancy and doctors will often find leukocytes in the urine that suggest the presence of an infection. However, some women who are pregnant have a bacterial infection in the urine without symptoms.

This is known as asymptomatic bacteriuria.

Normal results

Normal urine pH is slightly acidic, with usual values of 5.5 to 7.5. However, the normal range falls between 4.5 to 8.0.

A urine pH of 8.5 to 9.0 indicates the presence of bacteria, such as Proteus, Klebsiella, or Ureaplasma urealyticum, which cause UTIs.

Leukocytes in the urine without nitrite

If the test for leukocyte esterase is positive but finds no nitrite, an infection may still be present.

The test is particular to certain bacterial enzymes, which means it can pick up specific bacterial infections with more certainty. However, it is not highly sensitive, which means that the test does not pick up all bacterial infections. E. Coli bacteria are most commonly associated with nitrites in the urine.

Having leukocytes in the urine without nitrites can also lead to a false-positive result that points to a bacterial infection when there is none. The pathologist or technician will carry out further testing to confirm the presence of an infection.

This is particularly true when there are other causes of inflammation in the urinary tract. The genital canal can sometimes pass leukocytes into the urine during the process of giving a sample.

To avoid a false-positive result, people should clean the area around the urethral opening before giving the sample, using cleansing wipes and holding their labia or foreskin aside.

Take a sample halfway through urinating. The initial stream of urine may be contaminated by skin bacteria, so taking a sample this way also reduces the risk of a misleading outcome.

A UTI can affect the upper and lower urinary tracts, kidneys, bladder, urethra, and prostate.

Lower urinary tract infections may also have these specific names:

Both upper and lower UTIs can lead to leukocytes in the urine.

Symptoms vary and often overlap, but they might include:

Symptoms of more serious infections can include:

It is important to seek medical attention right away if any of these symptoms occur.

Kidney stones

Kidney stones are crystals that form when calcium and other minerals build up in a person's urine. They can vary from small to large. If it's the latter, they may cause pain and get stuck along the way, causing the flow of urine to be blocked.

Signs of kidney stones include:

Inflammation in the body can trigger the release of leukocytes. This can come from an injury, infection, or disease.

Leukocytes in the urine can also be from sexually transmitted infections, fungal infections, genitourinary tuberculosis, certain autoimmune or inflammatory diseases, and even inflammation outside of the urinary tract.

Most UTIs cause manageable infections that an individual can treat with antibiotics. The doctor may prescribe a range of different antibiotics, although they will only prescribe certain antibiotics to women during pregnancy.

More severe or serious infections with complications, such as abscesses, kidney involvement, or any infections that occur during pregnancy, may need more intensive treatment, including hospitalization.

The doctor may need to change the course of antibiotic drugs once the bacteria are identified. Certain bacteria can only be treated with specific antibiotics.

Below are some commonly asked questions about leukocyte esterase in urine.

Should I worry about leukocytes in urine?

Leukocytes in the urine are often the result of inflammation or infection, such as a UTI.

A person should not be concerned about this, as most UTIs can be treated with antibiotics. If leukocytes in urine point to a more serious infection or complication, more intensive treatment may be needed.

Can you have leukocyte esterase in urine but no UTI?

Leukocyte esterase in the urine does not always mean a person has a UTI. It can also point to kidney stones or general inflammation from an injury, infection, or disease.

Can anxiety cause leukocytes in urine?

According to a 2017 study, there may be a reciprocal relationship between anxiety/depression and lower urinary tract symptoms. However, more research is needed on this topic.

Leukocytes in the urine can indicate an infection or inflammation in the urinary tract.

It can also point to kidney stones or general inflammation as a result of injury.

Treatment options for UTIs include antibiotics but, in more severe cases, may require intensive interventions.

Infections that are more severe or carry complications, such as abscesses, kidney involvement, or those occurring during pregnancy, might require more intensive treatment, potentially involving hospitalization.

They Discover Bacteria In The Urine That Could Predict The Risk Of Aggressive Prostate Cancer

A scientific team from the University of East Anglia, in the United Kingdom, identified in the urine of a group of men a number of bacteria that are linked to a very aggressive type of prostate cancer. Research opens the door to developing a new type of detection of serious tumors with a urinalysis. The work was published in the journal European Urology Oncology.

According to the study, experts analyzed more than 600 patients with and without prostate cancer, to evaluate the usefulness of a bacterial urine test. This allowed them to identify 5 types of bacteria that repeated in different samples and tissue from men with cancer types that later became aggressive.

These are bacteria capable of growing without oxygen. Specialists revealed that some of these microorganisms were new, never found before. The discovery is of great value because it would allow the development of a new way to detect aggressive prostate cancer early.

Specialists believe that it is still too early to say for sure that the bacteria found are those that could cause cancer rather than just a useful biomarker.

Raúl Hernando Murillo, from the Javeriano Center for Oncology, highlighted in the latest issue of the Journal of Colombian Urology the importance of finding a way to detect the most serious prostate cancers. "Reducing mortality is the primary objective of screening (simple screening) for cancer and given the frequent late manifestation of symptoms, the search for the disease in an asymptomatic population is quite logical; however, this logic is based on the definition of neoplasia (tumors) malignant as the abnormal growth of cells capable of progressive invasion, ability which is determined by morphological changes and not by the dynamics of the disease. Today it is known that morphological changes have a broad spectrum with variable natural courses, including neoplasms that do not progress or that progress very slowly without manifesting during the patient's lifetime."

Given this, he added that "the detection of indolent tumors is common to the search for the disease in its invasive state, since detection in pre-invasive states is exempt from this discussion." The Colombian expert considered that "early detection of cancer cannot be done at any cost and that such intervention should avoid overdiagnosis of indolent tumors and therefore the undesirable effects of unnecessary treatment".

The team at the University of East Anglia, BBC reported, will continue to work to determine whether eliminating the infection caused by these bacteria could prevent malignant tumors. Until now, it has been known that a bacterial infection plays an important role in the development of some types of cancer such as stomach cancer, for example, and the use of antibiotics can reduce or eliminate the risk.

Prostate cancer is the second leading cause of death in cancer patients in Latin America. Specialists say that regular check-ups can detect early and increase the chances of treatment and cure, although they recognized that all men are at risk of prostate cancer, and that the most common risk factor is age. The older a man is, the more likely he is to suffer from prostate cancer.

The prostate is a gland in the male reproductive system that is located below the bladder and in front of the rectum. It contains cells that produce part of the seminal fluid that protects and nourishes sperm. Its size may change as a man ages. Cancer in this organ is caused by the malignization of certain prostate cells.

According to a publication by the Mexican Society of Urology, "it usually occurs after age 50 and its symptoms are no different from those of benign prostatic growth (BPH). Its timely detection allows it to be cured either through surgery or with some other type of procedure," he said.

If a cure is not achieved, the scientific entity added, "it is also possible to carry out palliative treatments that allow to prolong the survival of these patients. The lack of adequate information and the 'macho' attitudes of patients are what prevent us from being able to cure the vast majority of patients who suffer from it, since they do not go to the urologist for their routine check-up after 40 years of life," he warned.

After the diagnosis of prostate cancer, there are different treatments. "Applying general measures such as avoiding agents that cause inflammation to the organ, having adequate fluid intake and the use of specific medications or performing surgeries are the alternatives for treatment," added the Mexican scientific society.

Although prostate cancer is not always fatal, some tumors grow slowly and without causing problems for the patient and only need to be controlled. But science still has the challenge of diagnosing and applying rapid treatments to men who have the most aggressive versions of the disease, since some tumors are rapidly growing. The possibility of distinguishing through a urinalysis that there is a risk of suffering aggressive cancer will make it possible to develop unnecessary treatments for those who have not so aggressive tumors.

PSA blood tests and biopsy are currently available screening tests, although they cannot always predict which cancers will be harmful.

Research conducted by the University of East Anglia was conducted on 600 patients, one group suffering from cancer and the other not, in order to evaluate the usefulness of the bacterial urine test. Two of the five types of bacteria found were named after two sponsors of the study Porphyromonas bobii, by The Bob Champion Cancer Trust and Varibaculum prostatecancerukia, by Prostate Cancer UK.

"Among the things we don't know yet is how people get these bacteria, whether they are causing cancer, or whether a poor immune response allows the bacteria to grow," explained Dr. Rachel Hurst, a member of the research team.

The expert said that the team she is part of hopes that her findings and the work she will face in the future "may lead to new treatment options, which could delay or prevent the development of aggressive prostate cancer." "Our work could also lay the groundwork for new tests that use bacteria to predict the most effective treatment for prostate cancer in every man," he explained.

Meanwhile, Dr. Colin Cooper, one of the research directors, told the BBC that he was very sure that the findings were real: they had followed rigorous measures to ensure that there was no possibility of contamination while carrying out laboratory work. The expert assured that it is possible that some of the bacteria discovered are producers of hormones that drive the development of aggressive tumors.

"Nearly four out of 10 cancers in the UK are linked to known risk factors, such as smoking and obesity. But there are other risk factors that cause cancer, such as bacteria, that we know only beginning to identify," said Dr. Sam Godfrey of Cancer Research UK.

"More studies are needed to establish how these bacteria are involved in the growth of prostate cancer, but this research could help generate new screening and prevention tools that would help reduce the impact of these cancers on society," he added.

According to the Pan American Health Organization (PAHO), around 413,000 new cases of prostate cancer are diagnosed each year in the Americas. In the same period, approximately 85,000 patients die and 1 in 7 men will be diagnosed with prostate cancer in their lifetime.

Dr. Carlos Silva, head of the Oncology Service of the Austral University Hospital and British Hospital of Buenos Aires, and coordinator of the psychosocial area of LALCEC, emphasized that "a timely study can save a man's life". "Late detection can happen because in its early stages this type of cancer has no symptoms, so we emphasize the importance of routine studies," the specialist added.

"It is advisable to consult with the urologist who will be able to advise the patient on the best way to monitor the health of his prostate. If diagnosed early, the chances of cure and survival are high," said Dr. Gonzalo Vitagliano, head of the Oncology and Urolaparoscopy section of the German Hospital.

Different prostate cancer patients may experience different symptoms, and some men do not experience any symptoms. The CDC warns that the most common signs may be difficulty urinating, weak or interrupted urine flow, difficulty emptying the bladder completely. People who have prostate cancer may also have to urinate more often at night, experience pain when urinating, and may even have blood in their urine or semen. Ejaculation can also become painful. The CDC says men with prostate cancer may also experience pain in the back, hips, or pelvis that doesn't go away.

KEEP READING

Urine Bugs May Be A Sign Of Aggressive Prostate Cancer

By Michelle RobertsDigital health editor

Scientists say they have identified urine bacteria which are linked to aggressive prostate cancer.

The discovery might provide new ways to spot and even prevent these dangerous tumours, experts hope.

It's too soon to say if the bacteria might cause the cancer, rather than just be a helpful marker.

The University of East Anglia team which found the link plan more work to see if clearing the infection might prevent bad tumours.

Bacterial infection is known to play a part in the development of other cancers - a bug called H. Pylori can trigger stomach cancer, for example, and a course of antibiotics can get rid of this risk.

Prostate growths

Prostate cancer is not always life-threatening - some tumours grow too slowly to ever cause any problems, and can safely be left alone and simply monitored instead.

The challenge is diagnosing and quickly treating men who have the aggressive, fast-growing ones that harm, while sparing others from unnecessary treatment.

Currently available tests, such as the PSA blood check and a biopsy, are not always able to predict which cancers will be harmful.

For this latest work, published in the journal European Urology Oncology, the researchers studied more than 600 patients with and without prostate cancer, to assess how useful the urine bacterial test was.

They identified five types of bacteria which were common in urine and tissue samples from men whose cancers ultimately went on to be aggressive.

All were types of bacteria that can grow without oxygen. Some were brand new types, never found until now.

Two of the new bacteria species found by the team have been named after two of the study's funders - Porphyromonas bobii, after the The Bob Champion Cancer Trust and Varibaculum prostatecancerukia, after Prostate Cancer UK.

Dr Rachel Hurst, one of the research team, said: "Among the things we don't yet know is how people pick up these bacteria, whether they are causing the cancer, or whether a poor immune response permits the growth of the bacteria.

"But we hope that our findings and future work could lead to new treatment options, that could slow or prevent aggressive prostate cancer from developing. Our work could also lay the foundations for new tests that use bacteria to predict the most effective treatment for each man's cancer."

Her colleague Prof Colin Cooper, who co-led the research, told the BBC he was very confident that the findings were real - they had followed rigorous measures to make sure there was no chance of contamination as they carried out the lab work.

He said it was possible that some of these bacteria make hormones that drive the development of aggressive tumours.

Dr Sam Godfrey from Cancer Research UK, said: "Nearly four in 10 cancers in the UK are linked to known risk factors such as smoking and obesity. But there are other cancer-causing risk factors, such as bacteria, that we are only just beginning to identify.

"More studies are needed to establish how these bacteria are involved in prostate cancer growth, but this research could help lead to new screening and prevention tools that would help reduce the impact of these cancers on society."

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