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3.5 Minute

22-06-2024 Team Medicover urology

Written by Medicover Team and Medically Reviewed by Dr Ravi Shankar Karupothula

Epithelial Cells in Urine

Epithelial cells are the thin layer of cells that line various surfaces of the body, including the urinary tract. It's normal to have a small number of these cells in your urine, as they naturally shed from the bladder and urethra.

However, high levels of epithelial cells in urine may indicate a serious health issue like an infection, inflammation or kidney problem. A routine urine test is done to determine their presence and can help guide further diagnosis and treatment.

What are Epithelial Cells?

Epithelial cells are a type of cell that lines the surfaces of your body. They are found on your skin, the lining of your internal organs, blood vessels and various cavities throughout the body.

These cells form epithelial tissue, which acts as a barrier, protecting the body from physical damage, pathogens and dehydration. Epithelial cells also play important roles in absorption, secretion, sensation and transport.

Types of Epithelial Cells Found in Urine

During a urine test (urinalysis), three main types of epithelial cells may be observed. Identifying the type can help doctors pinpoint where a problem might be occurring in the urinary system.

1. Squamous Epithelial Cells

These are large, flat cells with irregular shapes.
They usually come from the outer lining of the urethra or the genital area.
Common cause: Often appear due to contamination during sample collection and usually do not indicate a serious issue.

2. Transitional Epithelial Cells

These cells line the bladder, ureters and upper part of the urethra.
A moderate number may be normal, but high levels could suggest bladder irritation, inflammation or infection.

3. Renal Tubular Epithelial Cells

These are small, round cells found in the kidneys.
Their presence may signal a more serious condition like acute kidney injury, glomerulonephritis or nephrotic syndrome.
High numbers are clinically significant and require immediate treatment.

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Causes of High Epithelial Cells in Urine

Several factors can contribute to the presence of epithelial cells in urine. Some common causes include:

Urinary tract infections (UTIs)
Kidney infections
Bladder infections
Inflammation of the urinary tract
Strenuous exercise

It's essential to identify the cause of epithelial cells in urine to receive proper treatment and prevent complications.

Symptoms of Epithelial Cells in Urine

High epithelial cells in urine themselves don't cause symptoms, but they often appear as a result of health issues. Possible signs you might experience:

Burning sensation during urination.
Cloudy or foul-smelling urine.
Frequent urge to urinate.
Lower abdominal or back pain.
Fever or chills (in case of urinary tract infection).
Presence of blood in the urine.

Epithelial Cells in Urine Test

A urine analysis is the test commonly used to detect epithelial cells in urine. During this test:

A urine sample is collected and examined under a microscope.
The number and type of epithelial cells are noted.
The presence of high epithelial cells may suggest infection, kidney disease or contamination of the sample.

The type of epithelial cells found can help doctors identify where in the urinary tract the issue originated:

Squamous epithelial cells: These usually come from the urethra and their presence might mean that the sample got contaminated.
Transitional epithelial cells: These cells are found in the bladder or ureters and a higher number of them can indicate inflammation or an infection.
Renal tubular epithelial cells: These come from the kidneys and finding them can be a sign of possible kidney damage or disease.

Epithelial Cells in Urine Normal Range

A small number of epithelial cells in urine is considered normal, as the lining of the urinary tract naturally sheds some cells.

In a typical urine microscopy test, finding 0 to 5 epithelial cells per high power field (HPF) is within the normal range. Anything above this may indicate a health issue such as a urinary tract infection, inflammation, kidney disorder or contamination of the sample.

The interpretation can also depend on the type of epithelial cells found, so a complete analysis by a doctor is essential for accurate diagnosis.

When to Worry About Epithelial Cells in Urine?

Finding a small number of epithelial cells in your urine is usually harmless. These cells naturally shed from the urinary tract. However, there are certain situations in which high levels may be a cause for concern and require medical attention.

You Should Worry About Epithelial Cells in Urine If:

If repeated urine tests show moderate to large numbers of epithelial cells
If the test result is paired with symptoms like burning or pain while urinating, cloudy or foul-smelling urine, blood in urine, fever or back pain, urinary urgency or frequency
If renal tubular epithelial cells are found
If high epithelial cells are seen along with protein in urine, white or red blood cells, casts or crystals

Treatment for Epithelial Cells in Urine

Treatment isn't aimed at the epithelial cells themselves but at the underlying cause that's leading to their increased presence. Once the cause is identified through urine tests, physical examination, or imaging, the following treatments may be recommended:

1. Urinary Tract Infections (UTIs)

Antibiotics are commonly prescribed to eliminate the infection.
Drinking plenty of fluids and maintaining hygiene support faster recovery.

2. Kidney Conditions

If renal tubular epithelial cells are detected, doctors may order kidney function tests.
Treatment depends on the diagnosis and may involve medications, lifestyle changes or in severe cases, hospital-based care.

3. Bladder Irritation or Inflammation

This can be treated with anti-inflammatory medications, increased water intake and avoiding bladder irritants like caffeine or spicy food.

4. Sample Contamination

If squamous cells appear due to contamination, no treatment is needed. A repeat urine test may be advised with a better sample collection technique.

5. Other Conditions

Managing health issues like diabetes, high blood pressure or autoimmune diseases is important for long-term urinary health.

Note: Always consult a doctor for an accurate diagnosis and treatment. Self-medicating can worsen symptoms or delay proper care.

Kidney Issues and Epithelial Cells

Epithelial cells in urine can sometimes be associated with kidney issues like kidney infections or kidney stones.

If you have recurrent episodes of high epithelial cells in your urine or if other kidney-related symptoms are present, it's crucial to seek medical care immediately.

Your doctor may recommend additional tests like kidney function tests or imaging tests or consultations with a specialist to manage kidney issues effectively.

Epithelial Cells in Urine During Pregnancy

It's normal to have a slightly higher number of epithelial cells in urine during pregnancy.

This happens because the kidneys work harder to filter waste, and hormonal changes can affect the lining of the urinary tract, causing more cells to shed into the urine.

How to Prevent High Epithelial Cells in the Urine?

Preventing high levels of epithelial cells often involves maintaining good urinary tract health and hygiene. Here are some helpful tips:

Stay hydrated: Drinking plenty of water helps flush out bacteria and toxins from the urinary system.
Practice good hygiene, especially for women. Always wipe from front to back and keep the genital area clean.
Avoid holding urine for too long: This can increase the risk of urinary tract infections.
Urinate after sex: Helps clear any bacteria that might enter the urethra.
Avoid harsh soaps or douches: These can irritate the urinary tract lining.
Manage chronic health conditions: Conditions like diabetes or kidney disease can affect urinary health, keep them under control with medical guidance.

When to See a Doctor?

You should consult a doctor if:

You have symptoms like pain during urination, lower abdominal pain or fever
Your urinalysis shows many epithelial cells
You have risk factors for kidney or urinary problems

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Conclusion

Epithelial cells in urine can indicate various health conditions, ranging from infections to kidney issues. Understanding the causes and implications of epithelial cells in urine is essential for timely diagnosis and appropriate treatment.

If you notice any concerning symptoms or abnormalities in your urine test results, don't hesitate to consult your healthcare provider for further evaluation and management.

Frequently Asked Questions

A small number of epithelial cells in urine is normal, but high levels may indicate kidney issues, infections, or other urinary tract problems.

Conditions like urinary tract infections (UTIs), kidney disease, bladder infections, and inflammation of the urinary tract can cause elevated epithelial cells in urine.

Not always. A few epithelial cells are normal, but a high count may require further evaluation to rule out infections or kidney-related conditions.

Routine urine tests are recommended annually or as advised by a doctor, especially if you have urinary symptoms or kidney disease risk factors.

Consult a doctor if you experience symptoms like frequent urination, pain, blood in urine, or if a urine test shows high epithelial cell levels.

Up to 15–20 epithelial cells per high power field (HPF) is generally considered normal in pregnancy. Higher levels may need further evaluation.