Leukocytes in the urine. Leukocyturia - what is it, hidden, asymptomatic

Leukocyturia is an inflammatory process that occurs in urinary tract, as well as the pelvis, kidney tissues. This is not a disease, but a certain factor indicating one of the many infectious diseases, including: cystitis, nephritis, pyelonephritis, as well as tuberculosis, prostatitis, etc. In the vast majority of cases (about 90%), leukocyturia is observed with urolithiasis.

Any infection in the organs of the urinary system is manifested by typical clinical symptoms namely, intoxication and pain. The inflammatory process is also confirmed by laboratory parameters. In the study of urine, leukocytosis, accelerated ESR, and an increase in the level of proteins (CRP) are detected. All these are pronounced signs of an acute inflammatory process. Its consequence is leukocyturia - the presence in the urine high level leukocytes, which exceeds the norm.

Why does such a phenomenon as leukocyturia occur, causes, treatment, symptoms, what are they?
Let's talk about this in more detail.

Why does leukocyturia occur? Causes

Inflammatory conditions lead to an increase in the number of leukocytes kidney disease bacterial nature in particular: pyelonephritis, glomerulonephritis.

If a patient is diagnosed with urolithiasis, blockage of the ureter by a stone quite often occurs. When an inflammatory infectious process is attached to this phenomenon, leukocyturia occurs.

Often this pathological phenomenon is observed in pregnant women. The fact is that expectant mothers very often suffer from cystitis. It is related to what is happening physiological changes. Therefore, if symptoms of cystitis occur, a pregnant woman should immediately consult a doctor.

Women affected by this pathology reproductive age who live sexually. In this case, the risk of infection through the urethra increases. Inflammation occurs, leukocyturia appears.

How is leukocyturia manifested? Symptoms of pathology

The inflammatory process in the urinary system is manifested by characteristic symptoms:

The occurrence of acute, blunt, or aching pain, usually in the lower back, lower back and/or lower abdomen, frequent urges to urination. Pain, burning sensation. Cloudy urine is very common

An increase in body temperature, in the absence of any symptoms of a cold.

How is leukocyturia corrected? Treatment

If a pathology is detected, the first step is to carry out further diagnostics of the body in order to detect the underlying disease. Then measures are taken to eliminate the source of inflammation, treatment of infection. The doctor differentiates a type of leukocyturia, develops a strategy for therapeutic measures.

In the presence of infectious leukocyturia, antibiotic treatment using antibiotics. Prescribe drugs of the cephalosporin group. Fluoroquinolol preparations, drugs of the classic penicillin series are used. At the same time, the patient is prescribed enzymes that help reduce the risk side effects.

If leukocyturia is caused by urogenital pathology, if pathogens such as chlamydia or ureoplasma are detected, the doctor will prescribe drugs of the tetracycline group.

During pregnancy, drugs of the cephalosporin group from the new generation are used. They usually do not have serious side effects, they are relatively safe for the body of the mother and the unborn baby.

Aseptic leukocyturia is usually treated topically with antiseptic drugs. Conduct irrigation, douching. Also, patients are prescribed immunomodulating drugs, vitamins from group B, and vitamin C. Careful observance of personal hygiene is recommended.

In order to reduce possible relapses infectious inflammatory process, carry out preventive course, seven-day antibacterial treatment. It is usually carried out one month after the main therapy.

Be aware that persistent, refractory, recurrent leukocyturia is usually indicative of unidentified sources. infectious inflammation. In such cases, the patient is usually placed in a hospital for a thorough examination and subsequent treatment.

Alternative treatment of inflammation of the kidneys

Traditional medicine widely uses bearberry leaves for the treatment of kidneys. With the help of the infusion of this plant, inflammation is removed, pain disappears. Usually treatment is carried out for a month. If necessary, take a break for 2 weeks, and then repeat the treatment.

To prepare, pour into a mug 1 tbsp. l. leaves. Add 200 ml of boiling water. Cover with a saucer, wrap with a warm towel. Leave for 1-2 hours in a warm place. Then strain everything. Take the medicine for 1 tbsp. l. after meal. This tool can not be used for glomerulonephritis and pregnancy.

Before using any folk remedies be sure to check with your doctor. Be healthy!

White blood cells are heterogeneous groups of cells that differ in their appearance as well as the functions they perform. The peculiarity of such cells is that they have a nucleus, but their own color is completely absent. With the help of leukocytes, both specific and non-specific protection of our body from external and internal pathogenic factors is carried out.

There are several types of white blood cells. Regardless of the variety, they all actively move, penetrate the tissues through the capillary walls. And already in the tissues, white blood cells absorb foreign particles and also digest them. This is a very complex process that has been studied for more than one year. In medicine, it is called phagocytosis. And the cells that participate in this process are called phagocytes.

If too many cells of foreign origin are present in the body, phagocytes are able to increase in size. Because of this, they are destroyed and thereby release special substances that cause inflammatory reactions local character. While the fight is going on foreign bodies and damaged cells, many white blood cells die. They form accumulations of pus, which we can often observe in open wounds. Pus is removed in several ways, one of which is through urine.

white blood cells

The rate of leukocytes in the urine varies depending on gender, as well as on the age of the person. So, the norm for adult representatives of the male half is the content of white bodies in urine from 0 to 3 in the field of view. For the representatives of the beautiful half, these limits vary from 0 to 5 units.

Permissible levels of leukocytes in urine depending on gender and age

An increased content of leukocytes in the urine, when their upper thresholds reach 20 units or more, is called leukocyturia. If these limits reach 60 units, and pus appears in the urine, it makes sense to think about a pathological process that is purulent-inflammatory in nature and is located in a specific organ from genitourinary system. At the same time, changes in urine are visible immediately, it is not even necessary to carry out any additional surveys in order to understand with accuracy - in the body, or rather, one of its organs has inflammation, which threatens with serious complications. Such urine is not transparent, it is cloudy with distinguishable threads of pus and flakes.

Leukocytes in the urine of a child are determined somewhat differently, and the norm in this case differs from the norms of adults. So, at birth and in slightly older children, urine should contain from 1 to 8 leukocytes in the field of view. It is noteworthy that the norms of boys are somewhat lower, their leukocytes should not exceed 5 units.

Even if the baby is completely healthy, up to 2 units of white bodies can remain in the field of view of his urine. In some cases, this is considered completely dangerous state and even a norm that applies only to children.

Causes of leukocyturia

A large number of leukocytes in the urine can appear due to the development of diseases such as:

Leukocyturia can develop in other conditions. Let's consider each of them in more detail.

Pregnancy. In some cases, this condition can cause the growth of white blood cells in the urine. Often this can mean infectious process that develops in the vagina. Especially the doctor should be alerted by the condition in which leukocyturia progresses rapidly, while it accompanies concomitant symptoms. It is very important to diagnose, or rather, exclude, in this case, inflammatory processes in the urea.
Kidney infection. Most often, pathological processes originate in the urinary tract, urea, and already further spread to the kidneys. The probability of developing a pathological process is especially high in cases where immunity is weakened or urea catheterization has occurred. During inflammation, the patient experiences pain in the lumbar region, the color of his urine changes, and his body temperature rises.
Infectious diseases of the urinary tract. These include cystitis, urethritis, prostatitis. In these conditions, patients experience soreness above the pubis, as well as pain during the act of urination.
Sexual infections that are passed from one sexual partner to another. These infections can become sources of inflammation, which leads to an increase in the number of white cells in urine.
Retention of urine in the bladder. This condition can cause the walls of the organ to overstretch, a pathogenic environment develops in it, which becomes a source of infection and an increase in white bodies.
Narrowed or blocked urinary tract. This state can also provoke the development of leukocyturia. In turn, kidney stones, malignant neoplasms, prostate hypertrophy and trauma can lead to such narrowing.
Tuberculous kidney disease or amyloidosis.

As for children, leukocyturia most often develops against the background of infectious diseases and inflammatory processes. Most often, an increase in leukocytes indicates cystitis, urethritis, inflammation in the kidneys and genital organs, impaired metabolic process, allergic reactions and some others pathological processes that can occur in the child's body.

An increased content of white cells can tell about the inflammatory process in the body

How to take tests correctly

It is determined whether leukocytes in the urine are elevated or not by conducting specific tests. However, these tests should be taken and collected correctly. After all, sometimes elevated white blood cells- just the result of improperly collected urine. To exclude this, if leukocyturia is detected in a patient in without fail It is proposed to retake the tests and undergo a second urine test. The doctor should be especially alert when the tests show the presence of leukocyturia, but the patient does not have any accompanying symptoms, he does not experience any discomfort or pain.

So, in the representatives of the fair half, leukocytes are able to enter the urine from the vagina, but in the representatives strong half- from the urinary tract.

When planning to take tests, adhere to the following rules.

Before collecting urine, take a shower and do a thorough hygiene procedure genitals.

Collect urine only in morning time days. Use sterile containers for these purposes, and even better - special containers for collecting analyzes. In this case, it is better not to collect the first portion of urine, but to flush it down the toilet. The most informative is the average portion of urine.

How to collect urine from babies

Collect urine small child not as simple as it might seem at first glance. This process can be accompanied by many mistakes, especially if the parents are young and do not know how to properly collect their baby's tests. Unacceptable methods are often used, which is why the test results are completely disappointing and make parents think that something is wrong with their child. Let's review everything possible ways collecting urine and see why some of them are completely unacceptable to use.

Wringing out a diaper or diaper. Yes, this method may seem strange to many. But there are also many parents who do not think of anything better than such a squeeze. So, this method is completely unusable, so forget about it forever! The fact is that the diapers are filled with a gel that absorbs all the incoming moisture. And even if your push-up attempts end in success, you will be able to collect not the baby’s urine, but the dissolved gel. With a diaper, the situation is the same: passing through matter, the urine is filtered and many components do not get into the tests. What is the correctness of the analyzes? They will surely show that the baby has a lot of leukocytes in the urine.
Pouring from a pot. Another erroneous choice. Of course, if you are using an old enamel pot, you can boil it before collecting the urine. But most night vases today are plastic, and it is not possible to properly disinfect them. And even if you wash it well, the tests will still show not the best results.
Using a jar. This option is more acceptable. But before collecting urine, such dishes should be thoroughly washed, boiled, or doused several times with boiling water, after which they should be dried thoroughly.
Use of a urinal. This is the most convenient and acceptable way to collect tests from infants. However, it also has some drawbacks. Such urinals are presented in the form of plastic bags, which have teardrop shape holes and an adhesive that makes it possible to attach the urinal where necessary. Before using it, the baby should be thoroughly washed. The most important thing is that you can’t leave the urinal on the child’s body all night, because during this time the baby will urinate more than once, which will greatly complicate the setting correct diagnosis. And, of course, it is impossible to exclude the fact that the urinal can simply simply peel off, and it can certainly interfere with the baby, so it is possible that he will remove it himself. Therefore, using such devices, be careful, try to follow the child until he does his business, and then immediately disconnect the bag.

Therapeutic measures

Treatment of leukocyturia is always symptomatic, because it is not the leukocytes themselves that are treated in urine, but the infections (or other diseases) that led to their increase. Thus, the choice of therapeutic measures always depends on the nature of the infection that led to the appearance of the above symptom.

For example, when an increase in the level of white cells causes urolithiasis, medical, instrumental, surgical, or combined treatment. Concerning drug therapy, then it involves taking antispasmodics, analgesics, anti-inflammatory drugs and nephrolithiasis.

In order for the tests of the infant to be reliable, urine must be collected correctly, observing strict precautions.

Surgical interventions are used in about a quarter of cases of urolithiasis, especially in those cases when the stones are too large and in diameter exceed the size of the lumen of the urinary tract.

At renal colic be sure to produce a cupping attack. This can be done using hot bath, heating pads, antispasmodics, novocaine blockades.

The doctor should be very careful with antibiotic prescriptions, because in this case it is imperative to take into account the degree of congestion in the urinary organs. Shown also spa treatment. In addition, all patients are required to be monitored in order not to miss the inflammatory process and control urodynamic disorders.

Apply measures to speedy recovery maybe the patient himself. To do this, first of all, you should observe personal hygiene. Daily hygiene of the external genital organs should be carried out, while washing should be done with warm water and using mild soap.

Second, avoid sexual intercourse until you are sure that you or your partner have completely cleared the infection and there is no chance that you will infect each other. Moreover, avoid random connections with partners in whom you are not sure at all, and do not know what he can be sick at the moment.

Underwear, like towels, should also be changed daily, because failure to do so can cause the infection to spread further and aggravate your health.

Often with leukocyturia, a dietary regimen can also help. Make it a rule to consume as much as possible cranberry juice- it contributes to the creation of an invisible protective layer in the urinary tract, which prevents the penetration of bacteria. However, such juice should be natural and should not contain too much sugar. In some cases, the doctor may recommend drinking a little water with baking soda(but only if your health allows it). The fact is that soda changes the pH of urine and urinary system, while the urine becomes alkaline, and in it, as you know,

With the help of urine, toxic and harmful elements obtained in the process of decay are removed from the human body. For this reason, the urine of a healthy person may contain leukocytes and pus in minimal quantities.

But as soon as purulent accumulations begin to reach impressive volumes and become visible to the eyes, we can confidently say that pyuria develops - that is, leukocytes accumulate.

The essence of pathology

Pyuria can develop in every adult of any gender, there are cases when pyuria was diagnosed in children. Everyone who suffers from this disease has pus in the urine, in the form of lumps, threads or.

Pathology is not taken for independent disease, it is the result of existing lesions or inflammatory processes. Purulent accumulations only indicate the appearance of significant problems in the organs of the ureteral system.

IN rare cases this disease is not associated with impaired performance urinary organs. Pus can be detected in the urine due to a breakthrough of suppuration that appears in nearby organs.

Form classification

The disease is usually distinguished by the localization of catarrhal processes:

There is also a classification of the disease, which is based on the method of three-vessel urine sampling:

initial- only in the first portion there is pus;
ultimate- it is possible to consider signs of purulent accumulations in the third part of the urine;
complete- in each portion there are clear signs of pathology.

Reasons for development

Pyuria is a sign of inflammation. It is likely that the pathology is still secretive, and the patient does not feel certain symptoms. However, infectious bacteria have already begun their work.

According to its prevalence and frequency of lesions main reason pus in the urine in women is considered:

coli;
streptococci and enterococci.

If the infection is nosocomial, then its causes are:

Pseudomonas aeruginosa (male type);
proteas;
fungi of the genus Candida.

Not very often, but the process can be caused by chlamydia, Haemophilus influenzae, staphylococci.

Symptoms of pathology

Clinical manifestations of leukocyturia will depend on the underlying disease. In most cases, it is accompanied by pain during the emission of urine, the release of urine in small quantities, an increase temperature regime body, headaches and lumbar pain, weakness and fatigue throughout the body.

Patients may not detect changes in urine immediately. clear signs problems are considered:

Asymptomatic leukocyturia

Most of the time it resolves without infection. bacterial type confirming extrarenal pathologies. One such example is worm infestation. This refers to latent leukocyturia, in which pathology is detected in urine after certain tests are carried out.

If we talk about finding pus in urine, then there will be a large number of factors that can influence this. For this reason, in this disease, its sources are determined individually. Much will depend on the indications of the urogram.

As a complication, inflammation accompanied by pyuria can be detected at the time of systemic lupus erythematosus, organ intoxication during poisoning, renal failure. chronic type, various allergenic manifestations, kidney disease, prostatitis.

Leukocyturia in pregnant women

An acceptable level of leukocytes for a woman should not exceed ten cells. At the time of pregnancy, a slight deviation from this level is allowed. But if the number of bodies white color exceeded the specified value, it is necessary to urgently pass the analysis. An excess of white blood cells indicates that inflammation begins in the body. If the test results confirm all concerns, the specialist prescribes an additional examination.

The treatment course can only be prescribed by a doctor. It should be noted that a specific therapy that lowers the level of leukocytes is not prescribed. Pyuria is a sign of an inflammatory process, and it should be treated first of all.

As a rule, a pregnant woman, given her term, is prescribed antibiotics. But medicines must be such as not to render negative impact to the developing fetus. In most cases, these are drugs from the cephalosporin group.

At the time of bacterial infections, pregnant women are advised antibiotics that have natural origin- garlic, parsley, onion. You can resort to the help of medicinal herbs, but in this case you will have to consult a doctor, since some plants are contraindicated during pregnancy.

A woman preparing to become a mother must remember that the right therapy can only be prescribed experienced specialist. picking up medications, it takes into account the diagnosis, individual features organism, gestational age. Self-medication in such a situation is prohibited, as it can cause negative consequences.

Pus in the urine of a child

Purulent accumulations in children's urine manifest themselves in the same way as in men. With this symptom, the child begins to experience pain at the time of the withdrawal of urine, which is excreted in small portions. Sometimes urinary retention occurs.

During pyuria, the temperature may rise, headaches appear, breaking in the lower back. Urine acquires a cloudy hue, pus in it is visible to the naked eye.

In such cases, you must consult a doctor. It will be necessary for the specialist to accurately establish the diagnosis and determine the cause of the manifestation of pyuria.

It is likely that little patient will be required bed rest, diet, drinking plenty of water, following all the recommendations of the doctor.

Diagnostics

Pyuria is defined by general analysis urine by the method of counting the level of leukocytes. For women, this value is 0 - 5, for men it is slightly lower and should not exceed 3, for childhood an indicator equal to 2 is determined. If excesses of the indicated levels are detected, tests should be repeated to exclude the possibility of errors in the selection and preservation of urine. With the repeated detection of leukocyturia, you can confidently talk about pathological changes.

Note that urinalysis is not considered the main indicator for diagnosing pyuria. Greater accuracy can be achieved by . If everything is done correctly and the level of leukocytes after counting exceeded 2,000, then the disease is confirmed.

It makes it possible to correctly determine the amount of all elements, which include leukocytes, in the daily amount of urine. During pyuria, their figure will have to reach three million.

Sometimes the disease is not diagnosed only by standard analyzes urine. IN similar situations we are talking about the pyuria of the latent form that occurs in chronic pyelonephritis. It is possible to detect such pyuria only with the help of provocative checks, using prednisolone or pyrogenal.

Having confirmed pyuria, it is necessary to establish the cause of its appearance and the affected organ. This is done by instrumental research:

ultrasound examination of the urea, abdominal organs;
using an intravenous pyelogram;

What indicators of urine indicate the cause of pyuria?

With the help of a microscope, a laboratory assistant can distinguish not only the leukocytes themselves, but also the type of their cells. The predominance of one of the types can indirectly indicate the cause of the inflammatory process:

neutrophils- are considered a sign of pyelonephritis or;
monocytes- indicate the appearance of glomerulonephritis or interstitial nephritis;
lymphocytes- caused by changes in immune responses, systemic diseases;
eosinophils- their presence proves that there is a violent reaction of an allergenic nature.

Treatment tactics

The therapeutic course should be comprehensive, long and aimed at eliminating the cause of inflammation and suppressing the development pathogenic flora at the site of infection. Eliminating only pus in the urine does not mean that complete recovery will be achieved.

Having specified the underlying disease that provoked pyuria, the doctor prescribes:

If the inflammatory process becomes acute, a dropper may be prescribed, with the help of which antiseptic compounds are introduced into the body, washing the cavities. Sometimes antibiotics are added to such solutions.

The treatment course can last several weeks and depends on the degree of damage. urinary organs.

The symptom of pyuria can be cured within a week, but if not treated complete treatment, then the disease will take a chronic form, getting rid of which will be much more difficult.

Disease prevention

By following simple requirements, you can minimize the risks of pyuria and other inflammations.

To do this, you will have to carry out daily hygiene of the genitourinary organs, organize balanced diet, which will include a sufficient amount of useful trace elements and vitamin formulations. The state of urine should be constantly monitored visually for transparency and the presence of inclusions. It is recommended to take urine for analysis once every six months.

The manifestation of pyuria is considered warning sign which will need to be dealt with promptly. If the disease is not treated, then severe ailments will develop, not excluding chronic insufficiency kidneys.

Leukocyturia is evidence of an inflammatory process in the urinary tract, pelvis and kidney tissues. Leukocyturia cannot be considered a disease, it is a very definite indicator of many diseases - cystitis, tuberculosis, nephritis, pyelonephritis, prostatitis and other infections of the urogenital area.

Causes of leukocyturia

Since leukocyturia is not a diagnosis, but only indicates inflammatory pathology, the reasons for it can be very diverse. Moreover, asymptomatic leukocyturia may not be accompanied by bacterial infections, but be an indicator of extrarenal pathology, for example helminthic invasion or urinary allergy

Leukocyturia causes may have the following, determined by the type of urogram:

In the presence of neutrophils that perform a bactericidal phagocytic role - an indicator possible pyelonephritis or tuberculosis.
Mononuclear type of urogram is an indicator of possible interstitial nephritis or glomerulonephritis.
In the presence of lymphocytes - an indicator of a possible systemic pathology(systemic lupus erythematosus), arthritis of rheumatoid etiology.
Eosinophils in the urogram are an indicator of a possible allergy.

The leukocyturia of the cause can manifest itself in the number of leukocytes and in the level of:

Glomerular level (renal) - a sign of glomerulonephritis, nephritis of interstitial tissues.
Calyxes and pelvises ( renal level) - acute or chronic pyelonephritis, septic kidney infarction (kidney carbuncle), abnormal position of the kidneys, tuberculosis, polycystic kidney disease, kidney hypoplasia, hydronephrosis, including congenital.
The level of the ureters (extrarenal level) is an indicator of the diverticulum of the ureter, the kink or doubling of the ureter.
Level Bladder- cystitis, including acute, stones, tuberculosis of the bladder.
Urethral level - indicator possible pathology urethra, phimosis.

Symptoms of leukocyturia

Any pathology of an infectious nature in these systems and organs is detected by clinical symptoms - intoxication, pain, as well as laboratory parameters - leukocytosis, accelerated ESR, and increased protein concentration (CRP). These are typical signs of acute inflammation, the result of which is leukocyturia - the presence in urine a large number leukocytes, exceeding the limits of the norm.

In healthy people, when examining urine, subject to personal hygiene, traces of leukocytes in urine can also be found, the norm for men is 2-3.5, for women - 2-5.6 in the field of view. Small leukocyturia is the detection of titers exceeding 6-10, if there is an indicator of 20 in the field of view, leukocyturia is considered undoubted and indicates an overt or latent infection of the urinary tract or kidneys. There is also massive leukocyturia, which is more correctly called pyuria, when purulent flakes are clearly visible in the urine.

Forms

Aseptic leukocyturia, infectious leukocyturia

Depending on the nature and duration of the inflammatory process, leukocyturia can have the following types:

infectious leukocyturia.
Aseptic leukocyturia.

Depending on localization inflammatory focus leukocyturia can be:

Renal leukocyturia.
Leukocyturia of the lower urinary tract.

Depending on the number of leukocytes detected, leukocyturia can be:

Small leukocyturia (microleukocyturia) - less than 200 per field of view.
Pyuria - 200 to 3,000,000 per field of view.

Infectious leukocyturia is always combined with the presence of bacteria in urine - bacteriuria, when more than one hundred thousand microorganisms are detected in the material in one liter.

Aseptic leukocyturia is characterized by the presence of lymphocytes and eosinophils, as well as the absence of a large number of bacteria, hence the name of the species - aseptic, that is, not having infection. Obviously, the presence of lymphocytes, which have the ability to detect and neutralize harmful antigens, as well as eosinophils, which ensure the effective destruction of foreign protein compounds, play a role in the asepsis of the inflammatory process.

To diagnose the cause of the appearance of leukocytes in the urine, it is extremely important to differentiate these two types. Infectious leukocyturia requires repeated studies and comprehensive antibiotic therapy. Aseptic leukocyturia, on the contrary, is neutralized without the use of antibiotics, which is very important for the treatment of pregnant women, elderly patients and children.

Leukocyturia in children

Leukocyturia in children, especially girls and adolescents, may be false and not associated with inflammation. internal organs or the urogenital area, and with non-compliance with personal hygiene and inflammation of the tissues adjacent to the genitals (skin). That is why leukocyturia in children is not always an indicator infectious disease and requires repeated urine tests. Usually the doctor finds out under what conditions and how the material (urine) was collected, whether there are diaper rash or inflammation in the genital area. An anamnesis is also collected, including family history, and it turns out whether there were dysuria - a disorder, a violation of the urination process. Elevated temperature body, possible injury, physiological factors, such as teething in children under one year old, can become useful information to differentiate the type of leukocyturia. In addition, the level of leukocyturia is determined using the two-glass test method. For all children with detected leukocytes in the urine, it is mandatory to undergo ultrasound examination bladder and kidneys. Among the reasons for which there may be leukocyturia in children, the most common are the following:

Acute or chronic pyelonephritis (obstructive, non-obstructive).
Interstitial nephritis.
Acute nephrosis.
Vulvit.
Enterobiasis.
Cystitis, acute or chronic.
Crystalluria.
Urinary allergy.
Intertrigo.

Leukocyturia in pregnant women

Pregnancy is always accompanied by anxiety for the health of not only the mother, but also the fetus. The susceptibility to all kinds of infections in a pregnant woman is increased due to the fact that the immune system directs all resources to adapt the body to a new, yet unusual state for it. It is for this reason that it is important to be examined in a timely manner and fulfill all the appointments of the attending gynecologist. It is also important to know what leukocyturia means during pregnancy.

Any indicator that exceeds the limits of the norm is evidence possible disease, an increase in the number of leukocytes in the urine is also a sign of inflammation in the body. Leukocyturia in pregnant women may indicate an infectious process in the vagina, in the kidneys or urinary tract. In order for the analyzes to be truly indicative, and not false, it is important to properly prepare the material - urine. False leukocyturia may be associated with non-compliance with the rules of personal hygiene, when vaginal discharge enters the urine, respectively, the level of leukocytes will be increased for understandable reasons that are not related to the disease. If vulvitis is absent, vaginitis is also not observed, and leukocytes in urine are elevated, a more comprehensive urological examination should be performed to determine the type of leukocyturia - infectious or aseptic.

The cause of leukocyturia can be cystitis, which is noticeable by impaired urination, fever, often pregnant women may experience asymptomatic leukocyturia, when cloudy urine is the only visible sign latent inflammatory process. There is no need to fear the treatment of cystitis. Leukocyturia during pregnancy, provoked by cystitis, is most often treated without the use of antibiotics.

Most dangerous option, which may indicate leukocyturia in pregnant women, are nephropathologies that threaten both the health of the expectant mother and the health of the baby. The most dangerous gestosis in the third semester, which can provoke intrauterine pathologies, fetal hypotrophy or hypoxia during childbirth. Pyelonephritis is also dangerous, clinically manifested by back pain, leukocyturia. Treatment of a pregnant woman with pyelonephritis is assumed only inpatient, when a woman is under constant control doctor and there is an opportunity to minimize the risks to the fetus.

Treatment of leukocyturia

Treatment, which involves leukocyturia, is aimed at treating the underlying disease, that is, eliminating the focus of inflammation and infection.

Treatment of leukocyturia is primarily a differentiation of the type of leukocyturia, accurate diagnosis causes and determination of the strategy of therapeutic interventions.

Infectious leukocyturia treatment involves only antibacterial. The appointment of antibiotics of the cephalosporin group is shown, as a rule, the course should last at least 10-14 days. Fluoroquinolols are effective, the course of which is slightly less - from 5 to 7 days. It is also possible to assign a classical penicillin group under cover" additional drugs- enzymes to reduce the risk of side effects. Leukocyturia treatment of urogenital pathologies also includes the appointment of macrolides, the tetracycline group, especially if pathogens such as chlamydia or ureoplasma are detected. The treatment that involves leukocyturia during pregnancy is mainly drugs of the new generation cephalosporin group, which do not have serious side effects and are relatively safe for the mother and fetus.

Aseptic leukocyturia treatment involves mainly local - in the form of irrigation and douching antiseptic preparations. The appointment of immunomodulators, vitamins of group B and ascorbic acid and adherence to personal hygiene rules.

To reduce the risk of relapse inflammatory infections preventive courses of gentle antibiotic therapy are shown for 7 days a month after the main basic treatment.

Persistent, recurrent leukocyturia indicates unidentified sources of infection. In such cases, hospitalization is needed for more comprehensive survey, clarifying the diagnosis and compiling a new, more effective therapeutic course.

Detection in urinalysis increased number white blood cells is called leukocyturia. To diagnose the disease, it is necessary to determine the source. In the development of pathology can take part:

renal parenchyma;
pelvis and calyx;
ureteral mucosa;
bladder;
urethral canal;
male genital organs adjacent to the urethra (prostate gland and seminal vesicles).

Moderate leukocyturia in infants accompanies the period of teething, and is caused by the reaction of the gums. High rate always speaks for the expressed inflammation.

How is the calculation done?

By appearance urine may suggest leukocyturia if turbidity, flocculent sediment, or filaments are present. Usually this is a sign of pyuria (pus), which also represents leukocytes, but destroyed, melted together with necrotic tissue remnants.

The existing method of color stripes allows you to identify leukocyturia most quickly. It is based on the biochemical reaction of the esterase enzyme, which is contained in granulocytic cells. The technique is suitable for conducting mass preventive examinations population. But she does not give an exact figure. All positive tests have to be quantified.

Special analyzers are the most modern devices, but not all laboratories can afford to purchase them. Therefore, the most common method remains the count of leukocytes in the Goryaev chamber.

Under the coverslip, divided into squares, a drop of urine is placed, it is examined at sufficient magnification and at the same time the leukocytes are counted with a manual counting machine.

The following conclusions are possible in decoding:

leukocytes are single in the field of view;
exact indication of the amount in leukocyturia;
"leukocytes entirely" or "occupy the entire field of view" with a significant number of cells.

The border of leukocyturia and pyuria is considered to be 60 cells in the field of view.

Other popular counting methods:

Nechiporenko method. It requires counting leukocyte cells in one milliliter of urine simultaneously with erythrocytes and cylinders.
Sample Kakovsky - Addis - ml of urine for analysis is taken from daily diuresis eliminates the possibility of fluctuations during the day.
Ambourge - a more subtle calculation, takes into account the function of excretion, since the volume of urine is taken according to the excreted per minute.

How to distinguish the norm from the pathology?

There is no consensus on the definition of normal limits for the number of leukocytes. Some researchers argue that normal should be considered:

for girls up to 10 cells;
for boys - up to 6.

Others insist on approaching this figure to zero healthy person, but allow:

for boys - 0–2;
girls - 0-3.

With diathesis in a child, leukocyturia can grow to 5–7. The upper limit for women is considered to be - 8 in the field of view, for men - 6 (according to other sources, respectively, 6 and 3).

The appearance of leukocyturia without pathology is explained by:

ability a small amount cells penetrate through the wall of blood vessels and enter the urine;
the presence of observer cells for the state of protection of the organ;
in children with increased throughput glomerular membranes due to functional underdevelopment.

Increased standards for girls and women are determined by anatomical features. Their urethral outlet lies close to anus, so there is always the possibility of hitting intestinal flora and requires additional protection.

Diagnosis cannot be based on the absence characteristic symptoms diseases, it is possible undercurrent when a person feels completely healthy. The appearance of asymptomatic leukocyturia means that it is necessary to prove the absence pathological changes additional research.

The mechanism of occurrence of leukocyturia

The pathogenesis of the problem is as follows. Increased detection of leukocytes in the urine is associated with their active leaching from inflammatory foci of the urinary tract. In response to the introduction of bacteria and other infectious agents leukocyte cells accumulate at the site of exposure. They "try" to fight foreign agents by phagocytosis ("swallow" them and dissolve) or delimitation from spreading to neighboring tissue areas.

Schematically shows the process of phagocytosis and the transformation of a leukocyte into an active macrophage, now it has the ability to absorb microbes

In the analysis of urine, bacteria (bacteriuria) are most often detected - coli. For inflammation of the urinary organs are most characteristic:

Proteus;
staphylococci;
streptococci;
klebsiella;
Pseudomonas aeruginosa;
tuberculosis mycobacterium;
fungi of the genus Candida;
viruses.

Each of the pathogens has its own "favorite" lesions and settles in the area from the urethra to the renal pelvis.

Kinds

Leukocyturia is proposed to be divided:

to the true one - when the detected cells appear in the urine directly from the organs of the urinary system;
false - is the result of getting from the external genital organs with vulvovaginitis in women, balanoposthitis in men, violations of the thoroughness of the implementation hygiene requirements when collecting urine for analysis.

Associated with an infectious agent:

infectious - caused by the above types of pathogens;
non-infectious - there is no concomitant bacteriuria in the analysis, such urine is considered abacterial or sterile, and the inflammation is aseptic.

The second option occurs during pregnancy, noncommunicable diseases urinary tract(amyloidosis, autoimmune acute glomerulonephritis), difficulties in identifying the pathogen in the case of a viral process, mycoplasmosis, ureaplasmosis, chlamydia, tuberculosis.

Based on the number of registered leukocytes, one can distinguish:

insignificant - if 8-40 cells are found in the field of view;
moderate - leukocytes up to 100;
pronounced - if the cells cover the entire field of view, usually it is already pyuria.

Minor leukocyturia is found:

with chronic renal failure against the background of amyloidosis of the kidneys, glomerulosclerosis with diabetes, glomerulonephritis;
initial stage acute glomerulonephritis;
prolonged feverish state;
nephrotic syndrome;
allergic reactions;
helminthic invasion in children;
genital infections;
systemic diseases;
treatment with Aspirin, antibiotics Ampicillin, Gentamicin and Kanamycin;
taking iron supplements.

Ulcers are able to be localized in the parenchyma, pelvis and portal zone

Severe leukocyturia (pyuria) is characteristic of the clinical course:

hydronephrosis with suppuration;
acute pyelonephritis of apostematous form;
abscess and.

According to the type of leukocyte abnormalities detected, there are:

monocytic or mononuclear - monocytes predominate among cells, occurs in cases of interstitial and glomerulonephritis;
neutrophilic - usually neutrophils account for up to 95% of the cellular composition, lymphocytes - the remaining 5%, typical for infection And initial period acute glomerulonephritis, with an exacerbation of the chronic form, the difference is less sharp;
lymphocytic - found in systemic diseases with kidney damage ( rheumatoid arthritis, lupus erythematosus);
eosinophilic - cells indicate allergic character inflammation, occurs against the background of abacterial glomerulonephritis and cystitis in pregnant women.

Causes

The causes of leukocyturia are most associated with inflammatory process in the organs of the urinary tract. Women are more likely to suffer from cystitis. In addition to the anatomical features of the urethra, they have more factors that disrupt blood circulation in the pelvis and bladder wall:

sedentary office work;
pregnancy;
tendency to constipation;
wearing compression underwear;
period of menopause;
reduced immunity;
susceptibility to endocrine pathology.

Pyelonephritis - begins with the renal pelvis. Infection of the kidney occurs hematogenously (through the blood) from foci chronic infection (carious teeth, sinusitis, chronic cholecystitis, adnexitis, prostatitis). It is possible to penetrate from the underlying paths in an ascending direction and lymphogenously.

Interstitial nephritis - the main process occurs in the parenchyma, it is considered autoimmune disease, the onset may be bacterial or viral infection. Associated with impaired functioning of the immune system, toxic effect drugs or chemicals.

Rarely, leukocyturia is detected:

with prostatitis - the same infection, a fall defensive forces, hypothermia, decreased physical activity;
tuberculosis of the kidneys - occurs against the background of a primary lesion of the lungs, tuberculosis mycobacterium enters the urinary tract with the blood stream;
urolithiasis.

Symptoms

Leukocyturia is rarely the only sign of the disease. It is possible to assume infection of the urinary system by the following symptoms:

dysuric disorders (increased or difficult urination);
pain in the suprapubic area, on one side in the lower back;
urine changes in color and smell;
pain, cramps, burning sensation during urination;
the occurrence of fever.

Violation of urination is one of the symptoms of pathology

With urolithiasis, leukocyturia is added to:

paroxysmal pain in the lower back with irradiation in the groin, half of the abdomen;
frequent urge to urinate;
excretion of small portions of cloudy urine;
the appearance of hematuria with a shift of the stone;
nausea against the background of a painful attack.

For manifestations of acute pyelonephritis, in addition to leukocyturia, typical high fever, intense back pain, cramps when urinating, nausea, vomiting, aching joints.

At chronic form pyelonephritis according to the severity of leukocyturia control the stages of exacerbation and remission. It may appear:

pyuria;
dull intermittent pain in the lower back;
increasing weakness;
temporary signs of dysuria.

In touch with interstitial nephritis indicate:

loss of appetite;
severe pain;
the appearance of edema;
an increase in protein in the urine (proteinuria);
anemia.

Diagnostics

For differential diagnosis leukocyturia, it is necessary to apply additional studies in order to establish the source of inflammation. There are practical tests to detect the level of pathology. Two-glass sample method - with continuous urination, urine is collected in 2 containers.

Evaluation of results:

leukocyturia in the first portion reveals the focus of inflammation in urethra or the prostate in men;
leukocytes in the second portion speak for the defeat of the overlying urinary organs.

Three-glass sample method - urine is collected in three containers. Grade:

the maximum number of leukocytes in the initial portion indicates damage to the urethra;
if the same distribution in all portions is a sign of kidney pathology;
the predominance in 2-3 glasses indicates a disease of the bladder.

To identify the latent type of leukocyturia, it may be necessary to conduct a prednisolone test: Prednisolone is administered intravenously, then urine tests are examined every hour. If chronic illness kidney is accompanied hidden symptoms, then the number of leukocytes increases by 2 times.

IN laboratory diagnostics helps to correctly determine the origin of leukocytes in the urine qualitative assessment of cells

Sternheimer-Malbin cells - are detected with special staining in the form of large pale blue formations (2-3 times larger than ordinary leukocytes). Inside, many granules are found that are in constant motion. Found in half of patients with acute form pyelonephritis and ¼ part with chronic. May pass into urine prostate, With vaginal discharge. It is diagnostically important that they are absent in cystitis.

"Active" refers to leukocytes detected in acute pyelonephritis. If distilled water is added to the urine sediment, then an artificial decrease will occur. osmotic pressure. This creates conditions for increasing permeability cell membranes these cells. Liquid enters inside, so the dimensions increase, the mobility of the internal granules increases.

To detect pathology, use:

palpation of the prostate in men, uterus and genital organs in women with taking swabs for a tank study;
blood tests for protein, nitrogenous substances, electrolytes;
ureterocystoscopy;
ultrasound examination of the kidneys and bladder; for men, a transrectal examination is recommended in the presence of palpation detected growth of the prostate;
pyelography intravenously or through bladder catheterization;
magnetic resonance or computed tomography if necessary.

Treatment

Therapy is not carried out for leukocyturia, but for the identified disease. The task of treatment is to remove the focus of inflammation or, in a chronic course, to achieve the most stable remission possible.

The patient must be prescribed a diet and the necessary drinking regimen to exclude the entry of irritating substances and wash out the infection

As anti-inflammatory therapy, antibiotics with the least toxic effect on the kidneys are needed. They are prescribed after determining the sensitivity by the method of tank analysis or immediately use a wide range of tools.

For the treatment of pregnant women, they try to get by with herbal remedies. Antibiotics include cephalosporins. They are the least harmful to the fetus. Urologists often recommend local procedures washing the bladder with antiseptic solutions. For patients with nephritis, treatment is based on the form. Antihistamines, cytostatics in combination with hormonal agents are prescribed.

Treatment of diseases accompanied by leukocyturia requires patience and following the doctor's recommendations. It is impossible to use untested advertised means on your own, because the state of other organs and body systems depends on the health of the kidneys.