In this Article
It’s normal in both men and women to find a few squamous epithelial cells in urine tests. But when found in large numbers, they often indicate a problem in the system and can be a cause for concern. There are many conditions such as urinary tract infections, yeast infections, kidney problems, liver disease and certain types of cancer that could cause a high number of epithelial cells in the urine. Continue reading to know what is normal and what is a cause for concern when you have more than normal range of epithelial cells in your urine.
What are Epithelial Cells?
Epithelial cells line the surfaces of organs in our bodies such as the skin, inside of the throat, intestines, all the organs and blood vessels. They are tightly packed and function as a barrier between the inside of the body and microbes from outside. However, sometimes viruses can find places to get through the epithelial cells to further invade the body and cause disease. Since epithelial cells make up the first layer of tissue on the organs they also come in different forms and sizes to perform different functions wherever they are present. For example, the epithelial cells on your skin protect your body from dirt and microbes while also being flexible to allow movement. They also produce sweat to keep the body cool.
Epithelial cells also line the inside of your food pipe and intestine where they help in the digestion and absorption of food that you eat. In other areas, they secrete enzymes, hormones and mucus in the body.
Types of Epithelial Cells in Urine
Epithelial cells vary in their shape, size and appearance. Majorly, there are three types that can be found in the urine sample.
These cells originate from the tissues that lie anywhere between the urethra and renal pelvis. They are able to stretch readily to accommodate changes in the volume of liquids in an organ.
These are large epithelial cells and originate from the female vagina and urethra. Squamous epithelial cells are the most commonly seen cells in urine during pregnancy.
3. Renal Tubular
The renal tubular epithelial cells are from the Kidneys and an increased number of these cells are taken seriously as they are a sign of a kidney disorder.
Ranges of Epithelial Cells in Urine in Pregnancy
To range the number of epithelial cells, you will need to undergo a urine evaluation test and the technicians look for the number of visible cells in a High Power Field (HPF) under the microscope. Based on how many they see, the tests report indicate few, moderate or many numbers of epithelial cells. Since these cells are shed from the body as an ongoing build and repair process, the normal range of epithelial cells in urine during pregnancy or prior to it can range from 1 to 5 flat cells under high power field.
Pregnant women generally have a slightly higher count of epithelial cells in the urine as their bodies are going through a lot of changes, therefore even 8-10 epithelial cells in urine during pregnancy should not be alarming. However, further tests to look for urinary tract infection, yeast infection or inflammation caused by another condition should be carried out. Higher ranges of epithelial cells than these are a cause for concern, for example, more and 15 renal tubular epithelial under high power field indicates a problem in the kidneys.
What if You Have High Epithelial Cells in Urine during Pregnancy?
If it is found that you have 15-20 epithelial cells in urine during pregnancy or more, it can be a cause for concern. Technicians have to first rule out the possibility of the presence of large amounts of sediments in the first urine sample that may be concentrated. It means you will have to drink more water and have the urine retested after some time. If there are significant epithelial cells in the subsequent testing, it could indicate one of the following causes:
1. Tissue sloughing in general
It is completely normal to lose some epithelial cells on a regular basis. All the organs in your excretory system have epithelial cells and they are shed now and then as part of the body’s ongoing repair and maintenance. If you’ve had little fluids to drink before a test and the urine is concentrated, it is possible to get a sample with high epithelial cells.
It is easy to contaminate the sample collecting cup if you do not follow the proper procedure to collect urine. If your genital is not clean prior to the test, it could contaminate the sample as there would be an accumulation of epithelial cells which would pass into the sample container. The same could happen if you fail to properly use the cleaning wipes provided to you to clean your genitals. Sometimes the cup can get contaminated when you touch its interior or it may have contaminants from the start, these could also throw off the readings. If you have suspicions of any of these, ask for another cup for a fresh sample to clear all doubts.
3. Urinary Tract Infections (UTI)
Urinary tract infections generally begin at the urethra from where the bacteria proliferate upward into the urinary system such as the bladder and finally the kidneys. When the bladder lining is irritated or inflamed, it causes sloughing of the bladder epithelial cells which can be found in the urine sample. In a severe UTI case which has made its way to the kidneys, it is possible to find renal epithelial cells in the urine samples and the doctor would treat the infection accordingly. It is important to note however that there could be other serious causes which can lead to similar test results as a UTI and as such, your doctor would look into it carefully. When random urine samples come back with high epithelial cells, UTIs must be ruled out first before proceeding further.
4. Kidney Disease
Pathologists also look for a particular type of cells coming from the kidneys. Finding epithelial cells from the renal tubes could indicate a severe infection in the kidneys or other kidney issues. The renal tubes function to filter out blood and produce urine. Finding a large number of these cells in a urine sample could be an indication of nephrotic syndrome. This condition is always caused by damage to the kidneys.
Treatment that follows the test depends on the cause of the abnormal numbers of epithelial cells and their type. Most of the UTIs are caused by bacteria and hence treated with antibiotics. The viral UTIs are treated with antivirals. Kidney disease is treated by managing the underlying cause such as high blood pressure, high cholesterol and blood sugar levels. Your doctor may also advise you on the following:
- Healthy dietary changes
- Cutting back on high salt and cholesterol foods
- Blood pressure medication to manage the progression of the disease and preserve kidney function
- Drinking plenty of water to stay well hydrated
- Cranberry juice to ward of UTIs
Finding epithelial cells in urinalysis is generally not a cause for alarm. Further testing and confirmation are needed to rule out other variables and establish a cause.