Often, people with the frequent tendency of developing urine infections undergo routine urinalysis tests. These may be done in several different ways. The dipstick test is the most common method of Urinalysis which can indicate presence of sugar, proteins, acidity, ketones as well as bacteria in the urine. In case of microscopic Urinalysis, a few drops of urine may be examined under the microscope and these often indicate white (WBC) or red blood cells (RBC) in urine without bacteria. Such results often confuse people; in that they want to know why these cells are present, despite the fact that there are no bacteria alongside them.
Presence of red blood cells or RBCs in urine is called Hematuria. If the blood is very obvious and seen with the naked eye, the condition is called Frank Hematuria. In case the cells are only spotted under a microscope, then the condition is called microhematuria. The dipstick urine test can also reveal this condition.
WBC and RBC in Urine: Does not always indicate urine infection
Traumatic abrasion can sometimes lead to presence of blood cells in the urine. This is particularly true when patients are suffering from kidney stones or have been placed on catheters etc. In most cases, the RBCs in urine automatically disappear after the trauma is removed and the wound has healed.
Likewise, white blood cells or leukocytes in urine may or may not indicate urine infections. For example, a condition called Interstitial Cystitis in women often leads to increased WBC count in the urine. This condition is characterized by inflammation of the bladder walls. It may be triggered due to hormonal fluctuations, particularly at the time of menstrual cycle changes. Interstitial cystitis also produces the same (or somewhat similar symptoms) such as abdominal pain, backache, pelvic pain etc as seen in urine or bladder infections.
Increased WBCs and RBCs in urine: What should you do next?
- Doctors might test for a number of factors in order to determine the next line of treatment. In most cases, the pH of the urine is taken into account. A pH of less than 5.5 can lead to recurrent uric acid stones which, in turn, damage the urethra and bladder walls leading to the presence of RBC and WBC in urine. An Ultrasound scan might also be done to determine if there are stones, though, many times, the ultrasound film might be unable to display smaller stones. A full CT scan may be required to evaluate the cause exactly.
- Many patients get their Urinalysis results which indicate higher WBC and RBCs in urine but the result is no bacterial or urine infection. However, if they are also suffering from severe pain on their sides in the abdominal areas, the doctor, in such a case, might perform other exams to rule out possibility that something is impinging on the ureters or the bladder walls.
- In many female patients, a small amount of WBCs and RBCs are even considered normal, particularly if one is clear that there are no sexually transmitted disease risk factors. One must naturally rule out kidney stones, and even review medications being taken, if any, as these could also lead to small amounts of blood cells in the urine analysis sample.
- In men, if there are substantial RBCs and WBCs in urine but no bacteria, one must go in for a prostate exam to rule out further complications.
Patients must watch out for other symptoms including pain, fever, cramps, lack of urine during peeing etc especially if they have a tendency of recurrent UTIs. If these do occur, one must consult with an urologist immediately.