Epithelial Cells in the Urine - An Overview

What Are Epithelial Cells in the Urine?

The human body consists of billions of epithelial cells that line the body surfaces, such as the skin and organs of the urinary tract. Their main function is to serve as a protective barrier between the insides and the outside of the body. Numerous microorganisms like viruses and bacteria tend to enter the human body but are stopped by the epithelial cells. The skin acts as the first-line defense system because it contains numerous epithelial cells. As these epithelial cells are present in the linings of the urinary tract organs, it is normal for some of them to be present in the urine. However, the problem arises when too many epithelial cells are present in the urine. It might signify kidney disease, infection, or other serious medical conditions. Therefore, the doctor might order a urinalysis to check the number of epithelial cells in the urine.

What Are Some of the Different Varieties of Epithelial Cells?

Epithelial cells are of different types based on their shape, size, and appearance. For example, the following three different types of epithelial cells might be found in the person’s urine based on their origin.

• Renal Tubular Cells - Renal tubular cells or renal cells are the most important of all epithelial cells. An increased number of renal tubular cells in the urine indicate kidney disease.

• Squamous Cells - Squamous cells are the largest epithelial cells that come from the vagina and the urethra. They are normally found in the female’s urine.

• Transitional Cells - They are present anywhere between the urethra and the renal pelvis. They are commonly found in older men and are also known as bladder cells.

What Are the Epithelial Cells in the Urine Test Used For?

Epithelial cells in the urine test are also known as microscopic urine tests and urinalysis. It is a part of the urine test known as urinalysis. A urinalysis might include a visual examination of the urine sample, tests for some chemicals, and a microscopic examination of the urine cells. This test is a part of the microscopic examination of urine. A doctor might recommend the patient undergo this test if a person comes with the following symptoms of kidney disorder or urinary tract infections:

• Dysuria (painful urination).

• Urinary frequency (urinating more than eight to ten times a day).

• Pain in the lower abdomen.

• Flank and lower back pain.

How Is the Test Performed to Check the Epithelial Cells in the Urine?

The doctor will ask the patient to collect a urine sample. When the patient visits the doctor before the procedure, the patient might receive a container or a sterile bag to collect the urine. The urine sample collected is sterile and not contaminated. This is known as the clean catch method. The steps of the clean catch method are listed below:

1. Wash the hands with water and soap solution.

2. Clean the genitals with the help of a cleansing pad provided by the doctor. Males should specifically wipe the penis tip, and females should clean their labia from front to back.

3. Start urinating and move the container under the urine stream to collect the urine.

4. Make sure to collect one or two ounces of urine into the container.

5. Finish urinating and return the collected sample to the hospital for evaluation.

What Do the Test Results Indicate?

A urine test might show three possibilities: there might be few, moderate, or many epithelial cells in the urine. Epithelial cells are normally shed off from the body. If one to five squamous epithelial cells are present in the urine after viewing from the high-power microscope, it is considered normal and not a problem. However, a person with many epithelial cells in the urine is more likely to suffer from urinary tract infections, kidney disease, and cancer. For example, the presence of epithelial cells containing many blood particles and hemoglobin might signify that the patient recently had red blood cells or hemoglobin in the urine. If more than 15 renal tubular cells are present when viewed through a high-power microscope, the kidneys are not working properly. If the urine shows squamous epithelial cells, the sample is unsterile. The clean-catch method prevents the squamous cells from entering the urine, so the doctor might provide a cleansing pad to wipe the area around the penis and the vagina before submitting the urine sample.

What Are the Conditions Associated With Increased Epithelial Cells in the Urine?

If the urine contains more epithelial cells, it might indicate the following conditions:

1. Urinary Tract Infection - It is a common condition that is mainly characterized by the bacterial infection of the urinary tract. The symptoms of urinary tract infections are listed below:

• Increased urinary frequency.

• Dysuria (painful urination).

• Burning sensation while urinating.

• Cloudy and foul-smelling urine.

• Hematuria (blood in the urine).

• Pain in the lower back or abdomen.

2. Yeast Infection - As the name suggests, yeast infection is caused by yeast, which is a fungus. Normally, yeast is present in small amounts in the female vagina. However, the problem arises when these yeasts outgrow the healthy bacteria in the genital tract. The symptoms of yeast infection are listed below.

• Vaginal soreness and itching.

• Pain after sex.

• Burning sensation while urinating.

• White discharge from the vagina.

3. Kidney Diseases - People suffering from long-standing or chronic kidney disease are more likely to exhibit epithelial cells in the urine.

4. Liver Diseases - The different types of liver diseases that might occur due to the increased epithelial cells in the urine are listed below:

• Non-alcoholic fatty liver disease.

• Alcoholic liver disease.

• Hepatitis.

• Primary biliary cirrhosis.

• Hemochromatosis.

The symptoms of liver disease are listed below:

• Weakness or tiredness.

• Loss of appetite.

• Jaundice.

• Reduced sex drive.

5. Bladder Cancer - Bladder cancer is a condition when the cells present in the inner lining of the urinary bladder show uncontrolled growth. The patient might show increased epithelial cells in the urine due to bladder cancer. The symptoms of bladder cancer are listed below:

• Frequent urge to urinate.

• Blood in the urine might change the urine color.

• A sudden strong urge to urinate.

• Burning sensation while passing urine.

• Pain in bones and pelvis.

• Weight loss without exercise.

• Swollen legs.

What Are the Different Risk Factors for Increased Epithelial Cells in Urine?

Several factors increase the risk of epithelial cells in the urine. The risk factors are listed below

• Recurrent kidney stones.

• Diabetes (elevated blood glucose levels).

• Hypertension (high blood pressure).

• Family history of renal disorders.

• Benign prostate hyperplasia (enlargement of the prostate gland).

• Recurrent urinary tract infections.

• Immunocompromised disorders like HIV (human immunodeficiency virus).

• Pregnant females.

Treatment of Increased Epithelial Cells in Urine:

Treating elevated epithelial cells in the urine depends upon the underlying causes. It has been observed that antibiotics can manage most urinary tract infections. The patient must drink sufficient water to recover from a UTI. The doctor might recommend the following:

• Keep the diabetes under control through insulin injections.

• Limit the consumption of cholesterol-rich foods.

• Cut down the salt consumption.

• Exercise daily and increase physical activity.

• Lose weight.

• Limit alcohol consumption.

• Have a healthy diet.

• Quit smoking.

Prevention:

Maintaining healthy bowel and bladder habits, urinating when the need arises, having a healthy diet, and drinking cranberry juice are some natural methods of preventing urinary tract infections due to the epithelial cells in the urine. In addition, patients suffering from chronic kidney disease often show elevated blood pressure. Therefore, the doctor might recommend controlling their blood pressure to live a healthy life.

Conclusion:

Epithelial cells are present throughout the body and carry out the essential functions of the body. It is alright to have some amount of epithelial cells in the urine. However, the problem arises when they exceed the required range. Diagnosing epithelial cells in the urine is challenging because the symptoms resemble many urologic conditions. Therefore, the doctor might recommend laboratory tests to detect abnormalities in the shape and size of these cells.