Leukocytes in Urine: Causes, Symptoms, Treatment & Prevention Tips 

Introduction

Have you ever experienced a burning sensation while urinating or felt the need to rush to the bathroom more often than usual? These symptoms can be uncomfortable and sometimes worrying, especially when they don’t go away quickly. 

In many such cases, a simple urine test may show the presence of white blood cells (WBC), also known as leukocytes. Normally, urine does not contain significant numbers of these cells. When they are found, it is called leukocytes in urine or pyuria. This result usually indicates that the body is responding to an infection or inflammation in the urinary tract. It may be associated with urinary tract infections (UTIs) or other urinary system issues¹. 

This article on leukocytes in urine might help you understand what it is, its causes, symptoms, and treatment options. 

What Are Leukocytes?

Leukocytes, commonly known as WBCs, are essential parts of the body’s immune system. They help protect the body by fighting infections caused by bacteria, viruses, fungus, and other harmful organisms. These cells are formed in the bone marrow and circulate throughout the blood and lymph system, continually protecting the body from disease. 

There are 5 different types of leukocytes; they are neutrophils, lymphocytes, monocytes, eosinophils, and basophils. Each type has a specific role in identifying and destroying harmful microbes². 

What Are Leukocytes in Urine?

Leukocytes in urine simply means the presence of WBCs in the urine. Normally, urine does not contain these cells, as they are part of the body’s immune system and stay in the blood to fight infections. 

When leukocytes are present in urine, it usually indicates that the body is responding to an infection or inflammation somewhere in the urinary tract, such as the bladder, urethra, or kidneys. This often occurs in conditions like urinary tract infections (UTIs), but it can also be linked to other problems¹. 

Hence, leukocytes in urine act as a warning sign that there may be an infection or irritation in the urinary system that needs attention. 

Causes of Leukocytes in Urine

The reasons for leukocytes in urine can be divided to two: 

• UTIs: One of the most common causes. Bacteria entering the urinary tract can cause infection in the bladder or urethra, resulting in leukocytes in urine³. 
• Kidney Infection: Causes bacteria to spread to the kidneys which often causes the release of leukocytes in urine³. 
• Urolithiasis: Stone in the urinary tract including kidneys can irritate the tract and cause leukocytes to get released in the urine^4,5. 
• Sexually Transmitted Infections (STIs): An STI caused by microbes such as Trachomatous, Gonorrhoeae, and Trichomonas can cause leukocytes in urine, especially in adolescents (women in particular)⁵. 
• Other Infections: Viral infections (herpes and HIV), bacterial infections (tuberculosis), fungal infections (candida and aspergillus) and  parasitic infections (schistosomiasis) can also cause WBCs to appear in urine⁵.
• Inflammatory Conditions: Chronic inflammation of bladder (cystitis), ureter (urethritis), kidney (interstitial nephritis), etc., can release WBCs into the blood, even if infections are absent^5,6. 
• Drugs: Certain types of drugs such as corticosteroids, antibiotics like penicillin NSAID painkillers, etc., can cause allergic interstitial nephritis (inflammation of kidney cells) and WBCs in urine⁵. 

Symptoms of Leukocytes in Urine

Leukocytes in urine usually indicate infection or inflammation in the urinary tract, so the symptoms are generally related to the underlying cause. The common symptoms include: 

• Burning sensation while urinating^6,7 
• Frequent urge to urinate 
• A strong urge to pass urine even if the bladder is empty⁷ 
• Cloudy and foul-smelling urine⁶ 
• Lower abdominal pain or discomfort⁸ 
• Pain in the side of the body (flank pain)³ 
• Blood in urine^3,8 
• Fever, chill, nausea, vomiting, fatigue, etc^3,7. 

Risk Factors for Leukocytes in Urine

Certain factors can increase the chances of having leukocytes in urine, often due to a higher risk of urinary infections or inflammation:  

• Poor Hygiene: Causes bacterial accumulation in the bladder contributing to UTI, thereby leading to the appearance of WBCs in urine^1,7. 
• Dehydration: Not drinking enough water⁹ reduces urine flow, making it easier for bacteria to grow and cause WBCs in urine. Also, dehydration can contribute to kidney stones or urinary tract stones⁸, which is another cause of WBCs in urine⁵. 
• Holding Urine: Not urinating and holding urine for a long period can lead to bacterial accumulation in the bladder or urinary tract and cause UTI¹⁰, which is a cause of WBCs in urine¹. 
• Female Anatomy: Women are more prone to urinary tract infections due to a shorter urethra^5,7, which can lead to the appearance of WBC in urine. 
• Week Immune System: Conditions like diabetes or other illnesses can make infections more likely⁵, with a possibility of WBCs present in urine. 
• Urinary Tract Interventions: Urinary catheters and surgical or diagnostic producers in urinary tract can cause irritation and inflammation which can release WBC in urine⁵. 
• Pregnancy: Hormonal changes and pressure on the bladder can increase risk of WBCs in urine⁵. 

Leukocytes in Urine During Pregnancy

Women are more likely to develop UTIs during pregnancy due to a variety of physiological factors. Hormonal changes and a developing uterus can put strain on the bladder and urinary tubes, allowing bacteria to grow and slow down urine flow. Pregnancy can also alter the normal balance of microbes in the body, reducing the immune system’s ability to fight infections. All these changes together make UTIs more common during pregnancy¹¹. 

Therefore, regular urine tests are a vital part of pregnancy treatment. These tests detect leukocytes in urine during pregnancy at an early stage, which may suggest an infection or inflammation. If leukocytes are discovered in urine during pregnancy, immediate action is important. Timely care helps to avoid issues for both the mother and the baby, such as kidney infections or premature birth¹¹. 

Diagnosis of Leukocytes in Urine

Leukocytes in urine are usually detected through simple laboratory tests that help identify its causes. The main diagnostic methods include: 

• Medical History: The doctor will take your medical history, which includes symptoms (such as burning or frequent urination), previous urinary infections, underlying diseases like diabetes, recent medications, and pregnancy status. This information assists in the identification of potential causes and risk factors^5,7. 
• Physical Examination: The doctor may conduct a physical examination to look for symptoms such as abdominal discomfort, flank pain, fever, or tenderness in the lower back or hip. These findings contribute to the identification of a urinary tract infection or related conditions^3,7,8. 
• Leukocyte Esterase Test (Urine Test): This is rapid test wherein urine is collected in a sterile container and tested immediately using a dipstick and a colour-specific pad. A change in colour on the dipstick indicates the presence of leukocyte esterase, a substance produced by WBCs, suggesting that there are WBCs present in the urine. In some cases it might also need microscopic examination¹. 
• Urine Culture: A urine specimen is collected and incubated on a suitable culture medium. It is then tested in laboratory for bacteria or yeast (which causes UTI and other infections), with results typically taking 24 to 48 hours¹².  
• Imaging Tests: In some cases, ultrasound or CT scans may be recommended to check for kidney stones, blockages, or structural problems in the urinary tract. These tests are especially useful in recurrent or complicated infections^5,6,8. 

Treatment for Leukocytes in Urine

Your doctor might decide the treatment for WBCs in urine depending on its cause. The following are some treatment options that your doctor may choose for you:  

• Antibiotics: These are the main treatments for bacterial UTIs and kidney infections. They restrict the bacterial growth and reduce infection. The type and duration depend on the bacteria identified in the urine culture.
  • Examples: Nitrofurantoin, Fluoroquinolones, Sulfamethoxazole, etc^3,7. For fungal and viral infections, antivirals and antifungal medicines may be prescribed. 
• Hydration: Drinking enough of water helps remove bacteria from the urinary tract by increasing urine flow and frequency. This helps to expel microbes from the bladder more quickly. It also reduces urine concentration, which helps alleviate burning and pain during urination¹³. 
• Pain Killers: Medicines may be given to alleviate pain, burning, and discomfort while urinating. These medications do not fight the infection, but they do assist in reducing symptoms. Pain relievers and urinary medications can help with urinating⁷.
  • Example: Paracetamol, Ibuprofen, Acetaminophen, etc. 
• Surgery: Surgeries may be suggested for causes like kidney stones, if they do not heal with medicines. In case of kidney stone, surges are preferred if the stones are growing, they are blocking urine flow (which can create UTI and other complications) and if they cause severe pain⁸. 
• Treatment of Underlying Conditions: Conditions like diabetes, kidney stones, or other urinary tract disorders need proper management to avoid recurrence.  

Note: This information is intended for general educational purposes only and should not be used as a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of a certified doctor for proper evaluation and treatment of any health condition. Do not self-medicate. 

Complications

If the underlying cause of leukocytes in urine are not detected and treated in time, especially when caused by an infection, serious health complications may arise. These include: 

• Pyelonephritis: A severe infection which can spread from the lower urinary tract to the kidneys, causing more severe illness³. 
• Chronic UTIs: Recurrent occurrence of UTIs, which become difficult to manage and affect daily comfort and urinary health. 
• Kidney Damage: Repeated or severe infections and conditions like kidney stone can affect the kidney health and cause permanent kidney damage and reduced kidney efficiency (acute condition)^6,8. 
• Sepsis or Urosepsis: In severe cases, the infection (or UTI) can enter the bloodstream and spread throughout the body, which can cause life-threatening conditions¹⁴. 
• Pregnancy Complications: Increase the risk of complications such as premature birth, low birth weight, or kidney infections, which may affect both mother and baby¹¹. 
• Systemic Symptoms: Symptoms like burning during urination, frequent urge to urinate, and lower abdominal discomfort may persist or become chronic, affecting overall health and quality of life. 

Prevention Tips

The following are some ways by which you can avoid leukocytes in urine: 

• Stay well hydrated: This can help eliminate bacteria from the urinary tract, lowering the chance of infection^7,13. 
• Clean the genital area properly, especially after using the toilet: This helps restrict bacteria from entering the urinary tract⁷. 
• Avoid holding urine: This reduces the chances of microbial growth in the urinary tract¹⁰. 
• Eat balanced diet: A healthy diet supports a strong immune system to fight infections¹⁵. 
• Manage underlying conditions like diabetes: This helps reduce infection risk⁵. 
• Limit use of harsh soaps, sprays, or scented products in the genital area: This can reduce chances of infection and inflammation⁷. 

Myths and Facts About Leukocytes in Urine

The following are some common myths on leukocytes in urine: 

When to See a Doctor?

Consult a doctor for leukocytes in urine if: 

• You have symptoms like burning during urination, frequent urge to urinate, cloudy or foul-smelling urine, or lower abdominal pain^3,6,7. 
• Symptoms persist, worsen, or keep coming back, especially if you have risk factors like pregnancy, diabetes, or kidney stones⁵. 
• You develop warning signs such as fever, flank pain, chills, or blood in urine, as these may indicate a serious infection^5,7,8. 

Also Read: Home Remedies For UTI By Dr. Siddharth Gupta

Conclusion

With this blog, we’ve tried to clarify the meaning of leukocytes in urine, their causes, associated symptoms, risks, diagnosis and management. They usually indicate an infection or inflammation in the urinary system, which is most typically caused by UTIs, and are generally manageable. Urine testing is critical for early diagnosis and therapy. With proper medical care, the majority of cases can be successfully handled and complications can be avoided. Maintaining proper hygiene and healthy habits lowers the likelihood of recurrence. 

Frequently Asked Questions (FAQs)

References

1. Leukocyte esterase urine test. 2025. Doi: https://medlineplus.gov/ency/article/003584.htm 

2. White Blood Count (WBC). 2024. Doi: https://medlineplus.gov/lab-tests/white-blood-count-wbc/ 

3. Crader MF, Kharsa A, Leslie SW. Bacteriuria. 2023. Doi: https://www.ncbi.nlm.nih.gov/books/NBK482276/ 

4. Chen Y, Liao CH, Chiang BJ, Huang HC, Chou YW. A Lower Urine White Blood Cell Median Can be a Predictor of Undiscovered Urolithiasis in Patients with Acute Urinary Tract Symptoms. Urological Science. 2020;31(3):115-121. doi:10.4103/UROS.UROS_12_20. https://www.researchgate.net/publication/355758362_A_lower_urine_white_blood_cell_median_can_be_a_predictor_of_undiscovered_urolithiasis_in_patients_with_acute_urinary_tract_symptoms 

5. Sherchan R, Hamill R. Sterile Pyuria. 2024. Doi: https://www.ncbi.nlm.nih.gov/books/NBK606125/ 

6. Li R, Leslie SW. Cystitis. 2023. Doi: https://www.ncbi.nlm.nih.gov/books/NBK482435/ 

7. Urinary Tract Infection Basics. 2024. Doi: https://www.cdc.gov/uti/about/index.html 

8. Kidney stones. 2024. Doi: https://medlineplus.gov/ency/article/000458.htm 

9. Bendig DW. The Differential Diagnosis of Sterile Pyuria in Pediatric Patients: A Review. Global Pediatric Health. 2021;8:2333794X21993712. doi:10.1177/2333794X21993712. https://pubmed.ncbi.nlm.nih.gov/34017902/ 

10. Jagtap S, Harikumar S, Vinayagamoorthy V, Mukhopadhyay S, Dongre A. Comprehensive assessment of holding urine as a behavioral risk factor for UTI in women and reasons for delayed voiding. BMC Infect Dis. 2022;22(1):521. doi:10.1186/s12879-022-07501-4. https://pubmed.ncbi.nlm.nih.gov/35668379/ 

11. Habak PJ, Carlson K, Griggs RP. Urinary Tract Infection in Pregnancy. 2024. Doi: https://www.ncbi.nlm.nih.gov/books/NBK537047/ 

12. Urine culture. 2024. Doi: https://medlineplus.gov/ency/article/003751.htm 

13. Booth J, Agnew R. Evaluating a hydration intervention (DRInK Up) to prevent urinary tract infection in care home residents: A mixed methods exploratory study. JFSF. 2019;04(02):36-44. doi:10.22540/JFSF-04-036. https://pmc.ncbi.nlm.nih.gov/articles/PMC7155301/ 

14. Porat A, Bhutta BS, Kesler S. Urosepsis. 2023. Doi: https://www.ncbi.nlm.nih.gov/books/NBK482344/ 

15. Nutrition and Immunity. Doi: https://nutritionsource.hsph.harvard.edu/nutrition-and-immunity/ 

16. Jepson RG, Williams G, Craig JC. Cranberries for preventing urinary tract infections. Cochrane Kidney and Transplant Group, ed. Cochrane Database of Systematic Reviews. 2012;2014(6). doi:10.1002/14651858.CD001321.pub5. https://pmc.ncbi.nlm.nih.gov/articles/PMC7027998/ 

17. Vaginal microbiota and urinary tract infections in women: the protective role of vaginal lactobacilli in counteracting urinary tract infections occurrence and recurrence. infez med. 2026;34(1). doi:10.53854/liim-3401-4. https://pubmed.ncbi.nlm.nih.gov/41788387/ 

18. Jabeen A. Correlation between Anxiety Level and Leukocytes in the Urine. JPCR. 2019;7(3). doi:10.19080/JPCR.2019.07.555712. https://juniperpublishers.com/jpcr/JPCR.MS.ID.555712.php 

19. Leonardi M, Espada M, Kho RM, et al. Endometriosis and the Urinary Tract: From Diagnosis to Surgical Treatment. Diagnostics. 2020;10(10):771. doi:10.3390/diagnostics10100771. https://pubmed.ncbi.nlm.nih.gov/33007875/ 

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