Pyuria Diagnosis and Treatment

urine sample on table in doctor's office

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Pyuria is a condition that occurs when excess white blood cells, or pus, are present in the urine. Pyuria causes cloudy urine and frequently indicates the presence of a urinary tract infection (UTI). Pyuria can also indicate sepsis, a life-threatening bacterial infection, or pneumonia in older adults.

In addition to pyuria, you can also have sterile pyuria — urine which contains white blood cells but still appears sterile, free from bacteria and microorganisms, based on culturing techniques. Sterile pyuria is typically caused by sexually transmitted infections such as gonorrhea as well as viruses. It can also be the result of a reaction to medications (like acetaminophen) or other conditions like Kawasaki disease and genitourinary tuberculosis. Parasites, kidney stones, tumors and cysts, and interstitial cystitis can also lead to pyuria.

Detecting and Treating Pyuria 

Both forms of pyuria can be determined from a urinalysis. Testing of the urine will be able to detect any bacteria that may be present. Since pyuria consists of urine containing pus, there may be visible changes in the urine. Urine may appear cloudy or thick.

If your urine appears thick or cloudy after multiple trips to the bathroom throughout the day, make an appointment with your doctor to have a urinalysis.

The way in which pyuria is treated depends on how it was caused. Most cases are caused by UTIs, which are treated with antibiotics. If your pyuria is not the result of a bacterial infection, more testing may be needed to determine the cause. Your doctor may order blood tests or imaging tests to rule out other conditions. If you are taking medications that can cause pyuria, your doctor may ask you to stop them, ruling your medications out as a cause.

What to Know About Urinary Tract Infections

Although most UTIs are not serious, they are painful. About half of all women will have at least one urinary tract infection in her lifetime. Some women will go on to have recurrent urinary tract infections. In most cases, antibiotic treatment will relieve the symptoms of UTI. You must take all the antibiotics prescribed or you risk your urinary tract infection returning. Your doctor may ask you to return for a follow-up urinalysis after you complete antibiotic treatment to make sure the infection is completely gone.

The most common causes of urinary tract infections include bacteria from the bowels that migrates to the urethra. Women are more likely to get urinary tract infections because their urethra is closer to their anus, as compared to men. Men also have longer urethras, making it harder for bacteria to make their way up to the bladder. For those men who do get a UTI, they are more likely to get a second one as the infection-causing bacteria can hide deep within the tissue of the prostate.

Practicing good personal hygiene can help prevent urinary tract infections. This includes always wiping from front to back after urination and bowel movements, as well as daily washing of the skin around and between the vagina and rectum. Washing, or showering, both before and after sexual activity, may also lower your risk of getting a urinary tract infection.

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