Pus Cells in Urine: Causes, Symptoms, Diagnosis & Treatment

You went for a regular urine test, probably didn’t think much of it — until the report came back with the words: “pus cells in urine.” Sounds worrying, right? But here’s the truth: it’s more common than you think, and in many cases, it’s treatable. Still, it’s not something to ignore either.

This article will walk you through exactly what pus cells in urine means, what causes them, how they’re diagnosed, and what you can do about it — explained in a clear, no-jargon way.

What Are Pus Cells in Urine?

Pus cells are white blood cells (WBCs) that help your body fight infections. When they’re found in your urine, it usually means your immune system is responding to something going wrong in your urinary tract — like an infection or inflammation.

This condition is medically known as pyuria.

In small numbers, pus cells in urine can be harmless. But a high count? That often means there’s a bigger issue that needs your attention.

What’s a Normal Range of Pus Cells in Urine?

Here’s what’s considered normal when a urine sample is viewed under a microscope:

  • Men: 0 to 5 pus cells per high-power field (HPF)
  • Women: 0 to 10 pus cells per HPF (since external contamination is more common)

Anything above these numbers is considered abnormal and should be investigated further.

What Causes Pus Cells in Urine?

There are several reasons why pus cells might show up in your urine. Some are minor, some more serious. Let’s look at the most common causes:

1. Urinary Tract Infection (UTI)

By far the most common reason. Bacteria enter the urinary tract and cause an infection. Your immune system sends WBCs to fight it — some end up in your urine.

Common UTI symptoms include:
  • Burning while urinating
  • Frequent urge to pee
  • Lower abdominal discomfort
  • Cloudy or foul-smelling urine
2. Kidney Infection (Pyelonephritis)

A UTI that travels up to your kidneys can lead to a more serious infection.

You might experience:

  • Fever and chills
  • Back or side pain
  • Nausea and fatigue
  • High pus cell count in urine
3. Sexually Transmitted Infections (STIs)

STIs like gonorrhea or chlamydia can cause urethral inflammation, leading to pus cells even if you don’t feel classic UTI symptoms.

4. Kidney or Bladder Stones

Stones can cause blockages or irritation, which leads to inflammation and sometimes infection — both of which can result in pus cells showing up in your urine.

5. Prostatitis (in Men)

Inflammation of the prostate can cause symptoms like pelvic pain, painful urination, and white blood cells in urine.

6. Tuberculosis of the Urinary Tract

A rare but serious cause. TB can affect the kidneys and cause chronic pyuria with no bacteria in the urine (called sterile pyuria).

7. Autoimmune Conditions

Diseases like lupus or interstitial nephritis can cause the immune system to attack the kidneys, leading to pus cells in the urine without any infection.

Symptoms to Watch Out For

Not everyone with pus cells in urine will have obvious symptoms. But if the cause is an infection or inflammation, you might notice:

  • Burning or pain while urinating
  • Cloudy urine or strong-smelling urine
  • Fever or chills
  • Frequent need to urinate
  • Lower back, pelvic, or flank pain
  • Fatigue or feeling unwell

If you’re feeling any of these, don’t brush it off. They’re your body’s way of telling you something needs attention.

How Is It Diagnosed?

If pus cells show up in your urine, your doctor may recommend further tests to understand what’s going on.

1. Routine Urine Test (Urinalysis)

This checks for:

  • Pus cells (WBCs)
  • Red blood cells
  • Proteins, glucose, ketones
  • pH and other abnormal urine findings
2. Microscopic Urine Analysis

A lab technician examines the urine under a microscope to count the exact number of pus cells and check for bacteria.

3. Urine Culture

If a UTI is suspected, this test identifies the exact bacteria causing it and helps select the right antibiotic.

4. Imaging Tests

An ultrasound or CT scan might be needed to rule out kidney stones, abscesses, or structural problems.

5. STI Tests or Blood Work

Depending on your symptoms, additional tests may be ordered to rule out infections or autoimmune conditions.

Treatment for Pus Cells in Urine

The treatment depends entirely on the underlying cause. Once the issue is identified, here’s how it’s usually managed:

Antibiotics

For UTIs, kidney infections, and most bacterial causes, antibiotics are the go-to treatment. Your doctor will choose one based on your urine culture results.

Hydration

Drinking lots of water helps flush out bacteria and keeps your urinary system working properly.

Pain Relief

If you’re in pain, over-the-counter painkillers like ibuprofen can ease discomfort while treatment takes effect.

Treating Underlying Conditions
  • Stones may require surgery or lithotripsy
  • STIs need targeted medications

Autoimmune diseases may require steroids or immunosuppressants

When to See a Doctor

It’s a good idea to seek medical help if you experience any of the following:

  • Pain or burning while urinating
  • Fever, chills, or body aches
  • Blood in your urine
  • Constant need to urinate
  • Cloudy or smelly urine
  • Back or side pain
  • Repeated UTIs or abnormal urine test reports

Don’t wait — early treatment prevents serious complications, especially if your kidneys are involved.

How to Prevent Pus Cells in Urine

You can reduce your risk of urinary issues with some simple daily habits:

  • Stay well-hydrated — 8 to 10 glasses of water a day
  • Don’t hold your pee for long periods
  • Wipe front to back (especially important for women)
  • Urinate after sex to flush out bacteria
  • Avoid strong soaps or intimate sprays that can cause irritation
  • Practice safe sex to lower STI risk

Manage chronic illnesses like diabetes, which can raise infection risk

Final Thoughts

Pus cells in urine are a clue — not a diagnosis by themselves. They simply mean your immune system is active in your urinary tract. Sometimes it’s just a mild infection. Other times, it points to something more complex.

The key is not to ignore your symptoms or brush off a strange test result. If you notice discomfort, changes in your urine, or keep getting infections, talk to your doctor.

Health doesn’t come from luck — it comes from listening to your body.