From the Guidelines
Having epithelial cells in your urine is generally normal in small amounts, but an elevated number may indicate inflammation or infection in the urinary system, and the most recent guidelines suggest that a clean-catch midstream technique can help reduce contamination and provide more accurate results 1.
Understanding Epithelial Cells in Urine
Epithelial cells naturally line the urinary tract and are constantly shed and replaced, so finding some in a urine sample is expected. However, the type of epithelial cells matters - squamous epithelial cells often represent contamination from the genital area during collection, while renal epithelial cells might suggest kidney issues.
Clinical Implications
If your urine test shows high levels of epithelial cells, your doctor may recommend additional testing, especially if you have symptoms like pain during urination, increased frequency, or cloudy urine. According to recent studies, the presence of epithelial cells in urine can be an indicator of underlying conditions such as urinary tract infections, kidney inflammation, or bladder cancer 1.
Diagnostic Approach
No specific medication is needed for epithelial cells alone, as treatment would target the underlying cause if one exists. The diagnostic approach involves evaluating the patient's symptoms, medical history, and laboratory results, including urine cytology and imaging studies if necessary. A recent study published in 2024 highlights the importance of accurate diagnosis and classification of bladder cancer, which can be facilitated by the use of advanced imaging techniques and biomarker testing 1.
Best Practices for Urine Sample Collection
When providing a urine sample, a clean-catch midstream technique can help reduce contamination and provide more accurate results. This involves cleaning the genital area, starting to urinate, and then stopping the flow of urine mid-stream to collect the sample in a sterile container. This method can help minimize the presence of contaminating cells and provide a more accurate representation of the urinary tract lining. As noted in a recent study, proper sample collection and handling are crucial for accurate diagnosis and treatment 1.
From the Research
Presence of Epithelial Cells in Urine
The presence of epithelial cells in urine can be an indicator of various conditions.
- Epithelial cells are a normal finding in urine, but their presence in large numbers can be a sign of an underlying issue 2, 3.
- There are different types of epithelial cells, including transitional epithelial cells (TECs) and renal tubular epithelial cells (RTECs), which can provide information about the source of the cells in the urine 3.
- The presence of squamous epithelial cells (SECs) in urine can reduce the accuracy of urinalysis for predicting positive urine cultures, as they can contaminate the sample 4.
Diagnostic Value of Epithelial Cells
- A cytological examination of urine can confirm the etiology of recurrent lower urinary tract infections (UTIs) and be an evidence-based criterion in the differential diagnosis of bacterial, candidiasis, and papillomavirus infection 2.
- RTECs can add value in the diagnosis of upper urinary tract pathology, and may be helpful in discriminating between upper and lower UTIs 3.
- The differentiation of epithelial cells in the urinary tract can provide information about the cell types and their distribution in the epithelium, which can be useful in understanding the development and function of the urinary tract 5.
Clinical Implications
- The presence of epithelial cells in urine should be interpreted in the context of other clinical findings and laboratory results, such as urine culture and urinalysis results 2, 3, 4.
- A thorough evaluation of the patient's symptoms, medical history, and laboratory results is necessary to determine the underlying cause of the presence of epithelial cells in urine.