Leukocytes, also known as white blood cells, are an essential part of the body’s immune system. They help fight off infections and other foreign substances that can harm the body. Leukocytes are normally found in the blood, but they can also be present in urine. The presence of leukocytes in urine, known as leukocyturia, can indicate a urinary tract infection (UTI) or other serious conditions. In this article, we’ll discuss what leukocytes in urine mean, what causes them, and leukocyturia treatment.

What is Pyuria?
Pyuria is a medical condition characterized by white blood cells (leukocytes) in the urine. Normally, there should be very few white blood cells in the urine, but pyuria occurs when there is an excessive amount of these cells.
Pyuria is often a sign of an underlying condition such as a urinary tract infection, kidney infection, or inflammation of the bladder or urethra. It can also be caused by non-infectious conditions such as kidney stones or prostate problems. In some cases, pyuria may not have apparent symptoms and is only detected through routine urine testing.
What are leukocytes in urine without nitrates?
Leukocytes in urine without nitrates may indicate an early or mild urinary tract infection, as not all bacteria that cause infections produce nitrate. It is possible that the white blood cells in the urine are present due to a non-infectious cause, such as inflammation or injury in the urinary tract.
In some cases, the absence of nitrate in the urine may also indicate a false negative result on a urine dipstick test, a common method used to test for leukocytes and nitrate in urine.
Symptoms of Leukocytes in Urine
The presence of leukocytes in urine may not always cause noticeable symptoms. However, if the underlying cause of the leukocytes is an infection, other symptoms may be present. Some of the common symptoms of leukocytes in urine include:
- Frequent urination
- Pain or burning sensation during urination
- Cloudy or strong-smelling urine
- Blood in the urine
- Pelvic pain in women
- Rectal pain in men
- Urgent need to urinate
If you are experiencing any of these symptoms, seeing a healthcare provider for an evaluation is essential.
10 Common Causes of Leukocytes in Urine
There are many potential causes of leukocytes in urine. Some of the common causes include:
1. Urinary Tract Infection (UTI)
Urinary tract infections (UTIs) are a common cause of leukocytes in the urine due to bacteria in the urinary tract. UTIs can occur in any part of the urinary tract, including the bladder, urethra, and kidneys.
The most common cause of UTIs is the bacterium Escherichia coli (E. coli), which is normally found in the digestive tract but can cause infection when it enters the urinary tract. UTIs can also be caused by other types of bacteria or by fungi.
Symptoms of a UTI may include:
- Pain or burning sensation during urination
- Frequent urination
- Urgency to urinate
- Cloudy or strong-smelling urine
- Pain or pressure in the lower abdomen or back
- Low-grade fever
Treatment for UTIs typically involves a course of antibiotics to eliminate the bacteria causing the infection. Over-the-counter pain relievers may also be recommended to alleviate symptoms such as pain and fever.
In addition to medication, lifestyle changes may help prevent UTIs. Drinking plenty of fluids, urinating frequently, and wiping from front to back after using the toilet can help prevent the spread of bacteria. Women may also benefit from urinating after sexual intercourse and avoiding the use of irritating feminine hygiene products.

2. Kidney Infection
A kidney infection, or pyelonephritis, is a type of urinary tract infection (UTI) that can cause leukocytes in the urine. It occurs when bacteria from a bladder infection travel up to the kidneys and cause an infection in one or both of them.
The most common cause of kidney infections is the same UTI, the bacterium Escherichia coli (E. coli). However, other bacteria and viruses can also cause kidney infections.
Symptoms of a kidney infection may include:
- High fever
- Chills and shivering
- Flank pain (pain on the side of the back, usually on one side)
- Painful or frequent urination
- Cloudy or bloody urine
- Nausea and vomiting
Treatment for kidney infections typically involves a course of antibiotics to eliminate the bacteria causing the infection. Depending on the severity of the infection, hospitalization may be necessary, especially if there are signs of dehydration or risk of complications. (Resource)
3. Kidney stones
Kidney stones can cause leukocytes in the urine, but it is not a common symptom. The presence of leukocytes in the urine in individuals with kidney stones usually indicates the presence of an accompanying infection.
Symptoms of kidney stones can include:
- Severe pain in the back, side, or groin
- Painful or frequent urination
- Blood in the urine
- Nausea and vomiting
- Difficulty passing urine or passing small amounts of urine
- Fever or chills (if an infection is present)
Treatment for kidney stones depends on the size and location of the stone. Small stones may pass on their own with increased fluid intake and pain management.
Larger stones may require medical intervention such as extracorporeal shock wave lithotripsy (ESWL), ureteroscopy, or percutaneous nephrolithotomy.
4. Interstitial Cystitis
Interstitial cystitis (IC) is a chronic condition that can cause leukocytes in the urine due to inflammation of the bladder wall. The exact cause of IC is not fully understood, but it is believed to be related to a defect in the bladder lining that allows irritants to reach the underlying tissues, leading to inflammation.
Symptoms of IC may include:
- Pain in the bladder or pelvic area
- Frequent urination
- Urgency to urinate
- Pain or discomfort during sexual intercourse
- Painful urination
- Blood in the urine
Treatment for IC may involve a combination of medications, lifestyle changes, and other therapies. Some common medications used to treat IC include pain relievers, antihistamines, and medications that help relax the bladder muscles.
5. Prostatitis
Prostatitis is a condition that can cause leukocytes in the urine due to inflammation of the prostate gland. The prostate gland is a small gland located below the bladder in men that produces semen.
The exact cause of prostatitis is not fully understood, but it can be caused by bacterial infections or non-infectious factors such as injury or irritation. When the prostate gland becomes inflamed, it can cause a variety of symptoms, including:
- Pain or discomfort in the groin area
- Difficulty urinating
- Frequent urination
- Pain or burning sensation during urination
- Blood in the urine or semen
- Painful ejaculation
- Erectile dysfunction
- Fever and chills
Treatment for prostatitis depends on the underlying cause of the condition. If the condition is caused by a bacterial infection, antibiotics may be prescribed to clear the infection. Pain relievers and anti-inflammatory medications may also be prescribed to help alleviate symptoms.
6. Sexually Transmitted Infections (STIs)
Sexually transmitted infections (STIs) can cause leukocytes in the urine, as they can cause inflammation and irritation in the urinary tract.
Some of the most common STIs that can cause leukocytes in the urine include chlamydia, gonorrhea, and trichomoniasis. These infections can be transmitted through sexual contact and affect both men and women.
Symptoms of STIs that can cause leukocytes in the urine can include:
- Painful or frequent urination
- Abnormal discharge from the vagina or penis
- Pain during sex
- Abdominal pain or discomfort
- Bleeding between periods or after sex
- Swollen lymph nodes in the groin area
- Skin rash or sores in the genital area
Treatment for STIs typically involves antibiotics to eliminate the infection. It is important to complete the full course of antibiotics as prescribed by a healthcare provider, even if symptoms improve or go away. Sexual partners should also be tested and treated to prevent reinfection and the spread of the infection.
7. Bladder or kidney cancer
Bladder or kidney cancer can cause leukocytes in the urine, as cancer cells can stimulate an immune response and cause inflammation in the urinary tract.
Symptoms of bladder or kidney cancer can include:
- Blood in the urine
- Painful or frequent urination
- Back or abdominal pain
- Unexplained weight loss
- Fatigue or weakness
- Loss of appetite
- Swelling in the legs or feet
Treatment for bladder or kidney cancer may involve surgery, radiation therapy, chemotherapy, or a combination of these treatments. The specific treatment plan will depend on the type and stage of cancer and other individual factors, such as overall health and age.

8. Medications
Certain medications can cause leukocytes in the urine as a side effect. These medications may irritate the urinary tract or cause inflammation, which can lead to the presence of white blood cells in the urine.
Some medications that can cause leukocytes in the urine include:
- Antibiotics
- Nonsteroidal anti-inflammatory drugs (NSAIDs)
- Chemotherapy drugs
- Diuretics
- Antipsychotic medications
- Anticonvulsant medications
- Immunosuppressive drugs
Symptoms of medication-induced leukocytes in the urine may vary depending on the specific medication and individual. However, common symptoms may include:
- Painful or frequent urination
- Blood in the urine
- Back or abdominal pain
- Fever or chills
Treatment for medication-induced leukocytes in the urine involves stopping the medication, causing the side effect, or adjusting the dose. It is important to consult with a healthcare provider before making any changes to medication regimens.
9. Pregnancy
It is common for pregnant women to have leukocytes in their urine due to changes in the urinary tract during pregnancy. Symptoms of leukocytes in the urine during pregnancy may include:
- Painful or frequent urination
- Blood in the urine
- Back or abdominal pain
- Fever or chills
- Vaginal discharge or irritation
Treatment for leukocytes in the urine during pregnancy involves identifying and treating any underlying infections or conditions. Antibiotics may be prescribed to treat bacterial infections, while antifungal medications may be used to treat yeast infections.
10. Inflammatory Bowel Disease (IBD)
Inflammatory Bowel Disease (IBD), including conditions like Crohn’s disease and ulcerative colitis, can cause leukocytes in the urine due to inflammation and damage to the urinary tract. The presence of white blood cells in the urine can indicate the presence of an infection or inflammation in the urinary tract.
Symptoms of leukocytes in the urine due to IBD may include:
- Painful or frequent urination
- Blood in the urine
- Abdominal pain or cramping
- Diarrhea or constipation
- Fatigue or weakness
Treatment for leukocytes in the urine due to IBD involves managing the underlying condition. Medications such as corticosteroids, immunomodulators, and biologics may be used to reduce inflammation and manage symptoms.
Prevention of Leukocytes in Urine
The prevention of leukocytes in urine depends on the underlying cause. However, some general tips to promote urinary tract health and reduce the risk of infections include:
- Stay hydrated by drinking plenty of water and fluids.
- Practice good hygiene, including wiping from front to back after using the bathroom.
- Urinate regularly and empty the bladder completely.
- Avoid using harsh soaps, douches, and other irritants in the genital area.
- Urinate after sexual intercourse to flush out any bacteria.
- Avoid using spermicidal products or diaphragms for contraception, which can increase the risk of urinary tract infections.
- Wear cotton underwear and avoid tight-fitting clothing that can trap moisture and promote bacterial growth.
- Avoid holding urine for prolonged periods and use the bathroom when needed.
For individuals with chronic conditions such as IBD or kidney stones, following a treatment plan and working with a healthcare provider to manage the condition can also help prevent leukocytes in urine.
Urine analysis for Pyuria
Urine analysis is a diagnostic test that examines a person’s urine for abnormal substances, such as blood, protein, glucose, or white blood cells. It is a commonly used test to detect and monitor various health conditions, including urinary tract infections, kidney disease, and diabetes.
The test involves collecting a urine sample and analyzing it in a laboratory using various methods, such as visual inspection, dipstick tests, and microscopy. The results of a urine analysis can provide valuable information about a person’s health status and help healthcare providers make a diagnosis and determine an appropriate course of treatment.
What exactly does having large leukocytes in urine mean?
The presence of large leukocytes in urine typically indicates an increased number of white blood cells (WBCs) in the urine. This usually indicates an underlying condition such as a urinary tract infection, kidney infection, or bladder inflammation. In some cases, large leukocytes in urine may also indicate a more serious condition, such as kidney disease or cancer.
When to see a doctor?
It is recommended to see a doctor if you have leukocytes in your urine or any of the following symptoms:
- Pain or burning during urination
- Frequent urination
- Urgent need to urinate
- Cloudy, foul-smelling, or discolored urine
- Lower abdominal or back pain
- Fever or chills
- Nausea or vomiting
These symptoms may indicate a urinary tract infection or another underlying condition that requires medical attention. In some cases, prompt treatment can prevent the infection or condition from worsening and causing more serious complications.