A health condition in which you have pus in the urine is called pyuria. In most cases, this disorder is caused by urinary tract infections (UTIs), but it may also happen due to sexually transmitted infections (STIs), viral infections, or chronic use of certain medicines. While the primary symptom of pyuria is cloudy and foul-smelling urine, it may also cause other symptoms. Usually, doctors treat this condition by managing its cause.
Furthermore, people with pyuria may also have increased levels of white blood cells (also called leukocytes) in the urine. In general, pus is a thick and discolored (in some cases, white, yellow, pink, or green) substance that the body produces to fight off an infection. The pus is made of white blood cells, dead tissue, and bacteria. In people with pyuria, there are 10 or more white blood cells per cubic millimeter of urine (pee). In addition, some people may develop a type of pyuria called sterile pyuria. It occurs when you have this condition, but doctors cannot identify any bacteria.
How Common is Pyuria?
This is a common condition that usually indicates the presence of other disorders (such as UTIs). For instance, about 8 to 10 million people get treatment from doctors for a UTI. Moreover, about 14% of women and 2.6% of men have sterile pyuria. Mostly, sterile pyuria occurs due to sexually transmitted infections.
Symptoms
Check below some symptoms that people with pyuria usually experience:
- Pain in the abdomen (belly), pelvic area, or side (flank)
- Frequent urination
- Pressure in the low part of the pelvic area
- Sudden urges to urinate
- Incontinence
- Dysuria (pain while urinating)
- Fever
- Nausea
- Vomiting
- Bloody urine (also known as hematuria)
If any of the previous symptoms occur, immediately contact your healthcare provider.
Causes
While the most common cause of pyuria is UTIs, it may also occur due to other health conditions. Examples include:
- Organ transplant rejection
- Transvaginal surgical mesh
- Kidney stones
- Sepsis
- Tuberculosis
- Pneumonia
- Interstitial cystitis (painful bladder syndrome)
- Viral infections (such as adenovirus)
- STIs, including gonorrhea, human papillomavirus (HPV), syphilis, human immunodeficiency virus (HIV), and others
Sometimes, people develop pyuria due to the misuse of certain medicines. For example:
- NSAIDs (nonsteroidal anti-inflammatory drugs) – For example, Aspirin, Ibuprofen, or Naproxen sodium
- Antibiotics that contain sulfa or penicillin
- Diuretics
- Proton pump inhibitors (these medications are used to reduce stomach acid production)
In addition, pyuria itself is not contagious, but some infections that often cause it may easily spread from one person to another. For example, STIs, UTIs, adenoviruses, and some types of pneumonia.
Risk Factors
Healthcare providers have identified some factors that may increase your risk of developing pyuria. Check some of them below:
- Age – People over 45 years old are more prone to pyuria.
- Sex – This condition can affect anyone, but it occurs more frequently in women than in men. The risk increases even more in postmenopausal women.
- Pregnancy
- Sexual activity
- Diabetes
- Urinary tract irregularities (such as vesicoureteral reflux)
- Urinary catheters
- Inflammatory disorders (including Kawasaki disease, systemic lupus erythematosus, sarcoidosis, and others)
- Weakened immune system
- Certain medical procedures (such as contrast dye or radiation)
What Are The Possible Complications of Pyuria?
People who leave this condition untreated may experience some complications. Check some examples below:
- Kidney infection (pyelonephritis) – This is a serious kidney infection that may cause fever, pain, and damage to the kidneys.
- Kidney abscesses
- Chronic kidney damage – People with long-term infection may also experience scarring, atrophy, and other chronic damage to the kidneys.
- Acute renal failure – This complication occurs in more severe cases, and kidney function may be acutely compromised.
- Sepsis – This is a serious health condition in which the infection passes into the bloodstream, causing severe inflammatory responses in the whole body.
- Blood poisoning
- Bladder dysfunction
- Underlying condition progression
The previous list does not contain a complete list of pyuria complications. However, you can consult with your healthcare professional about ways to reduce the risk or prevent them.
How to Prevent Pyuria?
It is not always possible to prevent this condition. One sure way to prevent pyuria is to prevent UTIs. Check below some tips that may help prevent urinary tract infections:
- Good hygiene – It is very important to wipe from front to back after urinating or having a bowel movement. It is also recommended to change the pads, tampons, and other hygiene products regularly. Doctors may also recommend washing the skin around the vagina and rectum with clean water and a mild (unscented) soap.
- Drink plenty of water – Drinking adequate amounts of water may help get rid of bacteria from the urinary tract.
- Change your clothing – Physicians usually recommend wearing loose clothing that maintains the genital area dry and prevents bacteria from entering or growing in the urinary tract.
- Urinating after sexual activity – You should urinate after sex because it helps clear the bacteria from the urinary tract.
Check below also some tips that may help prevent sexually transmitted infections:
- Practice safe sex – It is advised to use condoms or dental dams during sexual activity.
- Regularly test for STIs – Doctors often recommend getting tested for STIs regularly if you have new or multiple sexual partners.
Diagnosis
In most cases, this condition is diagnosed through a urine test (also called urinalysis). During this test, you will urinate into a special cup at the doctor’s office. Therefore, this urine sample will be checked for blood cells, bacteria, and blood under a microscope.
Treatment
The treatment is often different among people with pyuria because it depends on the exact cause of the disease. For instance, doctors often recommend antibiotics for UTIs, bacterial STIs, or tuberculosis. In general, you should finish the treatment with antibiotics as directed by your doctor, even if you do not have symptoms. Otherwise, the condition may return and cause more severe symptoms. It also becomes more difficult to treat. Do not hesitate to visit a doctor if your condition does not improve after finishing the treatment.
Frequently Asked Questions
What does pyuria smell like?
Usually, people with pyuria notice a foul odor that smells like ammonia from their urine. This substance has a strong and distinct smell that causes irritation of the mucous membranes in the nose. Moreover, ammonia is present in multiple cleaning products.
When should I see a healthcare provider?
If you notice any changes in your urine or if you think you have symptoms of a UTI or STI, contact your healthcare professional right away because it may indicate a serious health condition. You should also visit your doctor if you do not notice any improvements after finishing the treatment. In such cases, you may need other treatment options to clear the infection.
What is the difference between pyuria and a UTI?
A UTI is a common type of infection in the urinary system that is mostly caused by a bacterium called E. coli. However, pyuria is a condition in which pus appears in the urine. In most cases, it is a symptom of a UTI. Ask your healthcare provider if you have additional questions.
