女性中段尿尿液檢查尿沉渣中白血球數目增加的意涵
潘英昇
台南市立醫院泌尿科
The meaning of pyuria in female midstream urine analysis
Ying-Sheng Pan
Department of Urology, Tainan Municipal Hospital
Purpose: We found a phenomenon in some females after cystitis treatment that their infection symptoms subsided after full antibiotics treatment, but pyuria persisted in post-treatment analysis. This study is to realize the reliability of pyuria in female midstream urine analysis.
Materials & Methods: From Mar. 2015 to Feb. 2019 in our outpatient clinic for 67 female cystitis patients (mean age: 62.0±17.0) who got symptoms subsided or free after treatment, but still had persisted pyuria in midstream urine analysis (>10 WBC/hpf) we performed immediate repetitive urinalysis (urine collected from urethral catheter). We compared the difference in number of leukocyte & epithelial cell on these 2 consecutive analyses.
Results: In the immediate repetitive urinalyses of 67 patients, 42 patients had less than 5 WBC/hpf (34 had 0-1 WBC and 8 had 1-5 WBC). It meant that further treatment may be not necessary. In these 42 patients the original midstream urine analyses showed more than 10 WBC/hpf in all, >20WBC in 61.9%, >50WBC in 45.2% and numerous in 9.5%. On the observation about epithelial cell the original 67 urinalyses showed >5 epithelial cell/hpf in 53 patients (79.1%), but in the repetitive urinalyses only 2 patients (3%) had >5 epithelial cell/hpf.
Conclusions: The result of female midstream urine analysis is frequently affected by contamination of specimen and epithelial cells in the urinary sediment indicate contamination. So, pyuria in urinalysis cannot be the only warranty for antibiotics treatment. The change of symptoms should be considered in the continuity of cystitis-treatment. If with any doubt a urine specimen should be obtained by urethral catheterization.