Epithelial cells line various surfaces of the body, including the skin, blood vessels, organs, and urinary tract. A raised amount of epithelial cells in a person’s urine may indicate an underlying condition.

Epithelial cells line the surface of the body and act as a protective barrier. These cells cover a person’s skin and also occur along the surfaces of the digestive tract, the internal organs, and blood vessels.

There are three types of epithelial cells — transitional, renal tubular cells,and squamous cells:

  • Transitional cells occur between the urethra and renal pelvis in males.
  • Renal tubular cells are present in the kidneys.
  • Squamous cells are present in the vagina and urethra in females.

Healthy urine contains a small number of epithelial cells. However, an elevated number of squamous epithelial cells could indicate a contamination of the urine sample.

Testing for epithelial cells can help determine if a person has an infection, kidney disease, or other medical condition.

This article explores how and why urine undergoes testing for epithelial cells. It also discusses what the results mean and what conditions cause an increase in epithelial cells.

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The test for epithelial cells in urine is part of a urinalysis — a test that measures the levels of different substances in urine.

A doctor may order this test if a person experiences symptoms of a urinary infection or kidney disorder, such as:

  • frequent urination
  • pain when urinating
  • pain in the lower tummy
  • flank pain

A doctor may also order a urinalysis if a visual or chemical urine test shows that a person’s urine might contain a raised number of epithelial cells.

How to provide a urine sample

Before the test, a doctor will give a person a container to collect their urine in and a cleaning wipe. They will also explain how to take the sample.

It is important to clean the genitalia first to avoid contaminating the sample with cells and bacteria from the surrounding skin.

Most people will use the “clean catch” method to collect the sample. To do so, a person can perform the following steps:

  1. Wash the hands with soap and water.
  2. Open the container and avoid touching the inside.
  3. Using the wipe, clean the genital area:
    • To clean the penis, wipe the entire head.
    • To clean the vulva, spread the labia and wipe from front to back.
  4. Let a small amount of urine flow, and then use the container to collect the sample midstream.
  5. Finish urinating in the toilet, place the cap on the container, and return the sample as the doctor instructs.

The urine sample then goes to a lab for analysis of different substances.

There are three possible results of a test for epithelial cells in urine. These are:

  • few
  • moderate
  • many

If a person’s test result is “few,” this means their results are typical.

People typically have a few epithelial cells from the bladder (transitional) or external urethra (squamous) in their urine. A typical result for the presence of squamous cells in a urine sample is 15–20 per high-power field or less.

Having a result of “moderate” or “many” may indicate a medical condition.

Unless the person has other symptoms that point to a clear cause, the doctor will likely recommend further tests before making a diagnosis.

The next section of this article explores some medical conditions relating to high levels of epithelial cells in the urine.

An increased amount of epithelial cells in the urine may indicate one of the following conditions:

Urinary tract infection

There are three types of urinary tract infection (UTI). They each affect a different part of the urinary tract:

  • Cystitis: This is a UTI that affects the bladder.
  • Urethritis: This is a UTI that affects the urethra.
  • Kidney infection: This is a UTI that affects the kidneys.

Symptoms of a UTI include:

  • a frequent or urgent need to urinate
  • a pain or burning sensation when urinating
  • cloudy or smelly urine
  • blood in urine
  • pain in the lower abdomen
  • feeling tired or unwell

Yeast infection

Yeast is a natural fungus, and most healthy vaginas have a small amount of yeast in their vagina. However, when the balance of bacteria in the vagina changes, the yeast can grow and result in an infection.

This can occur due to taking antibiotics, typical changes in hormone levels, or a natural reaction to another person’s genital chemistry.

Symptoms of a yeast infection include:

Kidney disease

Kidney disease is a long-term condition where the kidneys do not work as well as they should.

The risk of kidney disease increases with age. Other risk factors include:

Liver disease

There are some different types of liver disease. Some examples include:

Symptoms of liver disease include:

Bladder cancer

Bladder cancer occurs when atypical tissue grows in the bladder lining.

Bladder cancer may cause an increased amount of epithelial cells in urine. However, it is important to remember that this alone does not indicate cancer.

Symptoms of bladder cancer include:

  • streaks of blood in the urine that may turn the urine brown
  • frequent urges to urinate
  • sudden urges to urinate
  • burning sensation when urinating
  • pelvic pain
  • bone pain
  • unexpected weight loss
  • swelling in the legs

Treatment for high levels of epithelial cells in the urine will depend on the underlying cause:

  • UTIs: Doctors typically prescribe antibiotics to treat UTIs.
  • Yeast infection: Treatments for yeast infections include antifungal tablets, creams, or suppositories.
  • Kidney disease: There is no cure for kidney disease, but the following may help a person manage their symptoms:
    • eating a balanced diet
    • exercising regularly
    • drinking less alcohol
    • quitting smoking, if applicable
    • taking medication to control diabetes, blood pressure, and cholesterol
    • undergoing dialysis
    • having a kidney transplant
  • Liver disease: Treatment for liver disease depends on the cause. If the disease is due to excess alcohol consumption, a doctor will help a person seek support to stop drinking.
  • Bladder cancer: There are many surgical and nonsurgical treatments available for bladder cancer. A team of healthcare workers will help an individual with bladder cancer determine the best treatment plan for them.

To prevent high levels of epithelial cells in the urine, a person can take steps to prevent the conditions that cause it. For example, individuals can help prevent developing a UTI by:

  • drinking plenty of fluids
  • urinating after sexual activity
  • taking showers instead of baths
  • wiping from front to back
  • avoiding douching or using sprays or powders in the genital area

To prevent vulvovaginal thrush, a person needs to:

  • avoid using soaps to wash the genitals
  • avoid perfumed menstrual products and toilet papers
  • avoid wearing synthetic or tight-fitting underwear
  • wipe from front to back

It is also important to manage underlying medical conditions, eat a balanced diet, and avoid smoking and drinking to help prevent more severe causes, such as kidney disease.

A raised amount of epithelial cells in the urine can be a sign of a minor infection, such as a UTI or yeast infection.

Anyone with urinary symptoms needs to contact a doctor for a urinalysis and a proper diagnosis. The sooner a person receives a diagnosis of the underlying condition, the sooner treatment can begin to alleviate symptoms.

Epithelial cells line various surfaces in the body. There are three types of epithelial cells — transitional, renal tubular, and squamous.

Urine typically contains a small number of epithelial cells. However, raised levels can indicate an underlying condition, such as a urinary tract infection, yeast infection, kidney disease, liver disease, and bladder cancer.