Elevated Epithelial Cells in Urine: Causes, Diagnosis, and Prevention Tips

Discovering elevated epithelial cells in a urine test can be concerning, but it's not always a sign of serious illness. In many cases, this finding is temporary and linked to lifestyle factors or minor health issues. However, persistently high levels may indicate an underlying medical condition affecting the urinary tract or kidneys. This article explores the most common causes of increased urinary epithelial cells, how they are diagnosed, and what steps you can take to protect your urological health.

What Are Epithelial Cells in Urine?

Epithelial cells line the surfaces of various organs, including the urinary tract—such as the urethra, bladder, ureters, and kidneys. A small number of these cells in urine is normal, especially after physical activity or due to natural cell turnover. However, when lab results show elevated levels, further evaluation may be needed to rule out infections, obstructions, or more serious conditions.

Common Causes of High Epithelial Cell Count

1. Intense Physical Activity

Strenuous exercise, particularly activities involving repetitive impact like running or weightlifting, can temporarily increase the shedding of epithelial cells from the urinary tract lining. This occurs due to increased blood flow and mechanical stress on the bladder and urethra. The result is often a transient rise in epithelial cells in urine samples. No treatment is required—simply allowing time for rest and hydration typically resolves the issue. To prevent recurrence, maintain a balanced workout routine with adequate recovery periods.

2. Contaminated Urine Sample

Improper collection techniques can lead to sample contamination, which may falsely elevate epithelial cell counts. For example, failing to clean the genital area before urination can introduce skin cells, vaginal secretions (in women), or smegma (in men) into the sample. If other urine parameters such as white blood cells, nitrites, or bacteria are normal and you have no symptoms, the result may simply reflect poor hygiene during collection. Repeating the test after 1–2 weeks with proper cleansing procedures often yields normal results.

3. Urinary Tract Infection (UTI)

One of the most frequent medical reasons for elevated epithelial cells is a urinary tract infection. Bacteria like E. coli can invade the urinary system due to poor hygiene, sexual activity, or weakened immunity. As the infection progresses, inflammation damages the mucosal lining, causing increased cell shedding. Symptoms often include burning during urination, frequent urges to urinate, cloudy or strong-smelling urine, and sometimes fever. Treatment usually involves prescribed antibiotics such as levofloxacin or ciprofloxacin, along with plenty of fluids to flush out pathogens.

4. Kidney Stones

Insufficient daily water intake increases the risk of mineral buildup and stone formation in the kidneys. These stones can irritate the inner walls of the renal system, leading to inflammation and sloughing off of epithelial tissue. Alongside elevated cell counts, patients may experience severe flank pain, hematuria (blood in urine), nausea, and difficulty urinating. Doctors may recommend herbal remedies like lithotriptic granules to help pass small stones naturally. Larger stones might require interventions such as extracorporeal shock wave lithotripsy (ESWL) or surgical removal.

5. Bladder Stones

Bladder stones often develop when kidney stones migrate down and remain lodged in the bladder, or due to chronic urinary retention. Over time, the constant friction irritates the bladder lining, potentially triggering metaplasia—a change in cell type—and excessive cell shedding. This leads to detectable increases in epithelial cells during urinalysis. Common symptoms include interrupted urine flow, lower abdominal discomfort, and recurrent UTIs. Surgical intervention is typically necessary to remove the stones and prevent complications.

When to Consider More Serious Conditions

While less common, persistent elevation of epithelial cells could signal something more serious, such as urothelial tumors or other malignancies in the bladder, ureters, or kidneys. If imaging tests (like ultrasound, CT scans, or MRI) reveal abnormal growths, or if there's unexplained hematuria and weight loss, a biopsy may be recommended. Early detection through regular screening improves outcomes significantly.

How Is the Condition Diagnosed?

To determine the cause, healthcare providers may order several diagnostic tools:

Urinalysis and microscopic examination – to assess cell types and signs of infection
Blood tests – checking kidney function markers like creatinine and BUN
Imaging studies – including color Doppler ultrasound, computed tomography (CT), or magnetic resonance imaging (MRI)
Cystoscopy – direct visualization of the bladder using a thin scope, if indicated

Preventive Measures for Optimal Urinary Health

Maintaining good urological wellness reduces the risk of abnormal findings in urine tests. Key habits include:

Drink plenty of water daily – aim for at least 8 glasses to dilute urine and promote frequent voiding
Practice proper hygiene – especially important for women; always wipe front to back after using the restroom
Change underwear regularly – choose breathable cotton fabrics to minimize bacterial growth
Stay vigilant during life stages – menstruation, pregnancy, and breastfeeding increase susceptibility to infections, so extra care is essential
Avoid holding urine for long periods – timely bathroom visits help prevent stagnation and infection

If you notice consistent abnormalities in your urine tests or experience any troubling symptoms, consult a specialist in nephrology or urology without delay. Timely evaluation ensures accurate diagnosis and effective management, helping you maintain long-term urinary and overall health.