Squamous Epithelial Cells

Urine
Optimal Result: 0 - 3 HPF.

>10 x 106/L squamous epithelial cells indicate skin/mucosal contamination of the sample.

What are epithelial cells?

Epithelial cells are the cells on the body's surface, such as the skin, urinary tract, blood vessels, and organs. They act as a protective barrier, stopping viruses from entering the body. Besides the protective function, epithelial cells perform other functions as well, such as:

→ Help with sensory detection of taste, smell or sight as they transfer signals through the sensory nerve endings

→ Secrete hormones, enzymes, hormones, and fluids

→ Absorb certain substances, such as nutrients from the food

→ Epithelial cells in the kidney excrete waste, and epithelial cells in the sweat glands excrete sweat

→ Filter blood, dirt, and particles

→ Allow selective diffusion of materials to pass through

In general, epithelial cells act as a barrier between the outside and inside of your body, and help protect your body from viruses.

What are squamous epithelial cells?

Squamous epithelial cells are large and irregularly shaped, with a small nucleus and fine granular cytoplasm; their presence suggests contamination

What are normal levels of epithelial cells in urine?

It is normal to have a few epithelial cells eliminated in the urine due to the normal shedding of cells along the urinary tract. However, many epithelial cells in urine may indicate an underlying health condition.

What are the different types of epithelial cells?

Epithelial cells are cells that come from surfaces of your body, such as your skin, blood vessels, urinary tract, or organs. They serve as a barrier between the inside and outside of your body, and protect it from viruses. A small number of epithelial cells in your urine is normal. A large number may be a sign of infection, kidney disease, or another serious medical condition. For that reason, your doctor may order a urine test or urinalysis to view your urine under a microscope. 

Epithelial cells can be of different shapes, sizes, and appearances. However, depending on the origin, three types of epithelial cells are present in the urine. These types include:

Squamous epithelial cells: 

They are the largest epithelial cells in the human body and are found in the vagina and urethra. These types of cells are commonly found in female urine.

Renal tubular epithelial cells

Also called renal cells, these are the most important epithelial cells. An increase in these cells in the urine may indicate a kidney disorder. 

The presence of renal tubule cells indicates significant renal pathology.

Transitional epithelial cells: 

Also called bladder cells, they are present between the male urethra and the renal pelvis. These types of cells are commonly present in older men.

The presence of transitional epithelial cells is normal. These cells are smaller and rounder than squamous cells, and they have larger nuclei.

What is the “clean catch” method?

The clean catch method of obtaining a urine sample usually prevents squamous epithelial cells from turning up in the urine. When using the clean catch technique, you’ll be given a sterilizing cloth to wipe the area around the vagina or penis before giving your urine sample. This prevents contaminants from your skin, like epithelial cells, from showing up in your sample.

References:

Kurn H, Daly DT. Histology, Epithelial Cell. 2023 Feb 17. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan–. PMID: 32644489.

Mohr NM, Harland KK, Crabb V, Mutnick R, Baumgartner D, Spinosi S, Haarstad M, Ahmed A, Schweizer M, Faine B. Urinary Squamous Epithelial Cells Do Not Accurately Predict Urine Culture Contamination, but May Predict Urinalysis Performance in Predicting Bacteriuria. Acad Emerg Med. 2016 Mar;23(3):323-30. doi: 10.1111/acem.12894. Epub 2016 Feb 17. PMID: 26782662.

Maher PJ, Jablonowski KD, Richardson LD. Squamous epithelial cell presence reduces accuracy of urinalysis for prediction of positive urine cultures. Am J Emerg Med. 2020 Jul;38(7):1384-1388. doi: 10.1016/j.ajem.2019.11.024. Epub 2019 Nov 28. PMID: 31843330.

Walter FG, Gibly RL, Knopp RK, Roe DJ. Squamous cells as predictors of bacterial contamination in urine samples. Ann Emerg Med. 1998 Apr;31(4):455-8. doi: 10.1016/s0196-0644(98)70253-7. PMID: 9546013.

Chen A, Caron A, Jackson NJ, Kanji F, Kuhlmann P, Le CH, Eilber KS, Anger JT, Ackerman AL. Defining Properly Collected Urine: Thresholds to Improve the Accuracy of Urinalysis for Microscopic Hematuria Evaluation in Women. J Urol. 2022 Feb;207(2):385-391. doi: 10.1097/JU.0000000000002200. Epub 2021 Sep 21. PMID: 34544262.

Poloni JAT, de Oliveira Vieira A, Dos Santos CRM, Simundic AM, Rotta LN. Survey on reporting of epithelial cells in urine sediment as part of external quality assessment programs in Brazilian laboratories. Biochem Med (Zagreb). 2021 Jun 15;31(2):020711. doi: 10.11613/BM.2021.020711. PMID: 34140834; PMCID: PMC8183119.

Owens CL, Ali SZ. Atypical squamous cells in exfoliative urinary cytology: clinicopathologic correlates. Diagn Cytopathol. 2005 Dec;33(6):394-8. doi: 10.1002/dc.20344. PMID: 16299739.

Regeniter A, Haenni V, Risch L, Köchli HP, Colombo JP, Frei R, Huber AR. Urine analysis performed by flow cytometry: reference range determination and comparison to morphological findings, dipstick chemistry and bacterial culture results--a multicenter study. Clin Nephrol. 2001 May;55(5):384-92. PMID: 11393384.

What does it mean if your Squamous Epithelial Cells result is too high?

If there are squamous epithelial cells in your urine, it may mean your sample was contaminated. This means that the sample contains cells from another part of the body. This can happen if you do not clean your genital area well enough when collecting your urine sample with the clean catch method.

The normal range of squamous epithelial cells in urine is typically zero to five squamous epithelial cells per high-power field (HPF). Typical diagnostic ranges fall into either few, moderate, or many but can also be measured in number. A normal range is less than 15 to 20 per HPF; therefore, more than 15 to 20 squamous epithelial cells per HPF indicate contamination in the urine sample.

More than five squamous epithelial cells in a single field of view can be considered an increased number that may indicate an infection or other health condition. If the number of squamous epithelial cells present is outside the normal range, you should consult a doctor to determine the underlying cause.

However, the normal range of squamous epithelial cells in urine may vary between laboratories and can be influenced by various factors, such as age, sex, and overall health. It is always best to consult a healthcare professional for an accurate interpretation of urine test results.

A moderate amount of squamous epithelial cells in the urine is not necessarily a cause for concern. However, if the number of these cells is consistently high or there are other signs of a urinary tract infection, further investigation and treatment may be necessary.

Squamous epithelial cells in urine may indicate the presence of an underlying health condition, but they do not necessarily indicate cancer. Squamous epithelial cells are flat, scale-like cells that are normally found in the outer layer of the skin and lining of certain organs, such as the mouth and vagina. When these cells are present in urine, it may indicate that they have been shed from an abnormal site, such as the bladder or urethra.

In some cases, the presence of squamous epithelial cells in urine may signify a bladder or urethral infection, irritation, or injury. However, other conditions, such as bladder or urethral cancer, can also cause these cells to be present in the urine. A cancer diagnosis cannot be made based on the presence of squamous epithelial cells in urine alone. Additional tests, such as a biopsy, a CT scan, or an MRI, may be necessary to determine the underlying cause and make a definitive diagnosis. Consult a healthcare provider if you are concerned about the presence of squamous epithelial cells in your urine.

Epithelial cells in urine are usually not a cause of concern. However, if the amount of these cells in the urine exceeds the normal range, it may indicate an infection or a serious condition.

Epithelial cells can be present in the urine due to several reasons, such as:

Specimen Contamination: Contamination while specimen collection is the most common cause of too many epithelial cells in the urine, especially in women. Contamination can occur due to using an unsterile collection cup or unclean genitals. To avoid specimen contamination, clean the genital area with a wet wipe. Urinate into the toilet to remove urethral bacteria before urinating into the collection cup. Submit the specimen immediately. 

Urinary Tract Infections (UTIs): The presence of epithelial cells in urine is mostly due to urinary tract infections. In such cases, microorganisms are also present. In some cases of UTIs, the urine will also have mucus strings. If a UTI is diagnosed, your doctor may also evaluate the number of leukocytes (white blood cells) in urine.

Kidney problems: The presence of several tubular or columnar-shaped epithelial cells in urine may be due to a kidney problem. If most of these cells are columnar, it may indicate a severe kidney injury with a risk of decreased functioning. Other changes that may point towards kidney damage include creatinine and urea in the urine. 

Kidney stones: Kidney damage or failure is a common complication of kidney stones. Kidney damage can cause an increase in the epithelial cells in urine.

Family history of chronic kidney disease: People with a family history of chronic kidney disease are more prone to developing this condition. Chronic kidney disease is a common cause of higher-than-normal epithelial cells in urine.

Menopause: Women in the postmenopausal phase with low estrogen levels may also have many epithelial cells in the urine. However, this does not mean they are necessarily at a higher risk for disease. Women who suspect menopause should get their hormone levels checked. 

Physical trauma or irritation: Activities like catheterisation, vigorous sex, or injury to the urinary tract can lead to physical trauma or irritation. This results in the increased shedding of squamous epithelial cells.

Bladder or urethral diseases: Certain diseases like bladder cancer, urethral cancer, and urethritis can cause increased shedding of epithelial cells into the urine.

Weak immune system: A weak immune system can cause an infection to reach a more advanced stage. As a result, the symptoms of a UTI may appear, which causes an increase in the epithelial cells in urine.

Liver disease: People with autoimmune liver disease are prone to recurrent urinary tract infections, increasing the epithelial cells in the urine range. 

Diabetes: High blood glucose levels can increase the risk of developing UTIs since the body cannot fight the germs. 

High blood pressure: High blood pressure for prolonged periods can stop the kidneys from working correctly. As a result, kidney damage may cause epithelial cells in urine to increase.

Enlarged prostate: An enlarged prostate can place pressure and compress the urethra. It can cause urinary tract infections due to incomplete bladder emptying.

Pregnancy: A higher count of epithelial cells in urine during pregnancy is normal since the woman’s body undergoes many changes. Furthermore, UTIs are common during pregnancy, which may result in elevated epithelial cells.

Ethnicity: The presence of epithelial cells in urine is typical for people who are African, Asian, American Indian, and Hispanic.

Elevated epithelial cells in urine may cause symptoms such as:

→ Pain or burning sensation while urination or sex

→ Frequent need to urinate

→ Blood in urine

→ Thick white discharge

→ Cloudy or smelly urine

→ Pain in the lower abdomen

→ Back pain

→ Soreness or itching in the vagina

→ Feeling tired or unwell

How to prevent elevated epithelial cells in urine?

If there are squamous epithelial cells in your urine, it may mean your sample was contaminated. This means that the sample contains cells from another part of the body. This can happen if you do not clean your genital area well enough when collecting your urine sample with the clean catch method.

Urinary tract infections and kidney diseases are two of the most common causes of elevated epithelial cells in urine. However, there are specific ways in which you can prevent these conditions, such as:

Staying hydrated: Drink several glasses of water daily to prevent diseases that cause high levels of epithelial cells in urine. 

Cranberry: They include a chemical that guards against bacteria attaching to the uterus lining. Drinking cranberry juice or eating cranberries helps promote kidney health and lower the risk of developing UTIs. However, the efficacy of cranberries is still debatable. 

Urinate as soon as you feel the urge: Holding urine for longer periods increases the risk of infection. Therefore, you should immediately urinate when you feel the urge.

Urinate after sexual intercourse: Both men and women must urinate after sex. It flushes out any bacteria that was introduced into the urethra.

Wipe carefully: You must wipe from front to back after urination or a bowel movement, as it prevents the spread of bacteria to your urethra. 

Do not use products in the genital area: Products like deodorant sprays or douches for the genital area can increase irritation and infection risk.

Wear loose-fitting clothes: Breathable clothes allow the area around the urethra to stay dry, limiting bacterial growth. 

How to treat increased squamous epithelial cells?

Treatment of excess squamous epithelial cells in urine depends on the underlying cause. There are several treatment options for excess squamous epithelial cells in the urine, including the following:

Antibiotics: May be prescribed to treat an infection, which can cause an increase in squamous epithelial cells in the urine.

Hydration: Increasing fluid intake can help flush out excess squamous epithelial cells in the urine.

Avoiding irritants: Avoiding harsh soaps, bubble baths, and spermicidal products can reduce the amount of squamous epithelial cells in the urine.

Medical procedures: In some cases, medical procedures such as a bladder wash or bladder irrigation may be performed to remove excess squamous epithelial cells from the bladder.

Surgery: In severe cases, surgery may be necessary to remove any underlying conditions that increase the squamous epithelial cells in the urine.

If the blockage occurs due to a tumor, treatment options may include surgery, radiation therapy, chemotherapy, and immunotherapy. Your doctor will assess your condition and recommend the best treatment option. Seek medical advice for proper diagnosis and treatment of this condition.

Treatment will depend on the cause of the abnormal number of epithelial cells. Most UTIs are bacterial and can be treated with an antibiotic. Drinking more water can also speed healing. For viral UTIs, doctors may prescribe medication called antivirals.

Treatment for kidney disease means managing the underlying cause of the disease, including blood pressure, blood sugar, and cholesterol levels. Your doctor may prescribe a blood pressure medication to slow the progression of the disease or preserve kidney function, even if you don’t have high blood pressure. Healthy dietary and lifestyle changes are also important.

Drinking cranberry juice or eating cranberries may help lower the risk of developing UTIs. Cranberries contain a chemical that may guard against bacteria attaching to the lining of your bladder. However, there’s still debate about this remedy’s efficacy in the medical community.

Frequently asked questions

Healthmatters is a highly-personalized health dashboard.

Instead of searching for your lab results in different places or tracking them down from different providers, Healthmatters houses, organizes, and interprets them all in one central location.

With a Healthmatters account, you can dive into the details of each biomarker and gain insights into the meaning behind your medical test data, anytime, anywhere.

For our professional users, Healthmatters provides intuitive tools that not only streamline analysis but also save valuable time when delving into your client's lab report history.

Healthmatters.io personal account provides in-depth research on 4000+ biomarkers, including information and suggestions for test panels such as, but not limited to:

  • The GI Effects® Comprehensive Stool Profile,
  • GI-MAP,
  • The NutrEval FMV®,
  • The ION Profile,
  • Amino Acids Profile,
  • Dried Urine Test for Comprehensive Hormones (DUTCH),
  • Organic Acids Test,
  • Organix Comprehensive Profile,
  • Toxic Metals,
  • Complete Blood Count (CBC),
  • Metabolic panel,
  • Thyroid panel,
  • Lipid Panel,
  • Urinalysis,
  • And many, many more.

You can combine all test reports inside your Healthmatters account and keep them in one place. It gives you an excellent overview of all your health data. Once you retest, you can add new results and compare them.

If you are still determining whether Healthmatters support your lab results, the rule is that if you can test it, you can upload it to Healthmatters.

While we work with many popular labs, we welcome reports from lots of other places too.

It's as simple as this: if you can get a test done, you can upload it to Healthmatters and we can interpret results from any lab out there. If laboratories can analyze it, we can interpret it.

If you’re on the hunt for a specific biomarker, contact us and we'll add it to our database. Anything from blood, urine, saliva, or stool can be uploaded, understood, and tracked with your Healthmatters account.

There are two ways to add your test reports to your Healthmatters account. One option is to input the data using the data entry forms. The other method is to utilize our "Data entry service."

Our data entry forms offer an easy, fast, and free way for you to input the reports yourself. Self-entry allows you to add an unlimited number of reports at no cost. We make the self-entry process user-friendly, providing dozens of templates that pre-populate the most popular laboratory panels and offering instant feedback on entered values.

For those who prefer assistance, we offer a "Data entry service" to help you input your data. Simply attach an image or file of your lab test results, and a qualified team member from our data entry team will add the results for you.

We support various file types, including PDFs, JPGs, or Excel. This service is particularly useful if you have many reports to upload or if you're too busy to handle the data entry yourself.

Our special data entry service makes it easy to add your results to your private dashboard. Just attach an image or a file of your lab test results, and our skilled data entry team will do the work for you. It's all done by humans, ensuring that your data is entered accurately and with personal care for each client.

Depending on your account, the data entry service can be included for free or come at an additional cost of $15 per report.

For users on the Complete monthly plan, the first report is entered free of charge, and each additional report incurs a fee of $15.

Unlimited account holders enjoy the entry of ten reports without charge. Subsequent reports are subject to a $15 fee per report.

Additionally, users on the Complete plan can upgrade to a yearly subscription from the account settings. The annual subscription includes a data entry service for five reports.

The Unlimited plan is a one-time purchase for $250, and it covers your account for a lifetime with no additional payments.

For the Complete plan, the cost is $15 per month. You have the flexibility to cancel it anytime through your account settings, ensuring no further payments. To avoid charges, remember to cancel at least a day before the renewal date. Once canceled, the subscription remains active until the end of the current billing cycle.

Additionally, you can upgrade to the yearly Advanced plan from within your account. The annual cost is $79, and it comes with a data entry service for five reports.

You can always upgrade to a lifetime version with a prorated price from a monthly or yearly subscription.

Simply log in and navigate to your account settings to cancel your subscription. Scroll down to locate the 'Cancel' button at the bottom of the page. Ensure you cancel at least one day before the renewal date to prevent any charges. Once cancellation is requested, the subscription remains active until the conclusion of the current billing cycle.

Our goal has been to make your Healthmatters account as intuitive as possible.

We’ve crafted multiple ways for you to navigate your data, whether you're glancing at a single report or delving into your historical test reports.

1. Graph View:

Dive into a visual journey with our biomarker graphs, showcasing over 40 data points. Combining years of results unveils trends, empowering you to make informed decisions. Our visualization tools make it a breeze to compare and understand changes over time, even if your results are from different labs. A search function and filters simplify the exploration of extensive data, allowing you to focus on what needs attention.

2. All Tests View

Explore neatly organized reports on a timeline, highlighting crucial details like dates, critical results, and lab/panel names. Each report opens up to reveal in-depth descriptions and additional recommendations for each biomarker. The history of previous results is just a click away, and you can download a comprehensive report for deeper insights. Color-coded and user-friendly, it's designed for easy reading, understanding, and navigation.

3. Table View:

For a holistic view of all biomarkers side by side, our table view is your go-to. Results are neatly displayed in a categorized and dated table, ideal for those with an extensive test history. Utilize sorting, filters, and color-coding to enhance your analysis and gain extra insights.

Yes, you can download information from your account. We can compile your labs into a CSV file. To download all your labs, you can go to Account Settings, and at the bottom of the page, you will find a link to download your information.

Yes, you can print your report. To do so, navigate to "All tests" and open the report you wish to print. You'll find a print button in the right corner of the report. Click on it, and your browser's print window will open. If you prefer to print in a bigger typeface, adjust the scale using the print window settings.

Yes, you can! We highly recommend activating Two-Factor Authentication (2FA) for your account. To do so, please navigate to the "Profile and Security" section of your account, where you will find instructions for activating 2FA.

Yes, you can. When entering values for the biomarker, you will see an "Edit Range" button. Click this button, and you'll have the option to enter a custom range.

A personal account is all about keeping your own lab test results in check. It's just for you and your personal use.

The professional account is designed for health professionals who wish to track and organize their clients' laboratory results.

Use promo code to save 10% off any plan.


We implement proven measures to keep your data safe.

At HealthMatters, we're committed to maintaining the security and confidentiality of your personal information. We've put industry-leading security standards in place to help protect against the loss, misuse, or alteration of the information under our control. We use procedural, physical, and electronic security methods designed to prevent unauthorized people from getting access to this information. Our internal code of conduct adds additional privacy protection. All data is backed up multiple times a day and encrypted using SSL certificates. See our Privacy Policy for more details.