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QUESTION: Hello sir,hope you are fine. Just want to know your explanation about my two reports that was done in a matter of 3 months.

Please give your advice and explanation.

Report 1 (february)
--RBC 0-2/HPF  ;ref:0-5 [(is it very alarming value?)]
--Epithelial cells 1-3/HPF ;ref:0-5
--Leukocytes (++)
-- Pus cells 20-25 ;ref:0-5

Report 2 (june)
--RBC Nil ;ref:0-5 (is it very alarming value?)
--Epithelial cells 0-4/HPF ;ref:0-5 {}
--Leukocytes Nil
--Pus cells 0-3 ;ref:0-5
--Why Epithelial cells still 0-4/HPF after treatment?
--Why Pus cells still 0-3/HPF after treatment?

ANSWER: Kamran:

This is one of the reasons why it is not always a good idea to give test results directly to patients as we get asked to explain normal results.

Epithelial cells come from the skin.  That's what epithelial means.  When the epithelial cell count is high, it means the urine was in contact too long with the skin and the specimen could be contaminated.

The "Ref:0-5)" means that in your laboratory, the normal reference (ref) range is from 0 to 5.  You had  0-4 so your result is normal.

Likewise, pus cells 0-3 is within the normal reference range for normal which in your laboratory is 0-5.

---------- FOLLOW-UP ----------

QUESTION: Thank you sir, but my question is why RBC will show its value in urine? did i had blood in urine?and is it alarming and harmful?

Answer
Kamran:

Again, you are getting all worked up over a NORMAL READING!  The reference range of normal for your laboratory for RBC's in the urine is 0-5 which means up to 5 RBCs is considered normal.  Your reading originally was 0-2.  0-2 is LESS THAN 0-5 and is WITHIN THE NORMAL RANGE.  Your repeat study is listed as Nil which usually means 0 which is also less than 0-5 and is also WITHIN THE NORMAL RANGE!

If there were persistent increased levels of RBCs in the urine, it would be a cause for concern even though it usually is nothing serious but that is a moot point because your RBC readings were and remain normal and therefore at nothing to be concerned about.

This is a good example of why it is not always advisible to try to interpret your own laboratory tests as laypersons are not trained to do this analysis, often do not understand what the normal range means, and jump to an unwarranted diagnosis or conclusion based exclusively on a laboratory test that may not always be completely reliable.  While you certainly have the right to the information, it wastes alot of valuable time to explain what is normal and patients often get quite anxious over things that are meaningless; so this happens to lots of people not just you.

I hope this has clarified the issue for you.

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Stephen W. Leslie, MD

Expertise

Questions concerning erectile dysfunction, kidney stones and prostate disorders including prostate cancer. I have a special interest in kidney stone disease prevention.

Experience

Full time practicing urologist with 30 years experience. Associate Professor of Surgery and Chief of Urology at Creighton University Medical Center. Editor in Chief of eMedicine Urology internet textbook. Author of only NIH approved book written for patients by a urologist on the subject of kidney stones "The Kidney Stones Handbook". Inventor of the "Parachute" and "Escape" kidney stone baskets and the "Calculus" stone prevention analysis computer program.

Organizations
American Urological Association, Ohio State Medical Association, Sexual Medicine Society

Publications
Men's Health, Journal of Urology, Urology, Healthwatch Magazine, Emergency Medicine Monthly, eMedicine, "The Kidney Stones Handbook", and numerous articles in various newspapers. He is also the editor of the Urology Board Review by McGraw-Hill used by urologists to study for their Board Certification Examinations.

Education/Credentials
Graduate of New York Medical College with residencies completed at Metropolitan Hospital New York, Albany Medical Center and University of Wisconsin-Madison.

Awards and Honors
Thirlby Award of the American Urological Association. Rated as one the country's Best Urologists by the Independent Consumer's Research Institute

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