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I have a son who was diagnosed with hydronephrosis last year. His urologist is monitoring him for now with monthly urine checks with our pediatrician's office. Every month his urine has had leukocytes as they culture overnight. The culture comes back fine, so I do not understand why does he always have leukocytes and is this normal? Can you tell me something about leukocytes in urine?

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Leukocytes are simply white blood cells, and are often a sign of infection. That is why his pediatrician continues to culture the urine. Pyuria is defined as eight or more leukocytes per cubic millimeter; this translates into 2-5 leukocytes per high power field on a slide. The assessment of pyuria however is imperfect, because the leukocyte count on a routine urinalysis can be affected by some factors. You have to know there are a few factors that alter the concentration of the urine. Furthermore, error may be introduced by variation for fluid that is eventually placed on the slide. A second test that assesses the leukocyte esterase is also used to predict pyuria. As long as his urine is culture negative and he remains symptom free, I would continue to follow-up with your urologist. It should be done on a periodic basis as you have been doing until now. One more possibility is that the method of collecting the specimen is flawed.
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