What Causes an Elevated Count of Small Round Epithelial Cells?

When some patients develop a urinary tract infection (UTI), they often exhibit an elevated count of small round epithelial cells in their urine. However, many patients are unfamiliar with this finding—what causes an increased number of small round epithelial cells?

What Causes an Elevated Count of Small Round Epithelial Cells?

An increase in small round epithelial cells occurs because these cells originate from the kidneys, ureters, bladder, and urethra. An elevated count in routine urinalysis may indicate underlying inflammation or, less commonly, a neoplasm.

The clinical significance of elevated small round epithelial cells is assessed comprehensively, primarily by evaluating whether white blood cells (WBCs) are increased in routine urinalysis and whether the patient exhibits bladder irritation symptoms such as urinary frequency, urgency, or dysuria. If no bladder irritation symptoms are present—or if WBCs are not elevated in urinalysis—further imaging studies, such as color Doppler ultrasound of the urinary system or renal CT, are recommended to assess for morphological changes secondary to inflammation or to rule out the presence of a tumor.

Elevated small round epithelial cells may be caused by a urinary tract infection. Specifically, inflammatory stimuli can induce exfoliation of epithelial cells, which are then shed into the urine. Nevertheless, patients with UTIs often display additional abnormalities on routine urinalysis—most notably, leukocyturia (elevated WBCs). Furthermore, UTIs frequently cause urinary frequency, urgency, and dysuria; pain may intensify particularly after urination. Therefore, when these clinical symptoms align with abnormal urinalysis findings, a diagnosis of UTI is strongly supported. Recommended treatment includes the antibiotic levofloxacin for anti-infective therapy, Yinhua Mieyanling granules (a traditional Chinese medicine formulation) for anti-inflammatory effects, and sodium bicarbonate tablets to alkalinize the urine and alleviate pain. We hope this information proves helpful to you.