Skip to content
Blood Test Tracker

Urine Squamous Epithelial Cells

A count of flat skin-type cells in a urine sample. A few are common. Many usually mean the sample picked up cells from the skin around the urethra.

AI-verified against cited sources. Awaiting expert reviewAlso called SEC, Squam Epi, Sq EpiLOINC 11277-1

Check your result

Sex (optional)

Type your result to see where it falls.

Nothing you type here leaves your browser.

What it is

Squamous epithelial cells are large, flat cells that line the last part of the urethra and the genital skin around it. A few turn up in most urine samples. Under the microscope, the lab counts them in a standard field of view, called a high-power field (HPF). Some labs report a number or range, and others use words like few, moderate or many.

Why it matters

This count is mostly a sample-quality check. Many squamous cells suggest the urine picked up cells, bacteria and white blood cells from the skin or genital area on its way out. That can make a urinalysis or a urine culture harder to read. Your clinician uses the count to decide how much weight to give the other results.

If it’s high

Many squamous cells usually mean the sample was contaminated during collection. They don't point to a problem in your kidneys or bladder. The count is only a rough guide, and studies show it predicts poorly whether a urine culture will turn out to be contaminated. Clinicians read it together with your symptoms and the other results.

Common causes

  • Normal shedding of cells, since a few are present in most samples
  • A sample that was not a clean-catch, midstream collection
  • Vaginal discharge or menstrual blood mixing with the sample
  • Difficulty collecting a clean sample, for example in young children or in people with limited mobility

What can help

  • Use the clean-catch method: wash your hands, clean the genital area with the wipe, start urinating into the toilet, then collect the middle part of the stream
  • Tell the lab or your clinician if you were menstruating or had vaginal discharge when you gave the sample
  • Ask whether a repeat sample is needed, especially if you have symptoms or other results are borderline

Usual ranges

What labs print as the reference range, by who was tested. Ranges differ a little between labs, so the range on your own report is the one your result is judged against.

For adults: 0–5 /HPF. Source: Quest Diagnostics, American Family Physician, Academic Emergency Medicine, Clinical Chemistry and Laboratory Medicine, Labcorp, Cureus (urinalysis table with the treating hospital's reference intervals), Journal of Medical Case Reports (urinalysis table with the treating hospital's reference intervals).

What can affect your result

  • How the sample was collected: a clean-catch midstream sample carries fewer squamous cells
  • Menstrual blood or vaginal discharge
  • How your lab counts and reports them: per high-power field, per low-power field, per microliter or in words
  • A sample that is not a clean-catch, midstream collection picks up more skin and genital cells.
  • Vaginal discharge or menstrual blood can add cells to the sample.
  • Labs count differently: per high-power field, per low-power field, per microliter, or in words.

Not applicable. The count reflects how the sample was collected, not a change in your body over time.

When to talk to a clinician

A high squamous cell count alone is not a reason for urgent care. If you have burning with urination, fever, back or side pain, or blood in your urine, contact a clinician whatever this result says.

Questions you could ask

  • Do my symptoms and the other urinalysis results point to anything, whatever this cell count shows?
  • Was my sample clean enough to trust the other urine results?
  • Should we repeat the urine test with a clean-catch sample?

Questions people ask

Does a high squamous cell count mean I have an infection or a kidney problem?

Not by itself. Squamous cells come from the skin and the outer part of the urethra, not from the kidneys. A high count mainly says the sample may not be clean. Infection is judged from your symptoms and from other results, such as white blood cells and bacteria.

How can I give a cleaner sample?

Use the clean-catch method. Wash your hands, clean the genital area with the wipe you are given, start urinating into the toilet for a few seconds, then collect the middle part of the stream in the container. Finish in the toilet and cap the container without touching the inside.

Why does my report say 'few' or 'moderate' instead of a number?

Many labs grade cells in words. There is no single definition of 'few' or 'many', so the same word can mean different counts at different labs. Your lab's own flag and range are the best guide.

Show the science and sources

For clinicians and researchers

Squamous epithelial cells line the distal third of the urethra and the vulva, and they also come from nearby skin. Their count is used as a specimen-quality indicator. AAFP (2022) states that more than five large squamous cells per high-power field suggests contamination with distal or extra-urethral flora, and that hematuria or pyuria still suggests UTI even then. Evidence for a fixed cut-off is weak: in 19,328 adult urinalyses with cultures at one academic medical center, the squamous cell count predicted culture contamination poorly (area under the ROC curve 0.680), although samples with more than 8 cells per low-power field gave a lower positive likelihood ratio for bacteriuria (2.35, versus 4.98 when no squamous cells were present) (Mohr 2016). Automated flow-cytometry cut-offs from one Brazilian hospital were 21.35 cells/µL for women and 5.05 cells/µL for men (Walber 2025), which are site-specific. Counts per HPF depend on the microscope field, and reports in HPF, LPF or per µL cannot be converted without lab-specific factors, so this catalog stores only the per-HPF unit. Word grades (few, moderate, many) have no universal numeric definition. Quest's Urinalysis, Complete (5463) lists squamous epithelial cells at 5 or fewer per HPF. Labcorp's reflex microscopy reports 'Epithelial Cells (non renal)' (LOINC 5787-7, 0–10 /HPF on its sample report) and 'Epithelial Cells (renal)' rather than squamous cells separately; because the non-renal count also includes transitional cells, it is not mapped to this marker.

LOINC 11277-1 (primary), 105117-6, 33219-7, 12258-0. Specimen: urine.

Sources

  1. Urinalysis, Complete (test code 5463), Quest Diagnostics
  2. Office-Based Urinalysis: A Comprehensive Review, American Family Physician (2022)
  3. Urinalysis: A Comprehensive Review, American Family Physician (2005)
  4. Urinary Squamous Epithelial Cells Do Not Accurately Predict Urine Culture Contamination, but May Predict Urinalysis Performance in Predicting Bacteriuria, Academic Emergency Medicine (2016)
  5. Quality indicators for urine sample contamination: can squamous epithelial cells and bacteria count be used to identify properly collected samples?, Clinical Chemistry and Laboratory Medicine (2025)
  6. Urinalysis, Routine With Microscopic Examination on Positives: sample report (test 003038), Labcorp (2026)
  7. 003038: Urinalysis, Routine With Microscopic Examination on Positives, Labcorp
  8. Urobilinogen in Urine, MedlinePlus Medical Test (NIH National Library of Medicine)
  9. Unraveling the Complexity of Non-typhoidal Salmonella Genitourinary Infection in HIV: A Case Report and Management Strategy, Cureus (urinalysis table with the treating hospital's reference intervals) (2025)
  10. An Emerging Human Pathogen: Raoultella Planticola, Cureus (urinalysis table with the treating hospital's reference intervals) (2025)
  11. An uncommon case of Chromobacterium violaceum urinary tract infection in a tertiary hospital in Ghana: a case report, Journal of Medical Case Reports (urinalysis table with the treating hospital's reference intervals) (2026)

AI-verified against cited sources. Awaiting expert review. Last reviewed 2026-10-03. How we build and check these pages.

Related markers