Chyluria--experience of Taipei Veterans General Hospital.
BACKGROUND
Chyluria is caused by rupturing of lymphatic varices into the pyelocaliceal system. Although Chyluria is rare in western countries, it is not uncommon in Asia. We would like to present the experience of diagnosis, evaluation and treatment of chyluria in Taipei Veterans General Hospital.


METHODS
From 1973 to 1999, a total of 30 patients with chyluria were reviewed. All had the chief complaint of milky white urine passage. They were investigated by multiple workup modalities including computed tomography, intravenous urography, lymphangiography, and cystoscopy. Fifteen cases received 1% silver nitrate instillation and 4 cases underwent nephrolysis either as primary or salvage treatment.


RESULTS
Lymphangiography was performed in 24 of the 30 cases and responsible causes of chyluria were noted in 21. They were followed up for at least 12 months in 9 patients treated by intrarenal pelvic instillation of silver nitrate and 3 by nephrolysis, respectively. Recurrence was found in 1 patient (11.1%) receiving silver nitrate only and no significant adverse effect was noted.


CONCLUSIONS
Lymphangiography is the most powerful diagnostic tool. Intrarenal silver nitrate instillation is a safe and effective management of chyluria.
Lin
Tzu-Ping
TP
Division of Urology, Department of Surgery, Taipei Veterans General Hospital, Taipei, Taiwan, ROC.
Hsu
Yen-Shen
YS
Chen
Kuang-Kuo
KK
Lin
Alex T L
AT
Chang
Yen-Hua
YH
Wu
Howard H H
HH
Huang
William J S
WJ
Kuo
Junne-Yih
JY
Chung
Hsiao-Jen
HJ
Chang
Luke S
LS
D000328:Adult; D000368:Aged; D002913:Chyle; D005260:Female; D006801:Humans; D008220:Lymphography; D008297:Male; D008875:Middle Aged; D012835:Silver Nitrate / Q000627:therapeutic use; D014057:Tomography, X-Ray Computed; D014556:Urine
D012835:Silver Nitrate