Silver nitrate sclerotherapy for chyluria: evaluation for the optimal instillation regime.
OBJECTIVE
To compare the efficacy of the 3-instillation regime with the 9-instillation regime of 1% silver nitrate solution for renal pelvic instillation sclerotherapy in patients with chyluria.


METHODS
59 Patients with chyluria were prospectively evaluated and randomized into two groups. The study group received 3 instillations (n = 29) while the control group received 9 instillations (n = 30). 1% silver nitrate was used.


RESULTS
In the study group of the 29 patients given sclerotherapy, 28 (96.5%) had complete symptomatic relief while symptoms persisted in 1 (3.44%). None of the patients had hematuria or any other severe complication. In the control group of the 30 patients given sclerotherapy, 29 (96.66%) had complete symptomatic relief while chyluria persisted in 1 (3.33%), 5 patients developed hematuria (16.66%) and 1 patient developed fever with UTI (3.33%). The results of the 3-instillation regime match the results of the more commonly used 9-instillation regime. With this shorter regime, the hospital stay, morbidity and overall complication rate is less and it is more cost effective.


CONCLUSIONS
We recommend the 3-instillation regimen in patients with chyluria refractory to conservative treatment.
Dhabalia
J V
JV
Department of Urology, Seth GS Medical College and KEM Hospital, Mumbai, India.
Pujari
N R
NR
Kumar
V
V
Punia
M S
MS
Gokhale
A D
AD
Nelivigi
G
G
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002913:Chyle / Q000378:metabolism*; D003558:Cystoscopy; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D007194:India; D007902:Length of Stay; D008206:Lymphatic Diseases / Q000175:diagnosis / Q000628:therapy* / Q000652:urine; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012597:Sclerosing Solutions / Q000008:administration & dosage* / Q000009:adverse effects; D015911:Sclerotherapy / Q000009:adverse effects / Q000379:methods*; D012835:Silver Nitrate / Q000008:administration & dosage* / Q000009:adverse effects; D013997:Time Factors; D016896:Treatment Outcome; D014556:Urine; D014567:Urography
D012597:Sclerosing Solutions; D012835:Silver Nitrate