Chyluria: The State of the Art

Guttilla, Andrea; Beltrami, P.; Bettin, L.; Galantini, Andrea; Moro, Fabrizio Dal; Ficarra, Vincenzo; Zattoni, Filiberto

doi:10.5301/uj.5000225

Cited by 8 publications

(11 citation statements)

References 55 publications

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“…There exists no universally accepted grading system for chyluria and a number of grading scales that are in current use have been described in world literature. 21 Chyluria may be graded mild, moderate or severe ( Table 2). The grading takes into account the degree of chyluria, associated symptomatology, episode frequency and the extent of calyceal involvement.…”

Section: Gradingmentioning

confidence: 99%

“…This drug acts against the microfilaria, the larval phase of the parasite. 21 Longer courses of DEC can be required and/or the treatment course can be repeated after 8 weeks if the response is unsatisfactory. Side effects can include itching, painful glands and skin rash.…”

Section: Conservativementioning

confidence: 99%

“…The role of endoscopy including retrograde pyelography is decisive in patients who have not responded to conservative or medical therapy. 21 …”

Section: Managementmentioning

confidence: 99%

“…The role of endoscopy including retrograde pyelography is decisive in patients who have not responded to conservative or medical therapy. 21 Diagnostic pathways. In the UK there is no clear consensus on the investigation protocol or algorithm for cases of chyluria.…”

Section: Investigationsmentioning

confidence: 99%

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Chyluria: what does the clinician need to know?

Stainer

Juliebø‐Jones

Juliebø

et al. 2020

Therapeutic Advances in Urology

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Chyluria is secondary to the presence of chyle in the urine. The classical appearance on inspection is of milky white urine, which is caused by a fistulous communication between the lymphatic system and the urinary tract. Worldwide, it is most commonly associated with the parasite Wuchereria bancrofti, which is prevalent in Asia, most extensively in India but also China and Taiwan. However, in the United Kingdom, Europe and North America, where the condition is rare, non-parasitic aetiologies predominate. Chyluria is occasionally associated with other urinary tract symptoms including infection, loin pain and haematuria. It may also cause hypoproteinaemia, weight loss and cachexia. Management is based on identifying the aetiology and depends on the severity of the chyluria and presence of associated symptoms. Given its predominate symptom being urinary, cases in the West can fall under the care of the urologist. The aim of this article is to provide an overview and summary of the aetiology, assessment and management of chyluria based on the most up-to-date evidence available. This was achieved through a non-systematic review of world literature.

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Section: Gradingmentioning

confidence: 99%

Section: Conservativementioning

confidence: 99%

“…The role of endoscopy including retrograde pyelography is decisive in patients who have not responded to conservative or medical therapy. 21 …”

Section: Managementmentioning

confidence: 99%

Section: Investigationsmentioning

confidence: 99%

See 2 more Smart Citations

Chyluria: what does the clinician need to know?

Stainer

Juliebø‐Jones

Juliebø

et al. 2020

Therapeutic Advances in Urology

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“…On the contrary, lymphoscintigraphy using 99mTc-nanocolloid has an equal accuracy to lymphangiography and is noninvasive [9] . This safe technique allows localization, lateralization, and knowledge of the functional extent of reflux and detection of recurrence [10] . Moreover, retrograde pyelography, single photon emission computed tomography (SPECT), diethyl carbamazine (DEC) combined with CT scan can be useful to identify lymphatic renal pathologies [11] .…”

Section: Discussionmentioning

confidence: 99%

Trans-urethral resection of bladder tumor (TURBT) and radiofrequency ablation of renal tumor: Rare etiologies of chyluria

Assaker

Hasbani

Vargas

et al. 2020

Radiology Case Reports

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Chyluria is a rare entity which is caused by abnormal communication between the lymphatic system and the urinary tract, which allows the passage of chyle into the urine. Whenever symptomatic, chyluria presents with lower urinary tract symptoms such as dysuria and hematuria. Multiple imaging modalities can aid in diagnosis such as lymphoscintigraphy, retrograde pyelography, CT scan of the abdomen and pelvis, and magnetic resonance imaging. Numerous etiologies are associated with chyluria among which are surgical interventions. Partial and radical nephrectomy have been reported in a number of symptomatic and asymptomatic cases, while radiofrequency ablation of renal tumors has been very rarely reported. Herein, we report 2 cases of chyluria; one caused by trans-urethral resection of a bladder tumor and another by radiofrequency ablation of a renal oncocytoma. Fat-fluid level in the urinary bladder was seen on both precontrast and postcontrast images of CT scan of the abdomen and pelvis. Cystoscopy demonstrated no evidence of any abnormality of the urinary bladder.

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