CT Diagnosis of Chyluria After Partial Nephrectomy

Miller, Frank H.; Keppke, Ana L.; Yaghmai, Vahid; Gabriel, Helena; Hoff, Frederick L.; Chowdhry, Aqeel A.; Smith, Norm D.

doi:10.2214/ajr.05.1165

Cited by 34 publications

(31 citation statements)

References 10 publications

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“…Their CT exams performed 1-3 months postoperatively showed various amounts of fatty material floating in the urinary bladder (Figs. 3,4,5). Their chyluria resolved spontaneously and was not visible on repeat CT exams 6-12 months later.…”

Section: Discussionmentioning

confidence: 87%

“…The underlying cause is usually obstruction of the thoracic duct or upper retroperitoneal lymph drainage due to surgical intervention, trauma, and various inflammatory or neoplastic processes. Pathologic or postoperative disruption of renal lymphatics may also result in retrograde flow of chyle into the kidneys and its urinary excretion [1,[3][4][5][6].…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, postsurgical or pathologic disruption of renal lymphatics would also permit urinary leakage of chyle due to relatively higher intraluminal pressure of cisterna chyli. This condition will manifest as the discharge of milky urine and the presence of fat-fluid level in the bladder on abdominal CT images [5,6].Our recent experience with ten cases prompted a review of the clinical and radiologic features of this entity. …”

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confidence: 99%

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Non-tropical chyluria: CT diagnosis

2011

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Chyluria is commonly associated with filariasis, which is prevalent among the population of tropical and subtropical regions. Chyluria is seldom encountered in the United States and other western countries, but may occur if the flow of chyle into the thoracic duct is blocked due to inflammatory, neoplastic, or various other etiologies. We report 10 adult patients, in whom the detection of fat-urine level in their bladder on abdominal CT provided the initial diagnostic clue to the presence of chyluria. This series included 7 men and 3 women, who ranged in age from 25 to 91 years (mean: 62 years). The associated lesions included renal angiomyolipomas (2), lymphangiomas of the kidney and bladder (1), metastatic testicular cancer (1), postoperative status following partial nephrectomy for renal cell carcinoma (4), left radical nephrectomy (1), and segmental cystectomy for carcinomas (1). The clinical and radiological features of this entity are presented along with a brief review of the pertinent literature.

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Section: Discussionmentioning

confidence: 87%

Section: Discussionmentioning

confidence: 99%

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confidence: 99%

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Non-tropical chyluria: CT diagnosis

2011

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“…2 However, chyluria after nephrectomy is very rare, and just four reports have been published. [2][3][4][5] We herein summarized the characteristics of 11 patients with chyluria after nephrectomy ( Table 1). Two underwent radical nephrectomy and nine underwent partial nephrectomy.…”

Section: Discussionmentioning

confidence: 99%

“…3 Four of them had undergone partial nephrectomy 1-3 months earlier, and their chyluria resolved gradually during follow-up studies 6-12 months later. However, persistent and severe chyluria can result in malnutrition and immune deficiency as a result of chronic loss of lipids, proteins and fat-soluble vitamins.…”

Section: Conflict Of Interestmentioning

confidence: 95%

Chyluria after partial nephrectomy: A rare but considerable complication

et al. 2012

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An 82-year-old male patient underwent open left lower-pole partial nephrectomy with a microwave tissue coagulator (Microtaze). Pathological findings showed clear cell renal cell carcinoma, pT1a, Fuhrman grade 2 with negative margins. Then 2 years later, he presented with urinary retention. His urine appeared cloudy and milky only after meals, but appeared normal at other times. He was diagnosed with chyluria after partial nephrectomy. Endoscopic sclerotherapy with silver nitrate was carried out, because his serum albumin decreased to 3.4 g/dL within 3 months. He had an uneventful postoperative course. His chyluria completely disappeared and has not recurred for 11 months. Although chyluria after nephrectomy is very rare, there is a possibility that the frequency of chyluria after partial nephrectomy might increase, because the number of partial nephrectomies continues to increase worldwide. We herein summarize this rare surgical complication and discuss the effectiveness of endoscopic sclerotherapy as a therapeutic tool.

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