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Post-nephrolithotomy chyluria.

Percutaneous nephrolithotomy has proved to be a cost-effective, safe and expeditious means of renal calculus removal since its introduction in the late 1970s. The inherent risks and complications of this procedure have been well documented but less common complications continue to surface as case selection becomes increasingly more difficult. We report a case of chyluria after percutaneous nephrolithotomy. The patient recovered completely after treatment with total parenteral nutrition and required no further intervention. The etiology as well as the treatment of this previously unreported complication following percutaneous nephrolithotomy is addressed.

Chyle↗

Chyluria treated with renal autotransplantation: a case report.

We report a rare case of chyluria in a patient from an area not endemic to filariasis. Initial surgical treatment consisted of stripping of the renal pedicle, following which the patient was free of symptoms for 3 months. Recurrence was noted and renal autotransplantation was performed. Chyluria has not recurred 12 months after the second operation. The etiology and various treatments of chyluria are discussed.

Adult↗

Recent distribution and treatment of filarial chyluria in Japan.

Since 1975 parasitism by the filarial worm has not existed in Japan. However, patients still present with filarial chyluria because the condition is one of the late manifestations of filariasis. From 1952 to 1973 renal pelvic instillation therapy, and surgical stripping and interruption of renal pedicle lymphatics were done in 217 and 383 patients, respectively, in the urology clinic of our and affiliated hospitals. Chyluria ceased immediately after instillation therapy in 129 of the 217 patients (59.4 per cent) but recurred in half of the cases. The short-term results of the surgical procedure were excellent. Chyluria ceased in 375 of the 383 patients (97.9 per cent) and diminished in 5 (1.3 per cent). Of 160 operated patients followed for more than 2 years recurrence of chyluria at contralateral and undetermined sites was observed in 41 (25.6 per cent).

Adult↗

Leakage of lymph through scrotal skin.

We report a case of scrotal dermal chylorrhea associated with chyluria. This is an uncommon complication of chyluria and the only case recorded in our series of 206 patients. Lymphograms showed the presence of abnormal reflux from the inguinal lymphatics into the scrotum.

Chyle↗

Spontaneous remission of chyluria.

The natural history of chyluria is not well known. We have followed 72 patients with chyluria who have not had treatment and the condition has disappeared in 36 cases (50 per cent). In these cases the duration of chyluria varied from 3 days to 20 years, with an average of 44.3 months, but it was less than 6 months in about half of the cases.

Adolescent↗

Chyluria: result of surgical treatment in 50 cases.

We treated 50 patients with chyluria by stripping the renal pedicle. Until further studies reveal the etiology of chyluria ligation and stripping of the pedicle remain the treatment of choice and this fact has been borne out by our long-term results.

Adolescent↗