Yadav Praveen Kumar, Swain Samir, Singh Anunay, Hasan Arshad, Haque Md Faizul, Kundu Gaurab, Sharma Bhupendra Kumar, Hota Datteswar
Department of Urology, SCB Medical College and Hospital, Cuttack, Odisha, India.
Urol Ann. 2021 Jan-Mar;13(1):36-40. doi: 10.4103/UA.UA_159_19. Epub 2021 Jan 19.
Management of chyluria with initial conservative approach and then using endoscopic sclerotherapy is a mainstay approach. However, a wide range of sclerosants are available with differential success rates and complication rates. This study evaluated the safety and efficacy of a single-dose instillation of 1% povidone iodine for the treatment of chyluria.
This was a prospective, observational study conducted on patients with chyluria who did not respond to conservative management with dietary restriction and diethylcarbamazine. The site of chyle efflux was identified by cystoscopy. A 6 Fr ureteral stent was inserted into effluxing side, diluted contrast was injected to delineate the pelvicalyceal system and the pyelolymphatic connection (arborization of the pelvicalyceal system), and a single-dose of 1% povidone iodine was instilled. Patients were observed for loin pain, fever, and disappearance of milky urine postinstillation and followed up at intervals of 3 months for a total duration of 1 year.
Of a total 50 patients included, 35 were men and 15 were women, with a mean age of 37 years. Pyelolymphatic connections were noted in 48% of the patients. All patients showed an immediate disappearance of milky urine. During 1-year follow-up, 92% of the patients were symptom-free till the last follow-up while only 8% of the patients experienced recurrence of chyluria which were treated with other treatment modalities. The mean duration of recurrence was 8 weeks.
Single dose of 1% povidone iodine was effective in immediate clearance of milky urine and well tolerated in patients with chyluria during 1-year follow-up.
采用初始保守治疗方法，随后进行内镜硬化治疗来管理乳糜尿是一种主要的治疗方法。然而，有多种硬化剂可供使用，其成功率和并发症发生率各不相同。本研究评估了单剂量滴注1%聚维酮碘治疗乳糜尿的安全性和有效性。
这是一项对乳糜尿患者进行的前瞻性观察研究，这些患者对饮食限制和乙胺嗪的保守治疗无反应。通过膀胱镜检查确定乳糜流出的部位。将一根6F输尿管支架插入流出侧，注入稀释造影剂以描绘肾盂肾盏系统和肾盂淋巴连接（肾盂肾盏系统的分支），并滴注单剂量的1%聚维酮碘。观察患者滴注后是否出现腰痛、发热以及乳糜尿消失的情况，并每隔3个月进行随访，总随访时间为1年。
纳入的50例患者中，男性35例，女性15例，平均年龄37岁。48%的患者存在肾盂淋巴连接。所有患者的乳糜尿均立即消失。在1年的随访期间，92%的患者直至最后一次随访时均无症状，而只有8%的患者出现乳糜尿复发，这些患者接受了其他治疗方式。复发的平均持续时间为8周。
单剂量1%聚维酮碘在即刻清除乳糜尿方面有效，且在1年随访期间乳糜尿患者耐受性良好。
