Silver nitrate sclerotherapy for chyluria: evaluation for the optimal instillation regime

• Published in: Urologia internationalis Vol. 85; no. 1; p. 56
• Main Authors: Dhabalia, J V, Pujari, N R, Kumar, V, Punia, M S, Gokhale, A D, Nelivigi, G
• Format: Journal Article
• Language: English
• Published: Switzerland 01.01.2010
• Subjects: Adult; Aged; Aged, 80 and over; Chyle - metabolism; Cystoscopy; Drug Administration Schedule; Female; Humans; India; Length of Stay; Lymphatic Diseases - diagnosis; Lymphatic Diseases - therapy; Lymphatic Diseases - urine; Male; Middle Aged; Prospective Studies; Sclerosing Solutions - administration & dosage; Sclerosing Solutions - adverse effects; Sclerotherapy - adverse effects; Sclerotherapy - methods; Silver Nitrate - administration & dosage; Silver Nitrate - adverse effects; Time Factors; Treatment Outcome; Urine; Urography; India
• ISSN: 1423-0399
• DOI: 10.1159/000296287

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. 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. 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. We recommend the 3-instillation regimen in patients with chyluria refractory to conservative treatment.