Retroperitoneoscopic Management of Chyluria: Our Experience

Aims: The aim of current study was to evaluate the efficacy of retroperitoneoscopic pyelolymphatic disconnection in the management of chyluria not responding to conservative therapy and two courses of retrograde pelvic instillation sclerotherapy (RPIS) that were considered as cases of intractable chyluria.

Methods: A total 21 patients of intractable chyluria underwent retroperitoneoscopic pyelolymphatic disconnection over a period of 30 months. They were then followed every three months for the history of absence or presence of milky urine. Every patient irrespective of the history of passing milky urine underwent biochemical test of urine to confirm the presence of chyle in their urine.

Results: Mean operation time was 123 minutes (range 93 to 156 minutes) and mean hospital stay was 3 days. One patient had persistence of chyluria until third postoperative day that was managed successfully with RPIS. Another patient developed recurrence of chyluria after three months of operation from side opposite to the operated side as evident on cystoscopic view and was also successfully managed by RPIS. Our overall success rate was 95.3%.

Conclusions: Retroperitoneoscopic pyelolymphatic disconnection is a safe and effective procedure in the management of intractable chyluria not responding to conservative therapy or RPIS.