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Query: UMLS:C0403608 (ureter)
 9,655 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The indications, investigations and techniques for treating patients with chyluria are presented. Thirty-eight patients were treated by lymphatic disconnection either at renal hilum or at lower ureter and bladder level. Pedal lymphangiography was essential to decide upon the level of operation. Results were satisfactory in the majority when chyluria was intractable.
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PMID:Technique of clearance (or disconnection) of dilated lymphatics in the renal hilum and lower ureter and bladder in cases of intractable chyluria or haemochyluria. 53 20

On the case of 10 years old boy with chyluria the authors emphasize the importance of lymphographic examination for proving the pyelolymphatic connection. The lymphographic examination was applied after the complete examination including computer tomography and ultrasound, since these examinations did not prove changes of the urinary and lymphatic systems which could explain the milky clouding of the urine lasting for several months. Changes in the biochemical profile were significant as well as non-constant ejaculation of milky cloudy urine from the opening of the right ureter. The lymphographic examination proved the link between the lymphatic urinary systems with changes on the lymphatic vessels and nodes.
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PMID:[Lympho-renal fistula in lymphatic imaging]. 273 Dec 98

Laparoscopic nephrolysis was performed in an 81-year-old man with recurrent chyluria. A total of five trocars were used for approaching the lymphatic ducts over the right ureter and renal hilum. The lymphatic ducts identified were easily ligated under laparoscopic magnification. The recovery of this patient was quick and uneventful. The follow-up urinalysis for chyle was negative, and his serum albumin concentration increased from 3.0 g/dL to 4.2 g/dL at 2 years postoperatively. This case report attests to the long-term efficacy of a laparoscopic approach to ligation of lymphatic fistulas for the treatment of recalcitrant chyluria.
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PMID:Laparoscopic nephrolysis for chyluria: case report of long-term success. 853 60

Chyluria is the passage of chylus into urine resulting in fistulization through the lymphatic system and the urinary system. This rare condition is usually caused by filaria infestation or malformations, neoplasia or trauma. We report a case of a 18-year-old man. The patient presented milky urine which had appeared after angiography following minor leg trauma. Physical examination revealed asymmetry of the face and cutaneous dyschromia. Blood tests revealed hypogammaglobulinemia and altered CD4/CD8 ratio (0.6). Urine tests showed proteinuria (30 mg/dl), lipiduria (triglycerides 750 mg/dl) and density of 1025. Renal function was normal. Abdomen computed tomography and urography were normal. Cystoscopy revealed the presence of milky urine in the bladder and selective catheterization revealed that the origin was the right ureter alone. Ascendent pyelography did not reveal any malformation of the urinary tract; but after this the chyluria spontaneously disappeared. The patient was rehospitalized 3 months later for recurrence. Lymphography was then performed and revealed a dilated lymphatic network with minute lacunar images projecting into the right kidney. Chyluria again disappeared spontaneously and recurred sporadically over the next two years in a patient who remained in good physical condition. The etiology of chyluria in a patient without filaria infestation is problematic, particularly when the most common causes (tuberculosis, neoplasia, trauma) are excluded as in our case. The asymmetry of the face, together with cutaneous dyschromia and the presence of a subarachnoidea cyst in the right temporal region suggested our patient had multiple congenital malformations.
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PMID:[Intermittent chyluria in a young man]. 872 1

A 21- year-old lady presented with chyluria, severe malnutrition, secondary amenorrhea, profound hypoalbuminemia, heavy proteinuria and renal tubular abnormalities suggestive of Type IV renal tubular acidosis. No particular cause for chyluria could be ascertained. She was successfully treated with an injection of 2% silver nitrate into the left ureter and urinary bladder. She continues to be well after 15 years of follow-up.
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PMID:Successful treatment of chyluria, glomerular and tubular abnormalities in a young lady with silver nitrate instillation. 1749

Chyluria is usually associated with abnormal retrograde or collateral flow of lymph from intestinal lymphatics into lymphatics of the kidney, ureter or bladder. Chyluria has been described in patients with lymphoma, carcinoma, trauma, abscess, tuberculosis, filariasis, pregnancy and stenoses of the thoracic duct. In this case report we describe a patient who presented with chyluria associated with severe hyperlipidemia due to nephrotic syndrome induced by microscopic polyangiitis. Laboratory, histological and radiological examination did not show evidence of filarial infestation, tuberculous infection or malformation of the lymphatic system. Treatment with corticosteroids and cyclophosphamide resulted in improvement of hyperlipidemia and disappearance of chyluria.
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PMID:Chyluria associated with renal vasculitis. 1840 92

Chyluria is an abnormal condition in which chyle appears in the urine because of a fistulous communication between the lymphatics and the urinary tract. It is not life-threatening and spontaneous regression is reported in 50% of cases. Lymphangiography has been the main imaging modality for localization of the site of fistula, but it is invasive and requires expertise. Lymphoscintigraphy using Tc-99m labelled colloid is a safe, non-invasive, reproducible technique, which bears less radiation exposure. A 67-year-old male presented with 7-month history of chyluria following a spinal surgery. Bilateral lower limb lymphoscintigram revealed sluggish lymph flow in the left lower limb and visualization of tracer in the left kidney consistent with lymphorenal fistula. Subsequent cystography revealed appearance of chylous urine from left ureter. Patient refused surgery.
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PMID:99mTc-Nannocolloid Localization of Lymphorenal Fistula Causing Chyluria. 1879 92

Chyluria is the passage of milky urine due to a lymphourinary fistula secondary to lymphatic stasis caused by obstruction of the lymphatic flow. This can be caused by parasitic or non-parasitic infections. Though chyluria is a commonly encountered entity in clinical practice particularly in developing countries like India, it is rarely discussed in English literature. We report a case of chyluria with right bifid ureter in a 50-year-old male patient who was treated with intrarenal pelvic instillation of 1% silver nitrate (AgNO3) and emphasis on the diagnostic implication of retrograde pyelography prior to endoscopic sclerotherapy in managing chyluria particularly in renal anomalies.
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PMID:Chyluria: is retrograde pyelogram mandatory prior to endoscopic sclerotherapy? 2439 70

Chyle is a milky lymphatic fluid that is normally formed in the small intestine to aid in the absorption of dietary fats. Occasionally, chyle leaks into the kidney, ureter, or bladder, which results in chyluria. Chyluria is most commonly caused by the parasite Wuchereria bancrofti and is therefore extremely rare in the USA. The use of robotic surgery for treatment has been suggested as a viable option, but has not been thoroughly reported in the literature. This article reviews the literature on the various treatment options for chyluria and presents the case of a 75-year-old Indian female from the USA who was diagnosed with non-parasitic, persistent chyluria and treated with right robotic ureterolysis, renal hilar dissection and intraperitonealization of the ureter.
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PMID:Robotic surgery for treatment of chyluria. 2686 49

Lymphangioleiomyomatosis (LAM) is a rare and progressive neoplastic disease of young woman, characterized by the proliferation of abnormal smooth muscle-like cells (LAM cells) in the lungs and axial lymphatics. A 44-year-old woman was referred to our hospital because pleural effusion was detected during a health checkup. She had chylothorax, chylous ascites, and chyluria, and her computed tomography scan showed a solid tumor in the pelvis. Surgical biopsy was performed; she was diagnosed as having LAM. We could not control the fluid collection and chyluria using standard medical treatments. Therefore, we chose to administer sirolimus, and her symptoms dramatically improved. The mechanism of chyluria presumably involved LAM cell infiltrates in the ureter via the lymphatic vessel flow, which causes LAM to develop because of ureter wall exposure.
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PMID:Successful treatment of a patient with chyluria due to lymphangioleiomyomatosis using sirolimus. 2934 35


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