Chylurie na partiële nefrectomie: een case report en overzicht van de literatuur

Abstract

Chyluria after partial nephrectomy: a case report and review of the literature Chyluria is a rare medical condition in which chyle, a lymphatic fluid with a milky appearance, enters the urinary tract. In developed countries chyluria is often iatrogenic due to surgical trauma, causing fistulation between the urinary and lymphatic system. A case of post-operative chyluria is reported. An extensive literature search was done in relation to the etiology and treatment of this pathology, thirteen papers were included for in depth analysis. A conservative approach is the preferred option for mild chyluria, consisting of restriction of long-chain fatty acids and addition of medium-chain triglycerides. Sclerotherapy is recommended in case of immunosuppression and malnutrition or when chyluria persists for over twelve months. In case of failure of sclerotherapy or severe malnutrition or immunosuppression, surgery is required to obtain a disconnection between the lymphatic and urinary system. Chyluria will often resolve spontaneously after six to twelve months. If the problem persists after conservative treatment or if nutritional deficiency or immunosuppression occurs, sclerotherapy or surgery is recommended.