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Unilateral pedal lymphography in patients with filarial chyluria
1Departments of Urology and Radiology, Okinawa Chubu Hospital, Gushikawa, Okinawa, Japan.
Objective:
To evaluate the usefulness of unilateral pedal lymphography in patients with filarial chyluria.
Patients And Methods:
Of 114 patients with filarial chyluria, all underwent lymphography (unilateral pedal in 106) and 55 underwent selective ureteric sampling for chyle.
Results:
Unilateral pedal lymphography in the 106 patients detected lymphaticorenal fistulae (LRF) in 104 (98%). Lymphatic crossover was seen in all 106 patients, from the second sacral segment to the first lumbar segment. The most frequent crossover site was at the L5 level (87%). There was complete correlation between the side of LRF and the side of chyluria as assessed by selective ureteric sampling.
Conclusion:
Unilateral pedal lymphography can detect LRF via lymphatic crossover even when it is on the opposite side from that injected with contrast agent. The advantages of unilateral lymphography over bilateral procedures are that it is easy to identify crossover channels, and the discomfort for the patient is reduced because there are fewer incisions and it is quicker. Unilateral lymphography is recommended as the initial method when lymphography is indicated in filarial chyluria.