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Silver nitrate sclerotherapy for chyluria: evaluation for the optimal instillation regime
J V Dhabalia1, N R Pujari, V Kumar
1Department of Urology, Seth GS Medical College and KEM Hospital, Mumbai, India.
Objective:
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.
Patients And Methods:
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.
Results:
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.
Conclusion:
We recommend the 3-instillation regimen in patients with chyluria refractory to conservative treatment.
