[CHYLURIA TREATED BY RETROPERITONEOSCOPIC LYMPHATIC DISCONNECTION: REPORT OF A CASE]

Chyluria is a rare condition characterized by the presence of milky urine caused by lymphatic leakage into the urinary tract. A 78-year-old man presented with milky urine and was found to have 3+proteinuria on urinalysis. Although contrast-enhanced CT revealed no abnormalities, lymphangiography followed by non-contrast CT demonstrated lymphatic leakage communicating with the right renal pelvis. Conservative management with a low-fat diet failed to improve his symptoms. Therefore, retroperitoneoscopic lymphatic disconnection was performed around the right renal hilum.On postoperative day (POD) 3, an increase in milky drainage suggested postoperative chyle leakage, and treatment with fasting, intravenous fluids, and octreotide acetate was initiated. Proteinuria resolved by POD 4. A fat-restricted diet was reintroduced on POD 8, and the drain was removed on POD 15. The patient was discharged on POD 27 without recurrence. At the 6-month follow-up, he remained asymptomatic with no evidence of relapse.This case demonstrates the effectiveness of retroperitoneoscopic lymphatic disconnection for treating chyluria refractory to conservative therapy.