Single-dose instillation of povidone iodine for chyluria: A safe and effective therapy

• Published in: Urology annals 2021-01, Vol.13 (1), p.36-40
• Main Authors: Yadav, Praveen, Swain, Samir, Singh, Anunay, Hasan, Arshad, Haque, Md, Kundu, Gaurab, Sharma, Bhupendra, Hota, Datteswar
• Format: Article
• Language: English
• Subjects: conservative management; Dosage and administration; endoscopic sclerotherapy; Iodine; Medical research; Medicine, Experimental; Original; Povidone; pyelolymphatic connections; sclerosant agents; silver nitrate; Urine
• ISSN: 0974-7796; 0974-7834
• DOI: 10.4103/UA.UA_159_19

Introduction: Management of chyluria with initial conservative approach and then using endoscopic sclerotherapy is a mainstay approach. However, a wide range of sclerosants are available with differential success rates and complication rates. This study evaluated the safety and efficacy of a single-dose instillation of 1% povidone iodine for the treatment of chyluria. Materials and Methods: This was a prospective, observational study conducted on patients with chyluria who did not respond to conservative management with dietary restriction and diethylcarbamazine. The site of chyle efflux was identified by cystoscopy. A 6 Fr ureteral stent was inserted into effluxing side, diluted contrast was injected to delineate the pelvicalyceal system and the pyelolymphatic connection (arborization of the pelvicalyceal system), and a single-dose of 1% povidone iodine was instilled. Patients were observed for loin pain, fever, and disappearance of milky urine postinstillation and followed up at intervals of 3 months for a total duration of 1 year. Results: Of a total 50 patients included, 35 were men and 15 were women, with a mean age of 37 years. Pyelolymphatic connections were noted in 48% of the patients. All patients showed an immediate disappearance of milky urine. During 1-year follow-up, 92% of the patients were symptom-free till the last follow-up while only 8% of the patients experienced recurrence of chyluria which were treated with other treatment modalities. The mean duration of recurrence was 8 weeks. Conclusion: Single dose of 1% povidone iodine was effective in immediate clearance of milky urine and well tolerated in patients with chyluria during 1-year follow-up.