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Войти в исследования Urology annals · 2021
Single-dose instillation of povidone iodine for chyluria: A safe and effective therapy.
СтатьяНазвание и аннотация: Перевод в очереди
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Yadav Praveen Kumar, Swain Samir, Singh Anunay, Hasan Arshad, Haque Md Faizul, Kundu Gaurab, Sharma Bhupendra Kumar, Hota Datteswar
Аннотация
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.
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.