A prospective study to evaluate the safety and efficacy of a single instillation of povidone iodine under fluoroscopy guidance for the treatment of chyluria

Introduction: Chyluria is a medical condition defined as presence of chyle in urine, resulting in a milky-white appearance of urine. The etiology of chyluria can be infective, traumatic and idiopathic. Materials and methods: A prospective study was carried out at a tertiary care centre over a period of 2 years from April 2021 to April 2023 where patients with agebetween 18-70 years with urine examination positive for chylomicrons were enrolled into the study .A total of 32 patients with chyluria underwent renal pelvic instillation sclerotherapy (RPIS). Results: A total of 23 patients showed an immediate disappearance of milky urine after procedure.8 patients with bilateral chylous efflux showed clearance after treatment on the other side.1 patient with bilateral chylous efflux had treatment failure during left sided sclerotherapy after successful treatment on right side a month prior.Recurrence was observed in 2 patients at 6 monthly follow up.One patient with recurrence had bilateral disease while another had unilateral disease.Patients with treatment failure and recurrence were given sclerotherapy one more time.Both patients with recurrence responded to retreatment and the patient with treatment failure was planned for laparoscopic nephronolysis. Conclusion: RPIS using a single instillation of 0.2% povidone iodine is safe, effective, well-tolerated, inexpensive and minimally invasive method for the management of chyluria.