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Background: Retroperitoneoscopic renal pedicle lymphatic disconnection has been described in the management of intractable chyluria., Methods: We retrospectively reviewed the clinical outcomes of 76 patients with intractable chyluria undergoing renal pedicle lymphatic disconnection via a retroperitoneoscopic (n = 59) or conventional open approach (n = 17). Operative time, intraoperative blood loss, volume of postoperative drainage, postoperative draining time, postoperative intestinal recovery, intraoperative and postoperative complications, and postoperative hospital stay were evaluated., Results: Compared with open surgery, retroperitoneoscopy was superior in terms of operative time, intraoperative blood loss, postoperative drainage, postoperative draining time, postoperative intestinal recovery time, and postoperative hospital stay. Recurrence developed in 2 patients due to the contralateral chylous efflux confirmed by cystoscopy during the period of 9-85 months of follow-up., Conclusions: With minimal invasion, sparing operative time, less blood loss, and rapid recovery, retroperitoneoscopic renal pedicle lymphatic disconnection can achieve at least the same clinical efficacy as open surgery., (Copyright © 2012 S. Karger AG, Basel.)

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., (Copyright (c) 2010 S. Karger AG, Basel.)

A sudden-onset chyluria after trauma was evaluated giving evidence of a lymphatic-urinary fistula in the right kidney. Treatment with somatostatin normalized the urinary pattern and the result was maintained even after the discontinuation of the therapy.

We investigated in conscious dogs the effects of intravenously administered 5-hydroxytryptophan (5-HTP) and cisapride on the postprandial jejunal mechanical activity by means of six closely spaced extraluminal strain gauge transducers. Drugs were given after administration of a nutrient meal. 5-HTP was given additionally after the administration of a noncaloric cellulose meal. Computer assistance was used to determine the temporal and spatial relationship of contractions and thereby to evaluate the length of spread of contractile waves. Both substances increased the propulsive activity, the contractile force and the motility index and fastened the transit rate of digesta. 5-HTP exhibited the most potent effect when given after administration of the nutrient meal.