PMC7395989_01
The color of urine samples prior and after the endoscopic sclerotheraphy, (a) prior to sclerotheraphy, (b) post surgery day 5, (c) one month after surgery.
CRIU2020-8853473.001.jpg
PMC7395989_01_CRIU2020-8853473.001.jpg
fig1
Macroscopically, urine appeared milky in colours (Figure 1(a)), and the analysis demonstrated severe proteinuria and a high triacylglycerides level of 370 mg/dl (standard 1-10 mg/dl). He had an uneventful recovery with complete clearance of urine over five days (Figure 1(b)) and was discharged later on a low-fat diet. On routine follow up at one month, his urine was completely clear (Figure 1(c)), and a 3 kg increase in body weight was also observed.
Cystoscopy view showing the chyluria.
CRIU2020-8853473.002.jpg
PMC7395989_01_CRIU2020-8853473.002.jpg
fig2
During diagnostic rigid cystoscopy and ureterorenoscopy, egress of milky urine from the left ureter was observed (Figure 2).
Left side retrograde pyelogram is showing the main lympho-urinary fistula at renal pelvis close to pelvic ureteric junction (marked by arrow).
CRIU2020-8853473.003.jpg
PMC7395989_01_CRIU2020-8853473.003.jpg
fig3
The retrograde pyelogram, performed subsequently, demonstrated a left-sided lympho-urinary fistula at the level of the renal pelvis (Figure 3).