Introduction

Chyluria, the passage of chyle into the urine giving it a typical milky appearance, is due to a communication between lymphatic and urinary system. Chyluria is rare except in the areas of the world where filariasis is endemic specially India, Japan, Southeast Asia, and parts of Africa, Australia, and South America (1). The most common cause of chyluria is parasitic infection secondary to filariasis caused by Wuchereria bancrofti.

In 1878, Bancroft discovered adult worm in an abscess cavity; in 1929 it was named as Wuchereria bancrofti (2-4). Wood demonstrated pyelolymphatic reflux during retrograde pyelography in 1929 (5). In 1968, Wucherer described microfilaria in the urine of a patient with hematochyluria. Kinmoth (1955) introduced the technique of lymphangiography, and Kittredge described the lymphaticourinary communication (6).

Chyluria can occur anywhere in urinary tract, but the chyluria of renal origin is the most common and usually represents the chronic stage of the filarial disease. Chyle consists of lymphatic elements: albumin, fat (triglycerides), and fibrin due to formation of a coagulum if a urine sample is left standing for a long time.

The quantity of lipids depends on the size of the fistula and the amount and composition of dietary fat. There are other pathologic conditions, which may clinically mimic chyluria and need differentiation (Table 1).

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