Filarial chyluria: Long‐term experience of a university hospital in India

Abstract

Background : Filariasis is an endemic problem in various Indian states. We evaluated the results of long-term follow up (10-20 years) of patients with filarial chyluria. Methods : We conducted a retrospective analysis of 160 patients treated for filarial chyluria who presented to the Banaras Hindu University Hospital from 1982 to 1992. Eighty-four patients (52.5%) were treated using diethylcarbamazine (DEC) and a fat restricted diet and 76 patients (47.5%) underwent surgery. To examine the long-term effects of filarial chyluria we analysed data on posttreatment recurrence, weight gain, dietary freedom, chyluria free period and a number of other associated factors.Results : Previous history of filariasis or its complication was documented in 19% of patients. In 71% of cases, cystoscopy showed that chylous efflux was predominant in the left ureteric orifice. The long-term remission rate was 62% in the conservatively managed group (DEC + fat restricted diet), whereas 90% of patients in the operated group were cured. Postoperative recurrence rate was 10%. There was more weight gain and dietary freedom along with a longer chyluria free period in the operated group relative to the conservatively managed group. Conclusions : Definitive surgical ablation of lymphatic urinary fistula is better than conservative medical management because it has a higher success rate, more dietary freedom and, therefore, better patient acceptability.

Does 24bp Duplication of Human CHIT1 Gene (Chitotriosidase1) Predispose to Filarial Chyluria? A Case-Control Study

“…In the year 2000, WHO started a worldwide campaign to eliminate filariasis. India contributes about 40% of total global burden and accounts for nearly 50%of the people at risk of filarial infection and the province of Uttar Pradesh has the highest prevalence, with 7 million affected people [2][3][4]. Chyluria occurs in up to 10% of patients with filariasis [5].…”

Filarial Chyluria as a Rare Cause of Urinary Retention

“…Fat intake, pregnancy and exercise are considered to be aggravating factors of chyluria, and these conditions should be avoided, especially in patients with recurrent or prolonged chyluria (16). In the present case, moderate to severe fatty liver was confirmed, which may have directly induced the patient's chyluria.…”

“…The symptoms of lymphatic obstruction generally appear one or two years after infection. It has been reported that chyluria has occurred in two (1.7%) of 119 filarial patients (13), two (2.5%) of 80 filarial patients (14) and up to 10% of filarial patients (15,16). Therefore, the complication of chyluria is a relatively rare condition in patients with filariasis.…”

“…According to Tandon et al, the cure rate of conservative therapy is approximately 60% (16). In Japan, Ohyama et al reported a cure rate of 61% (13), while Okamoto et al reported a cure in 15% and an improvement in 23% of conservatively treated patients (24).…”

“…Surgical intervention is helpful in cases of recurrent chyluria (16). According to Tandon et al, the cure rate of conservative therapy is approximately 60% (16).…”