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Filarial chyluria: Long‐term experience of a university hospital in India
Author(s) -
TANDON VIPUL,
SINGH HARBANS,
DWIVEDI U S,
MAHMOOD MUFTI,
SINGH P B
Publication year - 2004
Publication title -
international journal of urology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.172
H-Index - 67
eISSN - 1442-2042
pISSN - 0919-8172
DOI - 10.1111/j.1442-2042.2003.00761.x
Subject(s) - chyluria , medicine , surgery , lymphatic filariasis , cystoscopy , complication , urinary system , filariasis , lymphatic system , helminths , immunology
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 post‐treatment 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.