Chyluria, also known as chylous urine, is a condition marked by the presence of chyle in the urine. Chyle is an alkaline, odorless, milky fluid that contains lymph and emulsified fats. Although chyle leaks are rare, when they do occur, they can be found in several areas of the body, including the urinary tract, and caused by a variety of conditions.
What is Chyluria?
Chyluria is a condition caused by lymphatic fluid (chyle) passing into urine which results in the appearance of “milky” urine. The lymphatic fluid leaks into the urinary tract through a fistulous connection, which is a hole between the two systems. Chyluria can be caused by parasites or non-parasitic reasons.
Filariasis is a parasitic infection caused by a nematode worm from the family Filarioidae. The Wuchereria Bancrofti is the specific species that infects the lymphatic system and a chronic infection can cause a blockage in the lymphatic system which results in an opening created in the kidney, ureter or bladder, resulting in chyluria. This nematode is passed to humans (the definitive host) via mosquitoes (intermediate host), most commonly in Africa and South America. Once infected, the use of therapeutic drugs such as Diethylcarbamazine (DEC) is effective in eliminating the microfilariae from the blood and the adult worms from the lymph system.
Chyluria can be a result of other disease progressions, including tumors and tuberculosis. Tuberculosis is a bacterial infection which usually infects the lungs, but can also infect other parts of the body including the lymph nodes, kidneys, bones and joints. When infection of the lymph nodes occurs, the lymphatic system can be blocked, thereby resulting in chyluria. Tumors can grow in any part of the body, and in the case of a lymphatic tumor, a resulting blockage can lead to chyluria.
There have been cases of surgical procedures, such as partial nephrectomy or thoracic surgery, that can cause damage to the lymphatic system or a blockage of the thoracic duct, thereby resulting in chyluria.
There are several medical conditions, including pregnancy and congenital defects, which can result in chyluria. Congenital conditions can cause structural abnormalities of the lymphatic system. These abnormalities may lead to blockages which can lead to fistulous connections opening into the urinary tract. Pregnancy and childbirth can also cause damage to the lymphatic system and, although a rare occurrence, can result in chyluria.