Recurrent bilateral chyluria after lymphatic embolization successfully treated with renal pelvic instillation sclerotherapy: a case report

Chyluria is a rare condition caused by abnormal communication between the lymphatic system and the urinary tract. We report a case of recurrent bilateral chyluria in a 65-year-old woman who previously underwent lymphatic embolization but developed persistent symptoms. Retrograde pyelography demonstrated bilateral renal lymphatic reflux. The patient was treated with bilateral renal pelvic instillation sclerotherapy (RPIS) using povidone iodine for three consecutive days. Symptoms resolved rapidly and no complications occurred. The patient remained symptom-free during 36 months of follow-up. This case highlights RPIS as a minimally invasive therapeutic alternative for recurrent chyluria after failed lymphatic embolization. • Recurrent bilateral chyluria occurred after prior lymphatic embolization. • Retrograde pyelography demonstrated bilateral lymphatic reflux. • Renal pelvic instillation sclerotherapy successfully resolved the condition.