OBJECTIVE: To compare the efficacy and toxicity of 1% silver nitrate, 0.2% povidone iodine and 50% dextrose in renal pelvic instillation sclerotherapy (RPIS) for chyluria. PATIENTS AND METHODS: In a prospective randomized comparative study from January 1999 to June 2003, 106 patients (61 males and 45 females; mean age 36 years, sd 12, range 14-65) were randomized to receive 1% silver nitrate, 0.2% povidone iodine or 50% dextrose as RPIS. In all, nine doses were given at 8-h intervals, and patients followed at 6 weeks and then at 3-monthly intervals. Patients with 'persistence' or 'recurrence' of chyluria were treated with second course of RPIS using same sclerosant. RESULTS: The dextrose treatment was discontinued at mid-term because of poor success (one of 21 patients, P < 0.001). Of 85 patients, 44 receivedsilver nitrate and 41 povidone iodine; both groups were well-matched and the mean follow-up was 28.4 and 23.3 months, respectively. 'Immediate clearance' was recorded in 91% and 98%, and recurrence in 21% and 22% of patients after the first course of RPIS, after silver nitrate and povidone, respectively; Kaplan-Meier estimates of 'disease-free duration' in the two groups (23.6 vs 20.1 months) were also similar (P = 0.7906). The cumulative success rate after two courses of RPIS was 82% (silver nitrate) and 83% (povidone; P = 1.0). Five (11%) patients in the silver nitrate and one (2%) in the povidone group had significant flank pain during treatment. CONCLUSIONS:Povidone iodine 0.2% is as effective for RPIS as 1% silver nitrate.
RCT Entities:
OBJECTIVE: To compare the efficacy and toxicity of 1% silver nitrate, 0.2% povidone iodine and 50% dextrose in renal pelvic instillation sclerotherapy (RPIS) for chyluria. PATIENTS AND METHODS: In a prospective randomized comparative study from January 1999 to June 2003, 106 patients (61 males and 45 females; mean age 36 years, sd 12, range 14-65) were randomized to receive 1% silver nitrate, 0.2% povidone iodine or 50% dextrose as RPIS. In all, nine doses were given at 8-h intervals, and patients followed at 6 weeks and then at 3-monthly intervals. Patients with 'persistence' or 'recurrence' of chyluria were treated with second course of RPIS using same sclerosant. RESULTS: The dextrose treatment was discontinued at mid-term because of poor success (one of 21 patients, P < 0.001). Of 85 patients, 44 received silver nitrate and 41 povidone iodine; both groups were well-matched and the mean follow-up was 28.4 and 23.3 months, respectively. 'Immediate clearance' was recorded in 91% and 98%, and recurrence in 21% and 22% of patients after the first course of RPIS, after silver nitrate and povidone, respectively; Kaplan-Meier estimates of 'disease-free duration' in the two groups (23.6 vs 20.1 months) were also similar (P = 0.7906). The cumulative success rate after two courses of RPIS was 82% (silver nitrate) and 83% (povidone; P = 1.0). Five (11%) patients in the silver nitrate and one (2%) in the povidone group had significant flank pain during treatment. CONCLUSIONS:Povidone iodine 0.2% is as effective for RPIS as 1% silver nitrate.
Authors: John Schneider; Uwais B Zaid; Benjamin N Breyer; Benjamin M Yeh; Antonio Westphalen; Fergus V Coakley; Zhen J Wang Journal: J Comput Assist Tomogr Date: 2010 Mar-Apr Impact factor: 1.826
Authors: Mohammed M Seleem; Ahmed M Eliwa; Ehab R Elsayed; Hamdy Desouky; Hazem El Galaly; Khalid Abdelwahab; Salem Khalil; Mahmoud El Adl Journal: Arab J Urol Date: 2016-04-26
Authors: Andrea Guttilla; Paolo Beltrami; Laura Bettin; Andrea Galantini; Fabrizio Dal Moro; Vincenzo Ficarra; Filiberto Zattoni Journal: Urol Case Rep Date: 2016-06-24