Milky urine

Introduction Milky white urine, also known as chyluria, is milky white like milk. This is due to the inability to absorb sputum from the intestines, causing the chyle to flow back into the urine. Causing urinary fistula has congenital factors, such as congenital lymphatic valve dysfunction; there are also secondary factors, such as common filariasis and urinary system purulent infection. There are two main causes of chyluria: 1 non-parasitic, such as tuberculosis, malignant tumors and other extensive invasion of the retroperitoneal lymphatic vessels, lymph nodes, causing damage or obstruction, is rare. 2 parasitic, mostly due to filariasis. Nowadays, the common complications of urinary tract filariasis can occur in the acute phase and the chronic phase. Domestic data prove that the rabies scrotum can also have scrotal complications such as chyluria, hydrocele and spermatic sinus. But there are very few.

Cause

There are two main causes of chyluria:

1 non-parasitic, such as tuberculosis, malignant tumors and other extensive violations of the retroperitoneal lymphatic vessels, lymph nodes, causing damage or obstruction, is rare.

2 parasitic, mostly due to filariasis. Nowadays, the common complications of urinary tract filariasis can occur in the acute phase and the chronic phase. Domestic data prove that the rabies scrotum can also have scrotal complications such as chyluria, hydrocele and spermatic sinus. But there are very few.

an examination

Related inspection

Cystoscopy blood routine urine routine

1. Inquire whether there is a history of filariasis endemic areas, or a history of tumors, tuberculosis, chest and abdomen trauma, repeated episodes of milky white urine, with hematuria, whether it is induced or aggravated after high-fat meal or fatigue, with or without other silk The symptoms of worm disease, what kind of treatment, and how effective it is.

2. Urine routine examination and chyle test to distinguish between phosphate urine and pyuria. Those with negative chyle test can take fat meal inducement test.

3. Take blood and urine to check microfilaria.

4. Cystoscopy, to observe whether the ureteral orifice sprayed chyluria, pay attention to the side of the chyluria.

5. Lymphatic angiography to observe the passage of lymphatic vessels and urinary tract.

Differential diagnosis

Differential diagnosis of milky white urine:

1. Pyuria: When there is pyuria in the genitourinary infection, the urine is milky white and turbid, even with pus, and the surface resembles chyluria. However, patients with pyuria often have a history of genitourinary infection and have obvious urinary tract irritation. A large number of pus cells and white blood cells can be seen in routine urine examination. After the urine was allowed to stand, there was no floating fat drop, and the urine chyle test was negative. At the same time, the urine bacterial culture count was >105/ml.

2. Crystalline urine: The urine is clearer when it is discharged, and it is milky white and turbid after standing. Such patients often have no urinary system symptoms, urine microscopic examination shows more crystals, mainly oxalate, urate, phosphate. After the urine was allowed to stand, there was no floating fat drop, and the chyle test was negative.

3. Proteinuria: When the protein content in the urine is high, it may be cloudy and foamy. However, such patients often have a history of acute and chronic kidney disease, accompanied by symptoms such as edema and hypertension. Microscopic examination of urine sediment showed many red, white blood cells and casts, and the 24-hour urine protein was 1.0-3.5 g.

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