Mechanism Of The Chyluria Maybe The Injury Of The Pelvic Mucosa Dominantly Followed By The Disturbance Of The Lymph Circulation

Objective: In this article, we would like to re_discuss the mechanism lie in the Chyluria by combining our discoveries with the previous researches.Methods: First, a scrutiny has been made into the previous researches to find the defects of the prevailing theory, "Obstructive Theory". Second, from July 2003 to July 2007, 19 patients with Chyluria were admitted in our department and were all undergone with the Flexible Ureteroscopy. Then a novel hypothesis, based on our experiences and the discovery of our predecessor, was proposed to explicit the appearance of the Chyluria.Results: First, the "Obstructive Theory" seems to be groundless for the following 3 reasons, the Thoracic Duct of patients with the Chyluria was mostly patent instead of obstructed; the Chyluria would not occurred after ligation of the Thoracic Duct; and the renal pedicle lymphatic disconnection was effective. Our predecessor claimed the disturbance of the lymphatic circulation, for the tortuous and dilated lymphatic vessels and abnormal lymphatic valves. And in the 19 patients with the Chyluria of our department, the lymphatic-renal fistula was observed directly for the first time and mucosa between the adjacent 2 fistulae displays erosion, ulcer, and hemorrhage.Conclusions: We have enough reason to cast doubt on the authenticity of the "Obstructive Theory". We proposed such a hypothesis that mechanism lying in the Chyluria maybe the injury of the pelvic mucosa dominantly followed by the disturbance of the lymph circulation.