Successful Treatment of Idiopathic Chyluria by Direct Percutaneous Puncture and Embolization of the Fistula Site: A Case Report

We report a case of idiopathic chyluria in a woman in her 70s, successfully treated by direct percutaneous puncture and embolization of the fistula site. The patient had experienced persistent milky-white urine, progressive weight loss, and voiding difficulties for >3 years. Inguinal intranodal lymphangiography identified a lymphatic-urinary fistula near the lower pole of the left renal calyx. Later, under fluoroscopic guidance, the fistula site was directly punctured and embolized using n-butyl cyanoacrylate without complications. Her symptoms resolved immediately, and there has been no recurrence over a two-year follow-up period while she remained on a regular diet. This case highlights the effectiveness of direct percutaneous embolization of the fistula site as a minimally invasive treatment option for refractory chyluria.