{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T17:50:04Z","timestamp":1785520204215,"version":"3.56.0"},"reference-count":27,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2019,10,16]],"date-time":"2019-10-16T00:00:00Z","timestamp":1571184000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["TropicalMed"],"abstract":"<jats:p>Silver nitrate instillation (SNI) is one form of treatment for chyluria. However, there is the opinion that a high volume of SNI (&gt;10 mL) should be avoided because life-threatening complications have been reported. However, we have noticed that most severe complications occur in high-concentration treatments (\u22651%), even with a small volume. In addition, a small volume (\u226410 mL) of low-concentration (&lt;1%) SNI occasionally causes recurrence. Based on these facts, we aimed to evaluate a preliminary study of a novel single-injection regimen of low-concentration high-volume SNI. In this preliminary study, nine patients who underwent SNI were retrospectively examined. Patient characteristics, anesthesia, procedure, efficacy, complications, and duration of hospital stay were investigated. The volume of silver nitrate solution was decided based on symptoms, findings of pyelography, and vital signs, and it was given as a single instillation. This study was approved by the Institutional Review Board. The ranges of silver nitrate concentration and volume were 0.1%\u20130.5% and 15\u201330 mL, respectively. In all patients, proteinuria and cloudy urine disappeared immediately. However, two patients had recurrence after the initial SNI. These two patients were subsequently treated with increasing concentrations of silver nitrate (0.2% and 0.5%) from 0.1%, and they had complete symptomatic relief without recurrence for more than 6 years. None of the patients experienced severe complications. In conclusion, our preliminary study showed that a single instillation of low-concentration (0.1%\u20130.5%) and high-volume (15\u201330 mL) SNI is safe and useful. It is worth considering as a treatment option for chyluria.<\/jats:p>","DOI":"10.3390\/tropicalmed4040128","type":"journal-article","created":{"date-parts":[[2019,10,17]],"date-time":"2019-10-17T04:46:06Z","timestamp":1571287566000},"page":"128","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Preliminary Study of a Single Instillation of Low-Concentration High-Volume Silver Nitrate Solution for Chyluria: Is &gt;10 mL Instillation an Absolute Contraindication in the Real World?"],"prefix":"10.3390","volume":"4","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6963-5632","authenticated-orcid":false,"given":"Kensuke","family":"Mitsunari","sequence":"first","affiliation":[{"name":"Department of Urology, The Japanese Red Cross Nagasaki Genbaku Hospital, 3-15 Mori-machi, Nagasaki 852-8511, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5436-3064","authenticated-orcid":false,"given":"Yushi","family":"Imasato","sequence":"additional","affiliation":[{"name":"Department of Urology, The Japanese Red Cross Nagasaki Genbaku Hospital, 3-15 Mori-machi, Nagasaki 852-8511, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toshifumi","family":"Tsurusaki","sequence":"additional","affiliation":[{"name":"Department of Urology, The Japanese Red Cross Nagasaki Genbaku Hospital, 3-15 Mori-machi, Nagasaki 852-8511, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2019,10,16]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"bcr2014209188","DOI":"10.1136\/bcr-2014-209188","article-title":"Chyluria: A scourge of our region","volume":"2015","author":"Sinha","year":"2015","journal-title":"BMJ Case Rep."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1082","DOI":"10.1111\/j.1464-410X.2004.05108.x","article-title":"Is povidone iodine an alternative to silver nitrate for renal pelvic instillation sclerotherapy in chyluria?","volume":"94","author":"Goel","year":"2004","journal-title":"BJU Int."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"56","DOI":"10.1159\/000296287","article-title":"Silver nitrate sclerotherapy for chyluria: Evaluation for the optimal instillation regime","volume":"85","author":"Dhabalia","year":"2010","journal-title":"Urol. 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