Q: I am 55 years old male and passing white colour urine. It occurs suddenly and would continue for months together. I am facing this problem since 12 years without any remedy though I got myself checked by a nephrologist. All my test reports were negative. The urine smells very bad and occurs mainly in the morning or after taking spicy oily food. My doctor said that it may be a symptom of chyluria and advised not to worry.

A:Passage of milky urine after taking fatty meals may indeed indicate chyluria. It occurs due to blockage of lymphatic channels, mostly due to diseases like filariasis, and rupture of these dilated lymphatics into the urinary passage near kidneys. Whenever lymphatics carry heavy load of fats, as would occur after a heavy fatty meal, urine would contain these fats. Diagnosis is usually done by testing for these fats in urine and proving the lymphatic miscommunications by imaging studies like retrograde pyelography or lymphangiography. It is usually possible to identify the side throwing out such fats, right or left, by doing an endoscopic examination of the bladder after a fatty meal. Initial attempts are usually made to block these lymphatics by injecting some sclerosants like silver nitrate, failing which these communications may be surgically corrected by open or laparoscopic surgery.