Ultrasound-guided percutaneous ethanol sclerotherapy of simple renal cysts in children

Abstract

Objective To evaluate the efficacy of ultrasound-guided percutaneous ethanol sclerotherapy of the simple renal cysts in children.Methods Fourteen patients (6 hoys and 8 girls) with 15 simple renal cysts underwent percutaneous ethanol sclerotherapy in our department between June 2003 and June 2008.One boy had bilateral cysts.The patients' age ranged from 2 to 13 years (mean=6.5 years).The duration of the symptoms ranged from 2 days to 2 years.Indications for treatment were flank pain (n=7),hematuria (n=3),increasing cyst size (n=3),and urinary tract infection (n=1).A puncture needle was inserted into the cyst under the ultrasound guidance,followed by aspiration of the cyst fluid,and 95% ethanol injection.The volume injected was 20~30% of the aspirated volume.Patients were followed up by ultrasonography for 1 to 24 months.Results Three patients suffered transient local pain related to the injection.No other major complication was found during the procedure and during follow-up.The follow-up showed a progressive reduction of the cyst volume in all cases after one month.Six month after the procedure,complete ablation of 8 cysts (53.3%) and partial regression of 3 cysts (20%) were showen by ultrasonography.By the end of the first year,73.3% (n=11) of cyst underwent complete resolution and 13.3% (n=2) partial regression.Two years after the procedure,additional intervention was required in 2 patients due to persistence of cysts and related symptoms.The average cyst volume reduction rate was 89.8% in all 15 cysts.During the follow-up,12 patients were asymptomatic after the ethanol sclerotherapy,whereas 2 patients experience diminished flank-pain.Conclusions Ultrasound-guided percutaneous ethanol sclerotherapy is a safe,effective,inexpensive and minimally invasive procedure for the management of symptomatic simple renal cysts in children. Key words: Simple renal cysts; Punctures; Child