Ureteroscopic management of asymptomatic and symptomatic simple parapelvic renal cysts.

Xiawa Mao,Gang Xu,Jiaquan Xiao,Huifeng Wu

doi:10.1186/s12894-015-0042-5

Xiawa Mao, Gang Xu + Show 2 more

Open Access

https://doi.org/10.1186/s12894-015-0042-5

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Journal: BMC Urology	Publication Date: Jun 6, 2015
Citations: 39	License type: CC BY 4.0

Affiliation: Second Affiliated Hospital of Zhejiang University

Abstract

BackgroundTo investigate feasibility and safety of treating simple parapelvic renal cysts using flexible ureteroscopy with the Holmium laser.MethodsBetween February 2010 and July 2013, a total of 21 patients, aging from 29 to 71 (49.00 ± 13.23), were diagnosed with parapelvic renal cysts by ultrasonography in combination with contrast-enhanced computer tomography (CT) and intravenous urography (IVU) in the Department of Urology Surgery, People’s Hospital of the Zhejiang province. Fifteen patients were asymptomatic and 6 patients were symptomatic with flank pain. All patients underwent drainage of the cysts using flexible ureteroscopy with Holmium laser. Patients were followed up 1, 3 and 12 months after the operation.ResultsThe intervention was successful in 20 patients and failed in 1 patient who, subsequently successfully underwent a laparoscopic cyst removal. There were no intra-operative and post-operative complications reported. The mean operation time was 27 min (range: 15 to 45 min). The mean hospital stay was 2.6 days (range: 1 to 5 days). Twenty patients were followed up until 15 months after surgery. After such ureteroscopic management, there were no renal cysts detected in 7 patients (35 %) and a reduction in size of the renal cysts was found in 13 patients (65 %). Flank pain subsided in all 6 (100 %) previously symptomatic patients.ConclusionsFlexible ureteroscopy with the Holmium laser may be a feasible and effective treatment option in selected patients with simple parapelvic renal cysts. Further prospective randomized studies that compare the procedure to laparoscopic treatments are needed.

Highlights

To investigate feasibility and safety of treating simple parapelvic renal cysts using flexible ureteroscopy with the Holmium laser
Further prospective randomized studies that compare the procedure to laparoscopic treatments are needed
Most parapelvic renal cysts are found by chance and are generally symptomless but as they are closely associated with the hilar vessels and the collecting system they can produce symptoms of renal obstruction

Summary

Introduction

To investigate feasibility and safety of treating simple parapelvic renal cysts using flexible ureteroscopy with the Holmium laser. At least 20 % of adults will have formed simple renal cysts by the age of 40 and up to 33 % will have developed renal cysts at the age of 60 [1]. Most parapelvic renal cysts are found by chance and are generally symptomless but as they are closely associated with the hilar vessels and the collecting system they can produce symptoms of renal obstruction. The most commonly reported symptoms are lumbar discomfort (followed by urinary tract infection (9.5 %) and hematuria (4.8 %) [2]. Other possible consequences of parapelvic cysts include stone formation, vascular compression, renin-mediated hypertension and Department of Urology, The Second Affiliated Hospital of Zhejiang University A successful diagnosis can be achieved by ultrasonography and contrast-enhanced computer tomography examinations [3]

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