Percutaneous sclerotization of simple renal cysts with 95% ethanol followed by 24-48 h drainage with nephrostomy tube.
OBJECTIVE
We propose some technique devices for treating simple renal cysts with percutaneous puncture (PCN) to reduce recurrences.


METHODS
Between January 1995 and December 1998, a series of 42 patients, 13 females and 29 males, ranging in age between 49 and 73 were treated for symptomatic kidney cystic disease. The cysts varied between 7.4 and 13.6 cm in diameter and from 100 to 570 cm(3) in volume. This technique consists of echo-guided emptying of the cyst, and slowly inserting a quantity of pure 95% ethanol, equivalent to about 1/3 of the cyst volume, into the cavity. This acts as a sclerosant agent on the cyst walls. The protocol of this technique also includes positioning a curled drainage catheter, for 24-48 h, in suction, to ensure a correct collapse of the cyst walls and to avoid cyst recurrence.


RESULTS
Of the 42 patients treated, only 4 did not complete the protocol. In 3 cases, the patients were not able to stand the procedure because of intense pain during cyst filling with alcohol. The other patient had intracystic hemorrhage. The results were evaluated by ultrasonography at 7 days post-operatively and then at 1, 3, 6, 9 and 12 months later. There was a further follow-up lasting from 12 to 36 months. Of 38 patients treated, 29 (76%) did not have any recurrence. 8 patients (21%) developed a small liquid layer of 3-4 cm, which did not enlarge in subsequent check-ups. We observed a recurrence, which spontaneously reduced in volume, only in 1 patient.


CONCLUSIONS
This procedure was simple to apply in an out-patient setting and used low-cost materials which are easily obtained. Moreover, the results appear to confirm the validity of this technique.
De Dominicis
C
C
Department of Urology 'U. Bracci', 3, University 'La Sapienza', Rome, Italy. cdedominicis@uniroma.it
Ciccariello
M
M
Peris
F
F
Di Crosta
G
G
Sciobica
F
F
Zuccalà
A
A
Iori
F
F
D000368:Aged; D003131:Combined Modality Therapy; D004322:Drainage / Q000295:instrumentation* / Q000379:methods; D004869:Equipment Safety; D000431:Ethanol / Q000008:administration & dosage*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015552:Injections, Intralesional; D052177:Kidney Diseases, Cystic / Q000000981:diagnostic imaging / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D015911:Sclerotherapy / Q000379:methods*; D016896:Treatment Outcome; D014463:Ultrasonography
D000431:Ethanol