Long-term results of single-session percutaneous drainage and ethanol sclerotherapy in simple renal cysts.
OBJECTIVE
To demonstrate the efficacy and long-term results of the single-session ethanol sclerotherapy in simple renal cysts.


METHODS
Ninety-eight cysts in 97 patients (range: 18-76 years; mean age, 54 years) were included in the study. Indications were determined as flank pain in 74, hydronephrosis in 12, hypertension in 8, patient reassurance due to increasing cyst size in three patients. Mean follow-up period was 24.4 months. Procedures were performed with the guidance of fluoroscopy and ultrasonography at all times using 5-7 Fr pigtail catheters. After the cystogram that was obtained in all cases, 95% ethanol with a volume of 30-40% of the cyst volume was used as a sclerosing agent on an outpatient basis. Maximum volume of the injected ethanol was 200 ml. Follow-up examinations were performed 1, 3, 6 and 12 months after the procedure and once every year thereafter.


RESULTS
Average cyst volume reduction was 93% at the end of the first year. The cysts disappeared completely in 17 (17.5%) patients. After the procedure, in 67 (90%) patients improvement in flank pain was noted. Sixty-one (82%) patients were free of pain and in 6 (8%) of them the pain decreased. Normotension was obtained in 7 (87.5%) of the 8 hypertensive patients and no hydronephrosis was detected in 10 (83.3%) of the 12 patients after the procedure. Second intervention was required in 2 (2%) patients due to recurrence of cysts and related symptoms. One (1%) patient had small retroperitoneal hematoma that resolved spontaneously and in another (1%) patient spontaneous hemorrhage was detected into the cyst 1 year after the procedure. No other complication was detected during the procedure and follow-up.


CONCLUSIONS
Percutaneous treatment of simple renal cysts with single-session sclerotherapy is a safe, effective and minimally invasive procedure and can be used as an alternative to multiple-session sclerotherapy with comparable results. High volume, up to 200 ml ethanol can be used without adverse effects for large renal cysts.
Akinci
Devrim
D
Department of Radiology, School of Medicine, Hacettepe University, Shhiye, Ankara TR-06100, Turkey. akincid@hotmail.com
Akhan
Okan
O
Ozmen
Mustafa
M
Gumus
Burcak
B
Ozkan
Orhan
O
Karcaaltincaba
Musturay
M
Cil
Barbaros
B
Haliloglu
Mithat
M
D000293:Adolescent; D000328:Adult; D000368:Aged; D004322:Drainage / Q000009:adverse effects / Q000379:methods*; D000431:Ethanol / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015552:Injections, Intralesional / Q000379:methods; D007668:Kidney / Q000000981:diagnostic imaging; D052177:Kidney Diseases, Cystic / Q000601:surgery / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D012597:Sclerosing Solutions / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D015911:Sclerotherapy / Q000009:adverse effects / Q000379:methods*; D012997:Solvents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D013995:Time; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome; D014463:Ultrasonography
D012597:Sclerosing Solutions; D012997:Solvents; D000431:Ethanol