title: Ureteroscopic management of asymptomatic and symptomatic simple parapelvic renal cysts.
abstract: BACKGROUND
  To investigate feasibility and safety of treating simple parapelvic renal cysts using flexible ureteroscopy with the Holmium laser.
  
  
  METHODS
  Between 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.
  
  
  RESULTS
  The 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.
  
  
  CONCLUSIONS
  Flexible 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.
authors.affiliation: Department of Urology, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, P.R. China. evevev96@hotmail.com.
authors.forename: XiaWa
authors.initials: X
authors.lastname: Mao
authors.affiliation: Department of Urology, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, P.R. China. Zxlxg12@163.com.
authors.forename: Gang
authors.initials: G
authors.lastname: Xu
authors.affiliation: Department of Urology, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, P.R. China. Wuhuifengdoc@163.com.
authors.forename: HuiFeng
authors.initials: H
authors.lastname: Wu
authors.affiliation: Department of Urology, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, P.R. China. Jiaquanxiao@hotmail.com.
authors.forename: JiaQuan
authors.initials: J
authors.lastname: Xiao
mesh_terms: D000328:Adult; D000368:Aged; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D052177:Kidney Diseases, Cystic / Q000175:diagnosis* / Q000601:surgery*; D007682:Kidney Pelvis / Q000473:pathology / Q000601:surgery*; D053685:Laser Therapy / Q000379:methods*; D053844:Lasers, Solid-State / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D064847:Multimodal Imaging / Q000379:methods*; D012008:Recurrence; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome; D018608:Ultrasonography, Doppler; D018666:Ureteroscopy / Q000379:methods*; D014567:Urography / Q000379:methods