Quiste renal simple / Simple Renal Cyst

Los quistes renales simples son poco frecuentes en recién nacidos, niños y adolescentes. Suelen ser únicos, y ocasionalmente múltiples. No existen evidencias de riesgo familiar. El objetivo de la presentación fue resaltar la importancia del diagnóstico precoz de malformaciones congénitas y/o defectos estructurales del feto, por ultrasonografía, en la atención primaria de salud. Presentamos las imágenes ecográficas de un caso de afectación fetal por un quiste renal simple a las 36 semanas, sin otros hallazgos ultrasonográficos. Previo asesoramiento genético y dado la avanzada edad gestacional y el buen pronòstico con que cursan estos casos además de no tener otro defecto genético asociado, la pareja decidió la continuación del embarazo. El caso fue confirmado por ecografía posnatal(AU)

Simple renal cysts are rare in newborns, children and adolescents. They tend to be unique, and occasionally multiple. There is no evidence of family risk. The objective of the presentation was to highlight the importance of early diagnosis of congenital malformations and / or structural defects of the fetus, by ultrasonography, in primary health care. We present the echography of a case of fetal involvement by a simple renal cyst at 36 weeks, with no other ultrasonography findings. The parents decided to continue the pregnancy previous genetic counseling, given the advanced gestational age and good prognosis with these cases, and considering there is no other genetic defect associated. The case was confirmed by postnatal ultrasound(AU)

Comparison of percutaneous resection and laparoscopic deroofing of renal cysts / 中华泌尿外科杂志

Objective To compare the short term clinical efficacy of percutaneous resection and laparoscopic deroofing of renal cysts.Methods From October 2013 to June 2016,the data from 39 cases with renal cysts were followed for approximately 22 months (ranging 5-36 months).Patients were randomized into two groups.In the resectoscopic group(17 pts),the mean age of those patients was 57 years (ranging 34-81 years).The mean size of these cysts was 6.4cm (ranging 5.4-8.2 cm).The mean preoperative creatinine was 66.5μmol/L (ranging 38.1-108.8μ mol/L).The mean preoperative sodium was 141.4μ mol/L(ranging 135.6-145.1μmol/L).The mean preoperative potassium was 4.0μmol/L (ranging 3.4-4.7 μmol/L).In the latter laparoscope (22pts),the mean age of these patients was 60 years (ranging 46-73 years).The mean size of these cysts was 6.8cm (ranging 4.3-8.9cm).The mean preoperative creatinine was 74.8μmol/L (ranging 48.6-141.9μmol/L).The mean preoperative sodium was 141.5μmol/L(ranging 135.0-146.1 μmol/L).The mean preoperative potassium was 4.0μmol/L (ranging 3.1-4.8μmol/L).The operative time,blood loss,days of drainage,hospital stay and complications were compared with the two groups.Results All of the 39 cases were accepted the procedure successfully without open conversion.Compared the resectoscopic group with Laparoscopic,the mean operative time was 29.7 min (ranging 15-50 min) and 63.0min (ranging 20-1 00 min),mean blood loss was 36.6ml(ranging 10-80 ml) and 60.4ml(ranging 10-200 ml),days of drainage was 2.3 days and 3.1 days,hospital stay was 3.7 days and 5.1 days,the mean postoperative creatinine was 67.4 μmol/L(ranging 43.8-95.5 μmol/L) and 68.9μmol/L(ranging 46.5-157.6 μmol/L),the mean postoperative sodium was 141.2μmol/L(ranging 136.0-147.2 μmol/L) and 141.6 μmol/L(ranging 136.0-147.2 μmol/L),the mean postoperative potassium was 3.8 μmol/L (ranging 3.2-4.3 μmol/L) and 3.8μmol/L (ranging 3.3-4.3 μmol/L).The overall postoperative pathology was renal cysts.All cases were followed for approximately 19 months (ranging 6-35 months) and 22 months (ranging 5-36 months) in reseetoscopic and laparoscopic group respectively.No cysts recurrence was found by ultrasound.Conclusions Compared with laparoscopic deroofing,use of resectoscopic technology significantly enhances the possibility of achieving better intraoperative results in all patients with renal cysts.Percutaneous resection of simple renal cysts is safe and feasible.

The Clinical Value of Ultrasound-Guided Percutaneous Lauromacrogol Injection Sclerotherapy for Simple Renal Cyst / 中国生化药物杂志

Objective To analyze the clinical value of ultrasound-guided percutaneous Lauromacrogol Injection sclerotherapy in the treatment of simple renal cyst. Methods A total of eighty patients with simple renal cyst, who were divided into 40 groups according to the random number table, were divided into two groups from February 2016 to April 2017. The traditional group used traditional open renal cyst unroofing decompression. Ultrasound guided ultrasound guided percutaneous Lauromacrogol Injection sclerotherapy was performed in the ultrasound guided group. The therapeutic effect, operation time and the rate of successful puncture were compared between two groups of simple renal cysts. It needs to compare the volume of the cyst and the quality of life before and after the intervention. Results Ultrasound guided group simple renal cyst treatment effect was higher than the traditional group (P<0.05). The operation time of the ultrasound guided group was shorter than that of the traditional group, and the success rate of the one shot puncture was higher than that of the traditional group(P<0.05). Before the intervention, the volume and quality of life of the two groups were similar. In the ultrasound guided group, the volume and quality of life in the ultrasound guided group were better than those in the traditional group(P<0.05). Conclusion Ultrasound guided percutaneous Lauromacrogol Injection sclerotherapy is of high clinical value in the treatment of simple renal cysts. The utility model can improve the success rate of one puncture, shorten the operation time, and the exact effect can speed up the regression of symptoms and reduce the volume of the cyst. Therefore, this method can improve the quality of life of patients.

Clinical features and impact factors of simple renal cysts / 中国综合临床

Objective To analyze the main clinical features and impact factors of simple renal cyst (SRC), and to provide evidence for the future prevation and cure of simple renal cysts.Methods In this crosssectional study,a total number of 91 433 participants(aged 18-98 years old) were included who underwent health examinations during 2012-2014.The main life styles and clinical features of each participants were recored,and blood biochemistry test, urinanalysis and renal ultrasonography were performed.Results The prevalence of SRC was 2.70％ (2 465 subjects were diagnosed by ultrasonography).It was higher in men than women(2.95％ vs.1.68％, P =0.00), which was increased with the increasing of age (respectively 0.37％, 0.57％, 1.30％ ,2.69％ ,4.46％ and 6.91％ in the group of ≤29year,30-39 year,40-49 year,50-59 year,60 -69 year and ≥70 year,P＜0.01).The maximum diameter of simple renal cysts were (2.6±1.7) cm.Age,rate of men, body mass index, glucose, total cholesterol, creatinine, urea nitrogen, and urinary protein positive rate, kidney stone prevalence were higher in SRC group(respectively (61.11±11.24)year vs.(51.37±13.72) year, 87.59％ vs.79.88％, (25.27 ± 3.19) kg/m2 vs.(24.97 ± 3.35) kg/m2, (6.09 ± 2.08) mmol/L vs.(5.70 ± 1.85) mmol/L, (5.11 ± 1.54) mmol/L vs.(5.02 ± 1.37) mmol/L, (90.71 ± 34.84) μmol/L vs.(80.72 ±28.04) μmol/L, (6.03±3.60) mmol/L vs.(5.55±5.15) mmol/L,7.46％ vs.4.25％ ,7.06％ vs.1.28％ ,P ＜0.01) ,but glomerular filtration rate, triglycerides, rate of like salty, drink, smoke was lower than the group withoutSRC((79.01±19.89) ml/(min· 1.73 m2) vs.91.74±21.8 ml/(min · 1.73 m2),(1.57±1.48) mmol/L vs.(1.69± 1.82) mmol/L, 4.38％ vs.7.94％, 22.68％ vs.30.75％, 24.91％ vs.30.97％;P＜ 0.01).But,there was no difference between these two groups in serum uric acid ((309.16± 85.79) μmol/L vs.(312.38±91.22) μmol/L,P＞0.05).SRC as a dependent variable of multivariate log regression analysis.The result showed the OR of age, gender, fasting blood glucose, urea nitrogen, glomerular filtration rate, positive urine protein,kidney stone were respectively 1.040, 1.862, 1.035, 1.005,0.982, 1.254, 4.526, 95％ CI =1.037 -1.045,1.643-2.110,1.017-1.053,1.000-1.010, 0.980-0.984, 1.068-1.473,3.812-5.374;P ＜0.01).While the OR of multiple SRC was 0.43,95％ CI: 0.210-0.867 (P＜0.05) , when kidney stone as a dependent variable.Conclusion Old-age males are high risk population of catching SRC.Kidney stone and positive urine protein are important risk factors of SRC.Meanwhile kidney stone more easily induce single and small SRC.SRC is a key risk factor to induce renal function decrease.Therefore, GFR is a sensitive index of renal disfunction that induced by SRC.

Relationship of Simple Renal Cyst to Hypertension / 가정의학회지

BACKGROUND: Simple renal cyst is the most common cystic deformation found in adults. However, there were a few systematic Korean reports for the clinical symptoms and complications of simple renal cysts. The author's purpose was to determine the relationship between simple renal cysts diagnosed by abdominal ultrasonography and hypertension. METHODS: Among 13,482 persons who took a routine physical examination at Ulsan University Hospital in 2002, 5,127 persons who took medical examinations again in 2010 were selected. We excluded persons who had renal cyst, hypertension, diabetes, liver cirrhosis, kidney disease, thyroid disease, and cancer in 2002. Analysis was conducted for 505 subjects with newly diagnosed simple renal cyst and 2,744 subjects without renal cyst in 2010. The simple renal cyst group was compared to a control group without renal cyst. RESULTS: Among 3,249 subjects, simple renal cyst and hypertension were newly diagnosed in 505 subjects and 503 subjects. The subjects who had simple renal cysts had significantly higher hypertension incidence (odds ratio [OR], 1.53; 95% confidence interval [CI], 1.20 to 1.94). Significant hypertension incidence was observed especially when the subjects had cysts located on both kidneys (OR, 3.48; 95% CI, 2.12 to 5.71), two (OR, 3.08; 95% CI, 1.84 to 5.15) or more cysts (OR, 3.12; 95% CI, 1.38 to 7.04), and larger cysts more than 1 cm in diameter (OR, 1.55; 95% CI, 1.16 to 2.07). CONCLUSION: The presence of simple renal cysts was significantly positively related to the incidence of hypertension. Bilateral distribution, two or more number, and larger size than 1 cm diameter were the characteristics of simple renal cyst related to hypertension.

CT-Guided Sclerotherapy for Simple Renal Cysts: Value of Ethanol Concentration Monitoring

OBJECTIVE: The aim of our study was to evaluate the differences between sclerotherapy with and without ethanol concentration monitoring for the treatment of simple renal cysts. MATERIALS AND METHODS: Sixty-seven patients with 70 simple renal cysts were randomly assigned to two groups in a 12-month prospective controlled trial. One group (group A) was treated with computed tomography (CT)-guided sclerotherapy without ethanol concentration monitoring (33 patients with 35 cysts), whereas the other group (group B) had ethanol concentration monitoring (34 patients with 35 cysts) during the procedure. Treatment outcomes between the two groups were compared 12 months later with follow-up ultrasound examination. RESULTS: After the 12-month follow-up period, the overall success rate was 74.3% in group A and 94.3% in group B (p = 0.022). The mean cyst size before and after treatment was 8.6 +/- 2.0 cm and 2.3 +/- 2.9 cm, respectively, in group A, and 8.4 +/- 1.7 cm and 0.8 +/- 1.9 cm, respectively, in group B. The final size of the cysts in group B was significantly smaller than that in group A (p = 0.015). The likelihood of treatment with ethanol concentration monitoring being successful was approximately 16 times higher than without ethanol concentration monitoring (p = 0.026; odds ratio = 15.7; 95% confidence interval: 1.38-179.49). There were no major complications in either group. CONCLUSION: Monitoring of Hounsfield units (HU) of ethanol by CT is an effective method in the treatment of simple renal cysts with ethanol sclerotherapy. The ethanol sclerotherapy procedure can be terminated at the point of clear fluid aspiration because the HU (-190) of CT scan corresponds to it.

Glomerular Filtration Rate Difference between Renal Cyst Group and Control Group / 가정의학회지

BACKGROUND: The simple renal cyst is the most prevalent cystic deformation in adults and is most of them are incidentally found during medical examination. In this study, the clinical differences were compared between simple renal cyst and control groups diagnosed by abdominal ultrasonography during periodic medical examination. METHODS: We randomly selected 2,277 persons who took medical examination in one general hospital health promotion center. Among them, analysis was conducted for 188 subjects with simple renal cyst and 188 subjects without renal cyst whose sex, age, and body mass index were matched. Renal cyst subjects were compared with control group to search for their relationship with hypertension, renal function and microscopic hematuria, past medical history, social history, results of other abdominal ultrasonography findings, urine test, and blood test. RESULTS: Among 2,213 subjects, simple renal cyst was found in 188 subjects (8.5%). The subjects who had more than three simple renal cysts were significant older (P = 0.05) and the oldest age was 70's. Also, higher hypertension prevalence (P = 0.05), more microscopic hematuria, higher serum creatinine (P = 0.02), and lower glomerular filtration rate (P < 0.01) were observed in simple renal cyst group. CONCLUSION: It is needed to survey size, shape and change of simple renal cyst using abdominal ultrasonography as well as how its progression may be related to developing hypertension, decreased renal function and microscopic hematuria.

Long Term Follow-up Results of Percutaneous Aspiration with Sclerotherapy of the Simple Renal Cyst / 대한비뇨기과학회지

PURPOSE: Recently the percutaneous aspiration with sclerotherapy of the simple renal cyst are being widely used because of the high success rate and the low morbidity. However, studies concerning the long term result of this technique have been rarely reported. Thus, we performed this study to evaluate the long term results of this technique. MATERIALS AND METHODS: We evaluated the long term result of the treatment in 20 cases of simple renal cysts from July 1993 to July 1998. The symptoms associated with simple renal cysts were: none(55%), pain(35%) and palpable mass(10%). The simple renal cysts were treated with percutaneous aspiration and injection of 99% ethanol in 15 cases or percutaneous aspiration and injection of 10% tetracycline solution in 5 cases. All were followed by ultrasound from 18 to 58 months(mean 32.7 months). RESULTS: Complete collapse, partial collapse and recurrence of the renal cysts were 5/15(33.3%), 7/15(46.6%), 3/15(20%) in 99% ethanol group and 3/5(60%), 1/5(20%), 1/5(20%) in 10% tetracycline solution group, respectively. Overall efficacies were 80% in both groups. Furthermore, all recurrences occurred within the first year of follow up period in both groups. CONCLUSIONS: Therefore, percutaneous aspiration with sclerotherapy using 99% ethanol or 10% tetracycline solution seem to be an effective way to prevent re-accumulation of cystic fluid. It also proved to have a positive long term result concerning the relapse of the simple renal cyst.

Comparison of Single and Repeated Sclerotherapy Using a Pigtail Catheter for Simple Renal Cyst / 대한비뇨기과학회지

PURPOSE: Although simple renal cysts are benign and most of them do not require treatment, intervention is needed when symptom or urinary obstruction appears. Sclerotherapy of renal cyst is usually performed in conjuction with aspiration in simple renal cyst because of the high recurrence rate of 30-70% in aspiration alone. We compared the results of single and repeated percutaneous slcerotherapy in patients with simple renal cyst. MATERIALS AND METHOD: Sixty three patients with symptomatic or urinary obstruction causing simple renal cysts received ultrasound guided needle aspiration and sclerotherapy between March 1990 to December 1996. 42 patients received sclerotherapy once immediately after aspiration(group 1), and 21 patients received sclerotherapy at least twice after indwelling a 6.0 Fr pigtail catheter into the renal cyst(group ll). Follow-up with ultrasonography was performed in a 3 month internal for at least 6 months. Disappearance of the renal cyst was considered as complete regression and more than 50% reduction in the diameter of the remaining cyst as partial regression. RESULTS: The mean diameter of the renal cyst in group 1 (6.12cm) and 2(6.75cm) were not significantly different. Complete and partial regression were 8/42 (19.0%), 16/42(38.1%) for group 1 and 15/21(71.4%), 5/21(23.8%) for group 2, respectively. The overall success rate was significantly better in group 2(95.2%) compared to group 1(57.1%)(p<0.001). The pre-operative size of the cyst was not related to recurrence rate(p=0.184). CONCLUSIONS: These data suggest that repeated sclerotherapy using a pigtail catheter is better than single session for reducing the recurrence of simple renal cyst.

The Prevalence of Simple Renal Cysts Studied by Ultrasonography, and the Relations to Age and Hypertension / 대한신장학회잡지

Simple renal cyst is the most common space- occupying lesion of kidney in adults. However, there were a few systematic Korean reports for the prevalence of simple renal cysts. Our purpose was to estimate the prevalence of simple renal cysts using ultrasonography, and to determine the relations to age and hypertension. The subjects were 504 volunteers (aged over 29 years) of the persons who were enrolled a health check-up program of Naju Hospital, Naju, Korea. Number of male in 504 persons was 334 (66.3%) and female 170 (33.7%). Mean age was 55 years (range; 30-86). The results were as follows: 1) One or more renal cysts were found in 50 individuals of 504 persons aged over 29 years (9.9%). In 331 persons aged over 49 years, the prevalence of simple renal cysts was 12.1%. The prevalence was significantly increased with age (P<0.001), but the difference between male (9.6%) and female (10.6%) was insignificant. 2) Mean value of cyst diameter was 23mm (5-69 mm) and was not correlated with age. However, the cyst diameter was significantly higher in female than in male, 32.4mm vs 18.0mm (P<0.001). Total number of cysts per person tended to increase with age (P<0.001). 3) The correlation between prevalence of simple renal cysts and blood pressure was statistically insignificant. However, the prevalence of hypertension in persons with cysts was higher than in persons with no cyst (27.9% vs 15.3%, P<0.05). Cyst diameter was not correlated with blood pressure. 4)Urinalysis in persons with cysts, showed microscopic hematuria in 47.4% and proteinuria in 26.3 %, however, grade of microscopic hematuria and proteinuria were not correlated with cyst diameter. The concentrations of blood urea nitrogen, serum creatinine, hemoglobin and hematocrit were not affected by presence or absence of simple renal cysts. By comparison with the recent foreign reports, the prevalence of simple renal cysts in Korean was similar to those in foreigners. Our study ascertained that simple renal cysts are age-dependent and total number of cysts per person also increases with age. In most of persons with simple renal cysts, the renal function is not affected and the related symptoms are trivial. However, we suggested that simple renal cysts may cause hypertension. To elucidate the correlation between simple renal cyst and hypertension, further studies are needed.

Effect of Percutaneous Aspiration and Repeated Sclerotherapy of the Simple Renal Cyst / 대한비뇨기과학회지

Recently the percutaneous aspiration and sclerotherapy has become the most advocated procedure for the symptomatic, large, and simple renal cyst because of its minimal invasiveness and high effectiveness. But the recurrence rate of the simple aspiration and sclerotherapy was reported highly (30-70%). We analysed the effect of percutaneous aspiration and repeated sclerotherapy of the renal cyst in 42 patients from Nov. 1989 to Apr. 1995. Sclerosing agent were 99% ethanol in 33 cases, minocycline in 4 cases, and only aspiration was done in 6 cases. The method of repeated sclerotherapy was achieved about 2.2 times as which aspiration and instillation of sclerosing agent in standing of 8.3 Fr. pigtail catheter during average 2.5 days. After follow up for 17.4 (6-59) months, the complete collapse rate of the renal cyst was 78.7% in the using group of 99% ethanol. 25% in minocycline, 16.696 in the aspiration only. The complete collapse rate according to the times of sclerotherapy was 45.5% in one times, 78.6% in two times, 92% in three times. In conclusion, the sclerotherapy of the simple renal cyst with 99% ethanol was most effective, and we can be expect that the rate of complete collapse has been increased in the repeated sclerotherapy.

Percutaneous Aspiration and Instillation of Ethanol for the Simple Renal Cysts / 대한비뇨기과학회지

Recently the percutaneous aspiration and instillation with 95% ethanol, for the sclerosing therapy of the renal simple cyst, was widely used because of high recurrence rate in simple needle aspiration. Ten patients were instillated with ethanol after aspiration. Ages of patients were between 37 to 77 years old. Chief complaints were flank pain, gross hematuria, indigestion, epigastric discomfort and hypertension. After local anesthesia, the cysts were punctured with a trocar needle and inserted 8.3 Fr. single J-catheter with guide wire in turn, under ultrasonic guidance. After complete aspiration of the fluid, 95% ethanol was instillated as much as 20-30% of the cystic volume, and kept for 20-30 minutes. The pigtail catheter was removed after one day. The aspirated volume was 166 ml in average and nearly identical to transudate. There was no bacteria or malignant cells. Follow-up period was 7+/-2 months in average. Five cases were completely cured, four cases recurred but the cyst was smaller(< 50% of the original size) and one recurred as its original size. The complications were transient flank pain and facial flushing. In conclusion, aspiration and instillation with ethanol was very easy, safe, fast and effective treatment for the simple renal cyst.

Clinical Features and Treatment of Simple Renal Cyst / 대한비뇨기과학회지

We analysed 3,130 patients with simple renal cyst who were discovered in 27,216 men receiving routine ultrasound examination in our hospital. Incidence of simple renal cyst was 11.5% in all populations and ratio of male to female was 1.8: 1. Patients age ranged from 14 to 91 years (average age 63.8 years) and number of renal cysts were increased after fifth decade in both sexes. Size of cysts were increasing along with age. And 201 cases visiting Urology Department were examined on symptoms. Symptoms associated with simple renal cysts were : none( 77.6% ), pain ( 11.4% ), gross hematuria( 4.0% ) and epigastric discomfort( 3.0% ). Benign renal cysts were treated with percutaneous aspiration in 9 cases, percutaneous aspiration with sclerosing agent in 13 cases and only follow-up in asymptomatic 29 cases. All were followed by ultrasound from 6 to 38 months(average 27 months). Overall efficacy were 44.4% with aspiration and 92.2 % with combined therapy. Sclerosing therapy using 99% ethanol seems to be a safe and effective way to prevent reaccumulation of cystic fluid in symptomatic cases. But routine follow-up is sufficient in asymptomatic cases, since simple renal cysts increase slowly in size.

Simple Renal Cyst Treatment: Ultrasound-guided Aspiration Alone or with Instillation of 99% Ethanol into Renal Cyst / 대한비뇨기과학회지

Thirty-eight benign renal cysts in 35 patients were treated with or without 99% ethanol during diagnostic aspiration under ultrasonic guidance. All were followed by ultrasound from 3 to 59 months. There were twelve (80% ) recurrences in simple aspiration group. Two cases ( 6.25% ) were recurred in ethanol instillation group. All of the five symptomatic patients were relieved of subjective symptoms such as flank pain after alcohol instillation. Minor complications of local pain and temperature elevation were no more prevalent than with simple aspiration alone. There was no major complication. In conclusion, it is reasonable to treat and prevent of renal cyst by ablation of the cyst with alcohol at the same time as diagnostic procedure.

Ultrasound-guided Aspiration and Instillation of 95% Ethanol for Simple Renal Cyst / 대한비뇨기과학회지

Percutaneous aspiration followed by instillation with 95% ethanol was performed on 15 patients with benign renal cyst. 86.6% of patients showed remarkable reduction in size of renal cyst or abscence of cyst on sonography. Nine(81.8%) of the 11 symptomatic patient were relieved of subjective symptoms such as flank pain after instillation. There was no major complication with this procedure. A slight local irritable pain was noticed in 2 cases and 1 patient had not flush but three symptom were only temporary. This treatment seems to be a safe and simple and effective way to prevent recurrence of the cyst.

A Case of Giant Simple Renal Cyst / 대한비뇨기과학회지

Recently with the development of several diagnostic methods, incidence of renal cyst is progressively increased. Renal cysts are usually asymptomatic, produce no harm to the kidney and require no treatment once diagnosed. Herein was reported observation on a cases of giant simple renal cyst which revealed a palpable mass on the right upper quadrant in a 55 years old male. This case was definitely diagnosed by the physical examination, intravenous pyelography, ultrasonography, renal cystography, and selective renal angiography, and the cystic cavity which bad pin point sized communication with middle calyx of right kidney contained about 1300cc of clear yellowish fluid, The unroofing of cyst was performed, and also calycorrhaphy of middle calyx of right kidney was done.