Percutaneous Nephrostomy and Sclerotherapy with 96% Ethanol for Treating Simple Renal Cysts: Pilot Study

Abstract

Introduction: The objectives of this study were to evaluate the safety and efficacy of aspiration with percutaneous nephrostomy tube and sclerotherapy with 96% ethanol for a simple renal cyst.Methods: Between 2011 and 2014, 34 patients with symptomatic renal cysts were included in the study. The mean age was 52.3±4.6 years (range, 39–72 years). The patients had only flank pain. The procedure was performed with ultrasound guidance and under fluoroscopic control. After the puncture using an 18-G angiography needle, the guidewire was advanced to the collecting system. A 14-Fr nephrostomy catheter was then advanced over the guidewire. After cystography, 96% ethanol was injected into the cyst and drained amount 10%. We continued to daily inject the same amount of ethanol postoperatively until the drainage was <50 mL. Six months and yearly follow-up were performed using ultrasound.Results: Percutaneous access was achieved in all patients. Cysts were unilateral and single, with a mean diameter of 9.1±3.2 cm (range, 7–16 cm). The median drained volume was 212 mL (200–1600 mL), and the median injected ethanol volume was 54 mL (20–160 mL). Radiological improvement at the end of the sixth month and first year was 94.1% and 91.1%, respectively; 83.3% of patients had symptomatic decline. No major complication was observed after the procedure. Six patients had minor complications (pain) that resolved with medical treatments.Conclusion: Treating symptomatic simple renal cysts by aspiration with percutaneous nephrostomy tube and sclerotherapy with 96% ethanol was an efficient, cheap, safe and minimally invasive treatment alternative.

Keywords

• Simple renal cyst
• percutaneous nephrostomy
• sclerotherapy
• ethanol