Long-term results of surgical treatment of solitary kidney cysts

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Abstract


Introduction. Simple kidney cyst is a common disease that may need surgical treatment for pain, hypertension and kidney obstruction. Long term results of kidney cyst treatment need further investigation.

The aim of the study was to assess patient complaints and kidney ultrasound sonography data in patients in a long term after percutaneous cyst aspiration (PCA) with sclerotherapy and laparoscopic decortications of the cyst wall (LDC).

Patients and methods. In this retrospective study clinical data of 891 patients (277 (31,1%) men and 614 (68,9%) women, mean age 61,8 years) with simple kidney cysts operated by PCA and LDC (754 (84,6%) and 137 (15,4%) patients respectively) due to back pain, hypertension, big cyst size and obstruction of urine flow from the kidney was analyzed. Control survey and ultrasound sonography scans were performed in 80 (18,1%) patients, including 40 (50%) patients after PCA and 40 (50%) patients after LDC.

Results. At control sonography kidney cysts were found in 32(80%) and 27(68%) patients after PCA and LDC respectively, but median cyst size decreased. Compared to PCA, LCD more often resulted in complete disappearance of cysts and also caused more prominent cyst size reduction (p = 0,027), however the lengths of stay (LOS) was longer after LDC (p = 0,005). After surgery the back pain and hypertension persisted in many patients, while the flow of urine from the kidney normalized in all patients.

Conclusions. LDC compared to PCA was more effective in complete cyst removal and caused more significant decrease of cyst size. The LOS was longer after LDC, both LDC and PCA were effective in regaining urinary flow from the kidney. Back pain and hypertension should be considered relative indications for surgical treatment of kidney cysts.


Igor A. Korneyev

Author for correspondence.
iakorneyev@yandex.ru
I.P. Pavlov First Saint Petersburg State Medical University
Russian Federation, Saint Petersburg

doctor of medical science, professor, Department of Urology

Artem O. Kiselev

iakorneyev@yandex.ru
I.P. Pavlov First Saint Petersburg State Medical University
Russian Federation, Saint Petersburg

student, Department of Urology

Evgenij Ju. Ishutin

iakorneyev@yandex.ru
I.P. Pavlov First Saint Petersburg State Medical University
Russian Federation, Saint Petersburg

urologist, urologic clinic

Jurij A. Radomskij

iakorneyev@yandex.ru
I.P. Pavlov First Saint Petersburg State Medical University
Russian Federation, Saint Petersburg

urologist, urologic clinic

Salman H. Al-Shukri

alshukri@mail.ru
I.P. Pavlov First Saint Petersburg State Medical University
Russian Federation, Saint Petersburg

doctor of medical science, professor, head of the department. Department of Urology

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