Eight patients with histologically proven hydatid disease of the urinary tract underwent eosinophil count, ultrasonography (US) and computed tomography (CT). The findings were compared with those in 8 age-matched controls with simple renal cysts. Eosinophilia was not significantly different in the 2 groups. Mixed echogenicity on US and multivesicular cyst with mixed density on CT were the diagnostic features of hydatid cysts. Using these factors, both US and CT could diagnose or exclude hydatid disease in a significant number of patients with renal cysts. However, CT was more sensitive (88 vs 50%) and accurate (94 vs 75%) than US in the diagnosis of urinary tract hydatid disease. Retrograde pyelography confirmed communicating renal hydatid cysts in 2 patients. A practical algorithm for the investigation of urinary tract hydatid disease is suggested.
Eleven patients with hydatid disease of the urinary tract have been seen in the last 5 years. Seven patients had cysts of the kidneys and 4 had large retrovesical hydatids. Seven of the 8 patients with renal hydatids presented with loin pain and mass. Three patients with renal communicating hydatids also presented with haematuria which was due to passing "grape skin" (hydatid membrane) in the urine. Two patients with retrovesical hydatids had bladder outflow obstruction and 2 had bilateral ureteric obstruction leading to uraemia. Eight of 11 patients had associated hydatids of other organs such as the liver (4 patients), peritoneal cavity (2) and lungs (1). Computed tomography was the most useful and specific investigation. In both renal and pelvic (retrovesical) hydatid cysts, endocystectomy with either partial excision or plication of the ectocyst is the standard treatment. In renal communicating hydatids the options are either nephrectomy (partial or total) or endocystectomy with closure of the communication. The use of cryocone and scolicidal agents is mandatory during surgery.
Eleven patients with hydatid disease of the urinary tract have been seen in the last 5 years. Seven patients had cysts of the kidneys and 4 had large retrovesical hydatids. Seven of the 8
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