Non-conservative management of simple renal cysts in adults: a comprehensive review of literature

Time course of histopathological changes after bleomycin sclerotherapy in rabbit gallbladders as a model for simple hepatic cysts

“…Percutaneous aspiration with sclerotherapy is a minimally invasive, simple, safe, inexpensive and reasonably effective treatment for cystic diseases, such as simple hepatic, renal, splenic, pancreatic and ovarian cysts, as well as for lymphoceles ( 1-4 ). Bleomycin has been used successfully for management of cysts ( 3 , 4 ); it is an antibiotic chemotherapeutic agent derived from Streptomyces verticillus , which was first used as a sclerosant for malignant pleural effusions in 1976( 5 ). Intralesional bleomycin injection has been used successfully for the treatment of cystic diseases, including lymphoceles since 1977( 6 ), cystic craniopharyngiomas since 1985( 7 ), bronchogenic cysts since 1992( 8 ), simple renal cysts since 2012( 9 ) and simple hepatic cysts since 2015( 10 ).…”

Comparison of aspiration with sclerotherapy and laparoscopic deroofing for the treatment of symptomatic simple renal cysts: a systematic review and meta-analysis

“…By contrast, renal cysts with medium (> 4 cm) or large diameter (> 7 cm) are more likely to become symptomatic, with several complications including back pain, urinary tract infection, hemorrhage, hematuria, and hypertension [ 2 – 4 ]. However, there is not a direct association between cyst’s size and symptoms, because even a small cyst can lead to a clinical manifestation depending on its location [ 5 ]. The Bosniak classification—proposed for the first time in 1986—allows to classify renal cysts in five categories (i.e., I, II, IIF, III, and IV) based on their morphology and enhancement properties [ 6 ].…”

“…Yet, it has been estimated that 8% of simple renal cysts become symptomatic and need intervention [ 7 , 8 ]. Due to their growth, indeed, simple renal cysts can cause symptoms such as hypertension, hematuria, pain, parapelvic obstruction, and, in some cases, can undergo rupture [ 5 ]. For this reason, an intervention for this disease is indicated for all symptomatic patients, with the main goal of excising the cyst wall and evacuating the fluid [ 1 , 6 , 9 ].…”

“…For this reason, an intervention for this disease is indicated for all symptomatic patients, with the main goal of excising the cyst wall and evacuating the fluid [ 1 , 6 , 9 ]. There are currently several strategies for the treatment of symptomatic simple renal cysts, such as percutaneous aspiration with or without sclerosing agents, laparoscopic deroofing with transperitoneal and retroperitoneal approaches, robotic surgery, and open surgery [ 5 ]. Although the first two techniques are the most commonly used [ 5 ], to our knowledge, no clear indication exists for choosing between aspiration with sclerotherapy and laparoscopic deroofing.…”

“…There are currently several strategies for the treatment of symptomatic simple renal cysts, such as percutaneous aspiration with or without sclerosing agents, laparoscopic deroofing with transperitoneal and retroperitoneal approaches, robotic surgery, and open surgery [ 5 ]. Although the first two techniques are the most commonly used [ 5 ], to our knowledge, no clear indication exists for choosing between aspiration with sclerotherapy and laparoscopic deroofing. To address this issue, we carried out a systematic review and a meta-analysis of studies, which evaluated and compared the efficacy of aspiration with sclerotherapy and laparoscopic deroofing for the treatment of symptomatic simple renal cysts.…”