Sclerotherapy of renal cysts using acetic acid: a comparison with ethanol sclerotherapy

Cho, D S; Ahn, H S; Kim, S I; Kim, Y S; Kim, S J; Jeon, Gyeong Sik; Won, Jong Uk

doi:10.1259/bjr/41664864

Cited by 22 publications

(27 citation statements)

References 20 publications

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“…Although the etiology of renal cysts is not known exactly, it is claimed that it may be caused by the obstruction and ischemia of distal convoluted tubule (13). Most of the cysts are asymptomatic, and their regular follow-up is sufficient with regard to detecting malignant transformation.…”

Section: Discussionmentioning

confidence: 99%

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

Kadıhasanoğlu¹,

Kilciler²,

Atahan³

2016

Istanbul Med J

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Simple renal cysts are those with a benign character, which are frequent and generally asymptomatic, and which involve columnar epithelium (1, 2). Their prevalence increases with age, and it has been shown in studies that they are seen at a rate of 40% in the 40-year-old age group and at a rate of 50% above the age of 50 years (2, 3). Although most of the renal cysts are asymptomatic, patients may have complaints of side pain and hematuria, and also findings such as cyst rupture, hemoperitoneum, and hypertension may be seen (4).Renal cysts can be treated with various methods when they are symptomatic. As they may be symptomatic with pain, they may also be symptomatic with bleeding and superinfection (5). They can be treated with open, laparoscopic, endoscopic, or percutaneous methods (6, 7). Because there may be repeated effusion due to the live cyst wall as a result of cyst aspiration percutaneously, percutaneous methods are used mostly for diagnostic purposes (8). Sclerosing agent injection can be applied afterwards to decrease relapse. Endoscopically, marsupialization or excision of the cyst and removal of the cyst wall with laparoscopic methods are commonly applied treatment alternatives. Among these, percutaneous cyst aspiration and sclerotherapy performed with sclerosing agent injection are the most preferred treatment alternatives because they cause less pain and bleeding, involve a shorter hospitalization duration, and they can be applied even to outpatients (9). It has been demonstrated in previous studies that percutaneous sclerotherapy is practical, effective, and cost effective (10).Sclerotherapy is the prevention of fluid production by destroying the epithelium lining the inside of the cyst and the provision of adhesion (9). Protein denaturation takes place in sclerotherapy performed with ethanol, and fibrous scar tissue forms after cell death (8). Bismuth phosphate, minocycline, ethanolamine oleate, povidone iodine, tetracycline, and iodized oil as sclerosing agents were used with cyanoacrylate, sodium tetradecyl, hypertonic saline, ethanol, and acetic acid (11). Apart from efficacy, showing the least systemic effects or local complications, having high availability, and being cost effective are important in sclerosing agent selection. The cyst fluid volume can be followed, and the sclerosing therapy can be continued by placing the percutaneous nephrostomy catheter for the purpose of increasing the efficacy of the sclerotherapy applied after aspiration of the cyst percutaneously.Percutaneous Nephrostomy and Sclerotherapy with 96% Ethanol for the Treatment of Simple Renal Cysts: Pilot Study Introduction: The objectives of this study was to evaluate the safety and efficacy of aspiration with percutaneous nephrostomy tube and sclerotherapy with 96% ethanol for simple renal cyst.Methods: Between 2011-2014, 34 patients with symptomatic renal cysts were included in the study. Mean age was 52.3±4.6 years (range, 39-72 years). The patients had only flank pain. Procedure was performed with ultrasound guidan...

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Section: Discussionmentioning

confidence: 99%

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

Kadıhasanoğlu¹,

Kilciler²,

Atahan³

2016

Istanbul Med J

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“…Obstruction and ischemia of the distal convoluted tubule has been postulated as an etiology of renal cysts [10]. Most simple cysts are asymptomatic, and usually, regular follow-up is sufficient for management.…”

Section: Discussionmentioning

confidence: 99%

The comparison of percutaneous ethanol and polidocanol sclerotherapy in the management of simple renal cysts

et al. 2015

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“…The volume of ethanol injected after aspiration varies from 15% to 75% of the cyst volume, the maximum volume being 100-200 mL in various reports (5, 7, 8, 11, 16). The concentration of ethanol applied varied from 95 to 99.9%, but no author has been able to demonstrate any difference in the results related to these variations (1, 5, 7, 8, 11, 13, 16).…”

Section: Discussionmentioning

confidence: 99%

“…The maximum volume of ethanol injected was 200 mL to avoid systemic side effects, irrespective of the size of the cyst. The patient was placed in the prone and bilateral decubitus positions at least one time during 20 minutes in order to achieve satisfactory contact between alcohol and all surfaces of the cyst cavity (1, 6, 7, 11). Then the ethanol injected was completely removed and complete deflation of the cyst cavity was verified by CT.…”

Section: Methodsmentioning

confidence: 99%

“…Percutaneous aspiration with single or multiple session sclerotherapy has successfully been performed with high success rates. Several sclerosing agents have been used to exterminate the cyst wall epithelium, including ethanol (1-3, 5, 6), polidocanol (4), acetic acid (7), OK-432 (8), ethanolamine oleate (9), sodium tetradecyl sulfate (10), and 20% hypertonic saline (11). …”

Section: Introductionmentioning

confidence: 99%

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

Yang

et al. 2014

Korean J Radiol

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ObjectiveThe 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 MethodsSixty-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.ResultsAfter 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.ConclusionMonitoring 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.

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Sclerotherapy of renal cysts using acetic acid: a comparison with ethanol sclerotherapy

Cited by 22 publications

References 20 publications

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

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

The comparison of percutaneous ethanol and polidocanol sclerotherapy in the management of simple renal cysts

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

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