Water under the Bridge: 5-Year Outcomes after Percutaneous Ablation of Obstructing Parapelvic Renal Cysts

Abstract

Percutaneous endocystolysis is an effective minimally invasive treatment option for obstructing parapelvic cysts and is associated with excellent 5-year outcomes.

Different Successful Management Strategies for Obstructing Renal Parapelvic Cysts

“…Aspiration alone is associated with a high recurrence rate, as demonstrated in one of our patients. Laparoscopic management remains the favoured option, particularly in patients with multiple or anteriorly located parapelvic cysts [2]. However, laparoscopic decortication for parapelvic cysts is technically more challenging and associated with significantly greater blood loss and operative time compared to surgery for peripherally sited simple cysts, though both procedures have similar complication rates [3].…”

“…However, laparoscopic decortication for parapelvic cysts is technically more challenging and associated with significantly greater blood loss and operative time compared to surgery for peripherally sited simple cysts, though both procedures have similar complication rates [3]. Antegrade percutaneous nephroscopic ablation, with cyst wall fulguratation using a resectoscope with a rollerball electrode, has also been demonstrated to be safe and effective [2]. More recently, retrograde management with flexible ureteroscopy and incision and drainage of the renal cyst wall using a holmium laser has been demonstrated to be safe and effective [5].…”

“…There is a paucity of literature directly comparing different treatment options for symptomatic parapelvic cysts due to the rarity of the condition [2]. Currently, the management of parapelvic cysts is determined by anatomical characteristics and patient choice, as well as the expertise of surgical and radiology departments.…”

“…Potential complications include hydronephrosis, vascular compression, renin induced hypertension, stone formation, cyst rupture or haemorrhage [2]. We describe 3 patients with symptomatic, obstructing parapelvic cysts presenting at our institution over a 9-year period and provide valuable learning points gathered at the time of investigation and propose ways of managing this uncommon condition.…”

Pure Natural Orifice Translumenal Endoscopic Surgery Management of Simple Renal Cysts: 2-Year Follow-Up Results

“…1,14,15 Ureteroscopic marsupialization was first reported in 1991 5 as a complete transurethral natural orifice translumenal endoscopic surgery (NOTES) 16 that was significantly less invasive than percutaneous nephroscopy or laparoscopy. 4,14 Unfortunately, no large case series studies have reported on the success of this technique in the management of simple renal cysts. To investigate the feasibility and safety of this technique, we retrospectively examined the results of retrograde ureteroscopic marsupialization in the management of symptomatic simple renal cysts using 2 years of follow-up data.…”