Ureteroscopic management of asymptomatic and symptomatic simple parapelvic renal cysts

BACKGROUND: To investigate feasibility and safety of treating simple parapelvic renal cysts using flexible ureteroscopy with the Holmium laser. METHODS: Between February 2010 and July 2013, a total of 21 patients, aging from 29 to 71 (49.00 ± 13.23), were diagnosed with parapelvic renal cysts by ultrasonography in combination with contrast-enhanced computer tomography (CT) and intravenous urography (IVU) in the Department of Urology Surgery, People’s Hospital of the Zhejiang province. Fifteen patients were asymptomatic and 6 patients were symptomatic with flank pain. All patients underwent drainage of the cysts using flexible ureteroscopy with Holmium laser. Patients were followed up 1, 3 and 12 months after the operation. RESULTS: The intervention was successful in 20 patients and failed in 1 patient who, subsequently successfully underwent a laparoscopic cyst removal. There were no intra-operative and post-operative complications reported. The mean operation time was 27 min (range: 15 to 45 min). The mean hospital stay was 2.6 days (range: 1 to 5 days). Twenty patients were followed up until 15 months after surgery. After such ureteroscopic management, there were no renal cysts detected in 7 patients (35 %) and a reduction in size of the renal cysts was found in 13 patients (65 %). Flank pain subsided in all 6 (100 %) previously symptomatic patients. CONCLUSIONS: Flexible ureteroscopy with the Holmium laser may be a feasible and effective treatment option in selected patients with simple parapelvic renal cysts. Further prospective randomized studies that compare the procedure to laparoscopic treatments are needed.