ASPIRATION AND SCLEROTHERAPY OF SYMPTOMATIC SIMPLE RENAL CYSTS - VALUE OF 2 INJECTIONS OF A SCLEROSING AGENT

OBJECTIVE. The purpose of our study was to determine whether two injec tions of sclerosant were more effective than a single injection in tre ating symptomatic simple renal cysts. SUBJECTS AND METHODS. We reviewe d our results obtained by simple aspiration, by aspiration and a singl e sclerosant injection, and by aspiration followed by two injections o f sclerosing agent over 48 hr. We used 95% alcohol because of its capa city to safely sclerose the epithelial lining of renal cyst walls with out damaging the renal parenchyma. After 1-3 min of contact with the a lcohol, the epithelial cells lining the cyst become fixed and nonviabl e; the cyst capsule is penetrated only after 4-12 hr. Longer contact o f alcohol with the epithelial cell lining should theoretically result in the nonviability of more epithelial cells and therefore in a lower recurrence rate of cysts after aspiration and sclerotherapy. Our subje cts were 46 patients, 30 men and 16 women, treated over a 13-year peri od. They ranged in age from 38 to 75 years old (mean age, 47 years). F ifty-two cysts were treated. Twenty patients (20 cysts) had simple asp iration only, 15 patients (19 cysts) had a single injection of scleros ant after aspiration, and 11 patients (13 cysts) had two sclerosant in jections after aspiration. RESULTS. Of the 20 patients who had simple aspiration only, 16 cysts had recurred after 2 years. In the single-in jection group of patients, we found six recurrences after 2 years. No recurrence has occurred in the group of patients who had two sclerosan t injections after aspiration. CONCLUSION. Our findings suggest that t he results of treating symptomatic simple renal cysts are better in te rms of recurrence with two successive injections of 95% alcohol, proba bly because of the nonviability of more epithelial cells lining the cy st as a result of a longer period of contact with the alcohol. Our son ographic finding of pseudotumors at the sites of previously aspirated giant cysts in two patients is recorded.