Treatment of renal cysts with single-session percutaneous drainage and ethanol sclerotherapy: Long-term outcome

Objectives. To evaluate the safety, efficacy, and long-term outcome of sing le-session ethanol sclerotherapy for non-neoplastic renal cysts. Methods. In a prospective study, 32 patients with a simple renal cyst were treated with ultrasound-guided percutaneous aspiration, and no more than 10 0 mt sterile 99% ethanol was injected into the cyst. The procedure was perf ormed under local anesthesia, and the patients were hospitalized overnight. The serum concentrations of alcohol immediately after the sclerotherapy an d 1 hour later and the corresponding urine concentrations were measured. Th e mean follow-up period was 55 months (range 12 to 156), Control checkups w ere scheduled at 1, 3, 6, 9, and 12 months after the sclerotherapy. During the control visits, the patients underwent ultrasound measurement of the si ze of the cyst. The history concerning renal pain especially was evaluated by the urologist. The patients were asked if they did or did not have pain. The severity of pain was not evaluated. Results. Sclerotherapy with ethanol was performed successfully in all 32 pa tients with a simple renal cyst. The cyst disappeared completely in 7 patie nts (22%). The mean size of all cysts decreased from 7.8 cm (range 3 to 16) to 1.7 cm (range 0 to 9; P <0.0001), Before the sclerotherapy, 24 patients had symptoms due to the cyst, and 18 of these (75%) were asymptomatic afte r the ethanol sclerotherapy, In 2 patients the pain decreased, 2 patients w ere without change, and in 2 patients the pain increased, There was no corr elation between the size of the cyst and the intensity of pain. No major co mplications occurred. The serum concentration of alcohol varied from 0 to 0 .30 g/L and that in urine from 0.04 to 0.27 g/L. Conclusions. Percutaneous aspiration and sclerotherapy with ethanol for sim ple renal cysts is simple, fast, safe, effective, and inexpensive. The resu lts are comparable to those reported earlier. The treatment is without majo r complications. We propose sclerotherapy with 99% ethanol as the primary t reatment of simple renal cyst. The treatment can be done in an outpatient c linic. UROLOGY 57: 30-33, 2001, (C) 2001, Elsevier Science Inc.