Treatment of renal parapelvic cysts with a flexible ureteroscope

The aim of this study was to assess efficacy and safety of a flexible ureteroscope to treat renal parapelvic cysts. Treatment goals included avoidance of injury to renal vessels or hilar structure and minimizing the recurrence of cysts.

Renal parapelvic cysts from 15 patients that were incised and drained with a flexible ureteroscope were evaluated retrospectively between October 2011 and May 2013. Mean operation time, estimated blood loss and time of hospital stay were evaluated. Symptomatic and radiologic results, conducted by computed tomography or color Doppler ultrasound, were analyzed after surgery.

According to the Dindo-Clavien classification, no major complications were observed during the different types of surgery. One patient exhibited red hematuria (mild), while bladder irritation symptoms (mild) occurred in three cases in the hospital and in two cases in the first postoperative month (moderate). Average total operation times, mean duration for the incision in the renal parapelvic cyst wall and mean estimated blood loss were 31 ± 8 min, 13 ± 2 min and 20 ± 5 ml, respectively. Mean hospital length of stay was 3 days. Radiologic success was defined as no recurrence of the cyst or a reduction in cyst size by at least half. In one case, cyst size did not reduce to half of the previous size, whereas cyst sizes were reduced to less than half of the previous size in four cases. No cysts were detected in the other cases after 6 or 12 months.

Feasibility, safety and efficacy of the flexible ureteroscope for treatment of retrograde renal parapelvic cysts were demonstrated using appropriate patient selection and skilled surgical technique.