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Radiologically guided percutaneous aspiration and sclerotherapy of symptomatic simple renal cysts: a systematic review of outcomes

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Abstract

Simple renal cysts are common benign lesions of the kidney with up to 4% of patients developing symptoms necessitating intervention including pain and haematuria. We conducted a systematic review of the literature to determine the efficacy and safety of aspiration–sclerotherapy of symptomatic simple renal cysts. A systematic review using Cochrane guidelines was conducted on published literature from 1990 to 2020. RCTs, cohort studies and case series meeting the inclusion criteria were reviewed and cumulative analysis of outcomes was performed. A total of 4071 patients from 57 studies underwent aspiration ± sclerotherapy for their simple renal cysts. 87.7% of patients who had aspiration with sclerotherapy demonstrated ‘treatment success’ with a >50% reduction in cyst size and complete resolution of symptoms. 453 minor, transient complications occurred (11.2%) whilst a major complication rate of less than 0.1% (4 patients) was reported. Pooled analysis of all available current literature demonstrates that aspiration–sclerotherapy is a safe and effective first-line therapy for symptomatic simple renal cysts. Although we are unable to compare those undergoing aspiration alone to aspiration–sclerotherapy, it is evident the use of a sclerosing agent is integral to treatment success; however, the optimum agent, volume, injection frequency, and dwelling time are yet to be defined. Cyst size should be considered when discussing treatment options; however, we conclude it reasonable for aspiration–sclerotherapy to be used in the first instance in all cases of symptomatic simple renal cysts. Furthermore, we propose definitions of treatment outcome measures in order to allow direct comparative analysis across future studies.

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Authors and Affiliations

  1. Department of Urology, Broomfield Hospital, Chelmsford, UK

    Dominic Brown

  2. Department of Urology, University Hospital Monklands, Glasgow, UK

    Sarika Nalagatla & Tarik Amer

  3. Department of Urology, St George’s Hospital, Tooting, London, UK

    Thomas Stonier

  4. Department of Urology, Princess Alexandra Hospital, Harlow, UK

    Georgios Tsampoukas

  5. Department of Surgery, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar

    Abdulla Al-Ansari & Omar M. Aboumarzouk

  6. University of Medicine, Veterinary and Life Science, University of Glasgow, Glasgow, Scotland, UK

    Omar M. Aboumarzouk

  7. College of Medicine, Qatar University, Doha, Qatar

    Omar M. Aboumarzouk

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DB involved in project development, data collection, data analysis and manuscript writing. SN performed data collection, data analysis and manuscript editing. TS, GT and AA did manuscript editing. TA and OA participated in data analysis and manuscript editing.

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Brown, D., Nalagatla, S., Stonier, T. et al. Radiologically guided percutaneous aspiration and sclerotherapy of symptomatic simple renal cysts: a systematic review of outcomes. Abdom Radiol 46, 2875–2890 (2021). https://doi.org/10.1007/s00261-021-02953-9

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