Water under the bridge: 5-Year outcomes after percutaneous ablation of obstructing parapelvic renal cysts

Background and Purpose: There have been no large case series reporting on the success of percutaneous transparenchymal endocystolysis for obstructing parapelvic renal cysts. We report the largest series to date with 5-year outcomes. Patients and Methods: Percutaneous endocystolysis was performed in eight patients with obstructing parapelvic cysts between September 1998 and May 2002. The patients ranged in age from 52 to 79 years. Each patient underwent preoperative CT and retrograde pyelography. Postoperative follow-up, ranging from 60 to 103 months (mean 83.9 months), has included both symptomatic and radiologic assessment. Results: There were no intraoperative or postoperative complications. The mean operative time was 55 minutes (range 34-135 minutes). The mean decrease in the hematocrit was 2.7% (range 0.2-4.9%), with no patient requiring blood transfusion. The mean hospital stay was 1.3 days (range 1-2 days). Two patients have persistent small fluid-filled cysts but no clinical or radiographic evidence of obstruction. The six remaining patients have no evidence of symptomatic or radiographic recurrence. Conclusions: Percutaneous endocystolysis is an effective minimally invasive treatment option for obstructing parapelvic cysts and is associated with excellent 5-year outcomes.