Efficacy of single-session percutaneous drainage and 50% acetic Acid sclerotherapy for treatment of simple renal cysts

Abstract

Purpose: To evaluate the efficacy and long-term results of single-session 50% acetic acid sclerotherapy for the treatment of simple renal cysts, and to compare the therapeutic results of 5 and 20 min sclerosant dwell techniques.

Methods: During the past 9 years, 50% acetic acid sclerotherapy was performed on 67 cysts in 66 patients. An acetic acid volume corresponding to a mean of 23% of the aspirated cyst volume was injected into the cysts. A 20 min dwell time with position changes was performed in 32 cysts (31 patients; group I) and 8% of volume for a 5 min dwell time in 35 cysts (35 patients; group II). Three- and 6-month sonographic or CT follow-up was performed for a minimum of 1 year. Complete regression was defined as no remaining cyst measurable on sonography with or without a scar at the renal cortex. Partial regression was defined as a decreased cyst volume compared with that before sclerotherapy. The Mann-Whitney U-test was used to compare the therapeutic results between the two groups.

Results: For 67 simple renal cysts, complete regression on follow-up was observed in 21 of 32 cysts (66%; group I) and 22 of 35 cysts (63%; group II); the remaining 24 cysts all showed partial regression. The partial reduction rate of the cyst's volume was 97.4% (91.3-99.4%) in group I and 96.9% (90.8-99.5 %) in group II. There were no procedure-related major complications, and no statistically significant differences in the complete regression and partial volume reduction rates between the two groups (p > 0.05).

Conclusion: Fifty percent acetic acid is an effective and safe sclerosing agent for simple renal cysts. Fifty percent acetic acid sclerotherapy with a 5 min sclerosant dwell time, using a volume of about 10% of the aspirated volume, is sufficient for satisfactory results of simple renal cyst sclerotherapy.