Factors that influence the success rate in sclerotherapy of simple renal cysts with polidocanol

Aim: To evaluate the efficacy of aspiration and sclerotherapy with polidocanol (ASP) of symptomatic renal cysts and to assess factors that influence the success rate.

Subjects and methods: 54 patients with 61 cysts were treated with this method. The diameter of the cysts ranged from 5 to 13cm. The technique consists of puncture with 0.8–1.2mm Chiba needles, aspiration followed by injection of sclerosing agent (polidocanol 2–3%, 2–6ml).The efficacy was assessed 6 weeks later, with a decrease of 90% or more in volume being considered succesful. If the residual volume was larger then 10% a new session was performed. The patiens were folowed by ultrasound for 3–24 months.

Results: The efficacy was 42.6% after one injection, 54.01% after two and 3.2% after three injections.The recurence was encountered in 10% of cases (6 cysts), 5 beeing successful retreated with the same technique and 1 with laparoscopic surgery. Complications were noted in 2 cases, one with intracystic bleeding and 1 with intracystic septa formation. The following factors were associated with a higher succes rate: smaller cysts (diameter below 6cm), cysts in the right kidney and in young males, two injections and higher amount and concentration of sclerosing agent.

Conclusions: The treatment of renal cysts with ASP is an eficient and safe technique with succes rates depending on the initial volume of the cysts, number of sessions, concentration and amount of polidocanol injected and patient's age and sex.