The kidney cyst in most cases proceeds without severe symptoms and does not require treatment. If the pathology is accompanied by pain, increased blood pressure or disorders of excretory function, then the patient is shown surgery. Nowadays, doctors try to do without organ resection and most often perform a puncture of a kidney cyst. This is a painless and less traumatic method of surgical treatment. How is the procedure going? And how effective is it? We will consider these issues in the article.
Description of procedure
The doctor performs a puncture of the kidney cyst under the supervision of an ultrasound scan. The surgeon makes a small incision on the skin, inserts a needle into the cystic cavity and removes fluid. The contents are sent to the laboratory for histological examination. An empty cavity remains in place of the cyst, which subsequently overgrows.
This method of surgical treatment has the following advantages:
- low invasiveness;
- low likelihood of complications;
- fast recovery of the patient’s health after surgery.
However, the puncture of the kidney cyst has its drawbacks. After such an operation, a relapse of the pathology cannot be ruled out. To avoid the reappearance of a cyst, sclerosing drugs are introduced into the cavity during a puncture.
In addition, with a puncture, an infection can get into the excretory organs. Therefore, the procedure must be carried out, strictly observing the rules of asepsis. Also, to prevent infection, a postoperative course of antibiotic therapy is prescribed.
Indications
If the cyst is small and does not affect the functioning of the kidneys, then the operation is not performed. In this case, the patient is assigned a dynamic observation. He needs to periodically visit a urologist, as well as undergo laboratory and instrumental examinations.
If the pathology proceeds unfavorably, then the patient needs a puncture of the kidney cyst. Indications for the operation are as follows:
- severe pain syndrome;
- urination disorders;
- persistent arterial hypertension of renal origin;
- large sizes of the cyst;
- high risk of malignancy of cystic cavity cells.
In the old days, in the presence of such symptoms, it was necessary to excise or completely remove the kidney. Today, surgical treatment of cysts is most often carried out by puncture. Resection is used only in extreme cases.
Contraindications
Puncture of a kidney cyst can be done not by all patients. This surgery has contraindications. Therefore, before the operation, it is necessary to undergo a comprehensive examination to clarify the size, localization and structure of the neoplasm,
Contraindications to the puncture are as follows:
- Excessively large sizes of the cystic cavity (more than 7-8 cm). In such cases, the cyst often recurs, even with the introduction of sclerotic drugs. Such patients are shown a resection of the kidney.
- Sealed cyst walls. Such a cavity is almost impossible to sclerosize, since its dense walls do not stick together. Puncture in this case is ineffective.
- Localization of the cyst in the renal pelvis or sinuses. In such hard-to-reach areas of the body, it is impossible to penetrate through an incision in the skin.
- The cyst communicates with the renal tubule system. In this case, it is impossible to glue the walls of the cavity. A sclerosing substance will inevitably enter the tubules and spread throughout the organ, resulting in severe kidney damage.
- Multiple and multi-chamber cysts. During the puncture, the surgeon has to remove the contents from each neoplasm or chamber. Then the affected areas must be sclerotized. Carrying out a puncture is significantly complicated and rarely leads to positive results.
In addition, the puncture is not done in the acute period of any disease. The procedure is postponed until the patient recovers completely.
Preparation rules
If the patient was prescribed a puncture, it is necessary to carefully prepare for the procedure. Surgeons recommend the following rules:
- A week before surgery, you need to stop taking blood thinners.
- A few days before the procedure, vegetables, fruits and flour products are excluded from the diet.
- The puncture is performed on an empty stomach. The last meal is allowed no earlier than 8 - 9 hours before surgery.
- If the procedure is prescribed in the morning, then in the evening on the eve of the puncture, you need to clean the intestines with an enema.
It is also necessary to cut the hair in the lower abdomen and in the pubic zone. Shaving vegetation is not recommended. This can lead to irritation of the epidermis, and the skin in the surgical field must be healthy.
If the patient suffers from varicose veins, then compression underwear should be taken with you. It must be worn before the procedure and worn after a puncture.
Methodology
The patient lies on the operating table. The position of the body depends on the location of the neoplasm. Then the doctor treats the surgical field with antiseptics and injects local anesthetics.
When carrying out a puncture accuracy is necessary. It is very important not to touch the kidney parenchyma and blood vessels with a needle. Therefore, the entire procedure is controlled by ultrasound. With the help of ultrasound, the surgeon determines the necessary depth and location of the instrument. After that, the doctor puts on a special clamp on the needle. This device controls the depth of puncture. In addition, the needle is equipped with a special tip, which is visible on the monitor of the ultrasound machine. This ensures high accuracy and safety of the procedure.
The surgeon makes a small incision on the skin with a scalpel. Then the doctor spreads the tissues and fastens them with clamps. A needle is placed through an incision in the cystic cavity and the contents are evacuated.
Puncture is supplemented with the following procedures:
As already mentioned, the neoplasm may appear again after a puncture. A kidney cyst of 3 cm or more often recurs. Therefore, in many cases, the procedure is supplemented by sclerotherapy. Ethanol solution is introduced into the cystic cavity. The amount of sclerosing agent should be 1/4 of the volume of the removed fluid.
Ethyl alcohol is left in the cavity of the cyst for 5 to 20 minutes. During this time, the cells of the walls of the cyst die off and cease to produce fluid. Then ethanol is removed. If the procedure was successful, then the walls of the cystic cavity stick together. This minimizes the likelihood of relapse pathology.
If pus or blood is detected in the removed cystic fluid, then immediate sclerosis is contraindicated. In this case, drainage is first done. Special tubes are inserted into the cavity and cleaned and rinsed.
Drainage is left for 3 to 5 days until the signs of inflammation disappear completely. During this time, reorganization is repeated several more times. Then a sclerosing agent is introduced and the drainage tubes are removed.
How painful is the procedure? This question is of interest to many patients. Here is the opinion of those patients who did a puncture of a kidney cyst. In the reviews, it is reported that during the puncture and removal of the liquid, no painful sensations arise. This is due to the fact that the procedure is performed under local anesthesia. However, with the introduction of a sclerosing agent, most patients experience a strong burning sensation.
Possible complications
If the operation was performed by a qualified surgeon, then complications are extremely rare. If medical errors were made during the puncture, this can lead to trauma to the vessels and hemorrhage in the cystic cavity or fiber of the kidney. The needle can also damage the organ parenchyma, which in the future can provoke an inflammatory process. However, serious errors during the operation are very rare, since the procedure is carried out under the supervision of ultrasound.
In violation of the rules of asepsis, an infection can penetrate the kidney. This leads to the development of purulent inflammation. Some patients may experience an allergic reaction to an anesthetic or an ethanol solution for sclerotherapy.
Postoperative period
In the reviews about the removal of the kidney cyst by puncture, it was noted that after the procedure, many patients had a fever. In addition, a large hematoma is usually formed at the puncture site. However, such symptoms should not cause concern. This is a natural reaction of the body to surgery. After a few days, the fever goes away, and the hematoma resolves within 1 - 2 weeks.
If the puncture has passed without complications, then the patient is discharged from the hospital 2 to 3 days after the procedure. If drainage was used during surgery, then the hospital stay may be delayed up to 7 days.
At home, the patient needs to take antibiotics to prevent possible infection.
Within 7 - 10 days after discharge from the hospital, the following recommendations should also be observed:
- Wear a special bandage.
- Avoid physical exertion.
- Do not take alcohol or diuretics.
- Exclude spicy and salty foods from the diet.
2 weeks after the puncture, the patient must go to the doctor for an ultrasound examination. This is necessary to monitor the condition of the cavity.
If the patient determines the repeated production of cystic fluid during an ultrasound examination, then dynamic observation is necessary for 2 months. If this process continues for six months, then the puncture is performed again. However, relapse of the pathology after sclerosis is quite rare.
Patient opinion
You can find many positive reviews about the puncture of the kidney cyst. The reports indicate that the procedure was almost painless. Slight discomfort occurred only during the exposure of ethanol to the cyst walls. However, the burning sensation disappeared immediately after removal of the sclerosing substance.
Reviews of patients about the puncture of the kidney cyst indicate that the body recovers quite quickly after the intervention. About 2 weeks after the procedure, patients were able to return to their usual lifestyle.
Relapse of the pathology was very rare. Re-allocation of cystic fluid was diagnosed mainly in those patients who had not been sclerosed. Bonding of the walls of the cyst is contraindicated in patients with concomitant renal pathologies. This group of patients had to do repeated puncture. In such cases, it is advisable to use other surgical methods for treating cysts.