What is a kidney cyst
A simple cyst is a cavity with thin smooth walls filled with clear fluid. It is formed when a small section of the kidney tubule becomes detached and becomes a closed sac.
Such cysts are usually single, grow very slowly and do not affect the functioning of the kidney. They are found by chance during an ultrasound, prescribed for a completely different reason.
Separately, polycystic kidney disease is a hereditary disease in which multiple cysts form in both kidneys, gradually displacing normal tissue. This is a fundamentally different condition with a different prognosis and different management tactics.
Bosniak classification: why it's important
All renal cysts are graded according to the Bosniak classification based on contrast-enhanced CT. It answers the main question: what is the probability that it is not a cyst, but a tumor.
- Bosniak I - a simple cyst with a thin wall, without septations or inclusions; does not require treatment
- Bosniak II - cyst with thin septa or small calcifications; almost always benign, observation is usually sufficient
- Bosniak IIF - intermediate category, requires dynamic control
- Bosniak III - thickened septa, accumulation of contrast; significant risk of malignancy, usually requires surgical treatment
- Bosniak IV - the presence of a soft tissue component that accumulates contrast; is regarded as a malignant formation
Symptoms
Small simple cysts do not cause symptoms. Complaints appear when the size or complications are significant.
- Dull pain or heaviness in the lower back and hypochondrium on the affected side
- Palpable formation with very large cysts
- Increased blood pressure if the cyst compresses the kidney tissue and blood vessels
- Blood in urine
- Recurrent urinary tract infections
- Impaired urine outflow and hydronephrosis when the cyst is located in the pelvis area
- Sharp pain and fever during cyst suppuration
- Sudden pain when a cyst ruptures, often after injury
Diagnostics
- Renal ultrasound is the primary method; determines size, location and structure
- CT with intravenous contrast is the standard for Bosniak evaluation
- MRI is an alternative for iodine contrast intolerance and in pregnant women
- General urine test
- Blood creatinine and kidney function assessment
- Blood pressure control
- Biopsy - only in selected cases, when the result will change the tactics
A separate task of the examination is to clarify whether the multiplicity of cysts is a manifestation of polycystic disease, especially if relatives had similar problems.
When does a cyst need to be treated?
Most simple cysts do not require intervention - a control ultrasound once a year is sufficient. Treatment is discussed in specific situations.
- The cyst causes persistent pain
- Large size with compression of the renal tissue or collecting system
- Impaired urine outflow and development of hydronephrosis
- Cyst-associated hypertension
- Cyst suppuration
- Hemorrhage into the cyst or its rupture
- Category Bosniak III–IV or suspicious dynamics
- Rapid growth on observation
Treatment methods
- Cyst puncture with sclerotherapy - under ultrasound control, the contents of the cyst are removed with a needle and a sclerosing agent is injected so that the walls stick together; low-traumatic method, but relapse is possible
- Laparoscopic excision of the cyst - removal of the free wall of the cyst through several punctures; the most radical method for simple cysts, relapses are rare
- Open excision of the cyst - in complex location or in combination with other interventions
- Partial nephrectomy or nephrectomy for Bosniak III–IV cystic lesions when a tumor cannot be ruled out
- Fine needle aspiration for polycystic disease - for decompressing large cysts and reducing pain
- Antibacterial therapy and drainage - for suppuration
Observation: what is important to know
- A simple cyst can be monitored by ultrasound approximately once a year.
- Tell your doctor if you experience pain, blood in your urine, or increased blood pressure.
- Save previous pictures and conclusions - dynamic comparison is more important than a one-time description
- Avoid injury to the lumbar region with large cysts
- Control your blood pressure
- Do not try to “dissolve” the cyst with herbs and dietary supplements - there are no proven methods for conservative elimination of cysts
Where kidney cysts are examined and treated in Tashkent
To make the right decision on a cyst, you need high-quality ultrasound and CT with contrast, and, if necessary, the ability to perform a puncture under ultrasound guidance or laparoscopic surgery.
In Tashkent, such examination and treatment are carried out at the UROLOGIC COMPLEX medical center and at the Tashkent Medical Park clinic.
Take all previous ultrasound descriptions to your appointment: the dynamics of size over the years often turns out to be a decisive argument in favor of observation or, conversely, intervention. Clinic contacts are below on the page.
