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  • Kidney function - to be or not to be?

    As it is known, according to the research of statistics, every fourth person aged over 42 years shows one or even several kidney cysts, the sizes of which exceed 10 mm. Moreover, the frequency of detection of this disease is the greater, the older the person, there not less than eight out of a hundred people with this pathology need serious treatment.

    The need for a different kind of medical manipulation arises only when the patient has complaints:

    1. for pain or discomfort in the kidney projection;
    2. on changes in the nature of urine or trouble urinating;
    3. for increased blood pressure.

    Also a reason to treat a kidney cyst seriously is the large size of the cyst( 50 mm or more) and the presence of other diseases of this organ, for example, pyelonephritis or urolithiasis. If there are no above complaints, and the kidney cyst itself does not exceed 50 mm, then such a patient is recommended to perform once or twice a year an ultrasound examination of the kidneys in order to control the growth or stability of the volume of volume formation.

    For today with the medical-diagnostic purpose the most successful technique with minimal invasiveness is percutaneous puncture of the kidney. In some cases, if there is evidence, laparoscopic surgery or open access can be performed.

    What is a puncture of the kidney cyst?

    Puncture of the kidney cyst is a medical manipulation that involves the puncture of the formation, the suction of liquid contents from it, which is then sent for examination, and often the introduction of a sclerosant. This procedure is performed using a special needle under the control of ultrasound or X-ray imaging of the organ.

    This is important! Puncture of the kidney cyst with suction of its contents in more than half of the cases soon led to its reappearance. Since this was only part of the solution to the problem: the contents were removed, and the walls lined with fluid-secreting cells remained, which caused the development of relapses. At the moment, the problem of refilling the once drained cyst disappeared, thanks to the use of the method of sclerosing the cavity.

    Sclerotherapy of the cavity during kidney puncture is carried out by introducing pure ethanol( 96%) in an amount equal to about a quarter of the volume of the extracted liquid, a combination of alcohol with antibiotics or antiseptics is also applied, after 7-15 minutes the drug is extracted from the cyst.

    This is important! Some experts recommend a longer exposure time for sclerosant( up to 2 hours).Also, according to the data of a number of authors, after 12 hours of repeated renal puncture with the introduction of ethanol or another sclerosing agent, a much more pronounced effect is achieved and the probability of recurrence of the cyst decreases.

    How is the kidney puncture performed?

    The procedure for puncturing the kidney cyst is performed under local anesthesia and takes a little more than half an hour. The patient is asked to lie down on a healthy side or on the stomach, the site of the future puncture is treated with an antiseptic and corked with an anesthetic. A special puncture needle pierces the skin and underlying tissues, and then it is injected into the cyst under the control of the ultrasound machine( X-ray machine) and the contents of the cavity are extracted through it. Usually, the fluid obtained during the kidney puncture has a straw-yellow hue, but if the cyst has degenerated into a malignant tumor, the punctate may be reddish or even brown.

    Part of the obtained liquid is sent for cytological and biochemical studies. After the evacuation of the contents of the cysts, its walls collapse, and a contrast medium is injected into the cavity to check whether it communicates with the calyx or the renal pelvis. In the case where the cavity is isolated from other kidney structures, sclerosing drugs are administered.

    Contraindications to puncture

    In a number of cases, the kidney puncture can not be performed because of contraindications:

    1. Multiple or multi-chamber cysts - to achieve a positive result from kidney puncture, it is necessary to remove the contents and sclerosis all cysts or all chambers of the same formation, but with such a course of this kidney pathology it is difficult to produce the procedure in the required volume;
    2. Calcification or sclerosis of the wall of the cyst - due to compaction of the cystic membrane after removal of the liquid, it does not subside, therefore the puncture in this case is not effective;
    3. Paraplevikalnoe location of the cyst - with this location of education percutaneous access to it is difficult;
    4. The cyst communicating with the renal cavity system - the introduction of sclerosing substances is impossible, since they will spread through the cavity system, damaging it;
    5. Its diameter exceeds 75-80 mm - at such sizes the probability of its recurrence after puncture is very high.

    This is important! The larger the size of the cyst, the less effective it is for sclerotherapy. This statement concerns formations whose diameter has passed for 7 centimeters.

    In these cases, a puncture with the introduction of ethanol may be ineffective or unavailable due to the localization of the formation, therefore alternative methods of its treatment are performed, such as laparoscopic surgery or removal through open access.

    Possible effects of renal puncture

    Kidney function is a procedure that is performed on an outpatient basis and in most cases does not require in-patient follow-up. The consequences of puncture are rare, since the capabilities of modern ultrasound devices can avoid the majority of possible errors during manipulation, such as damage to large blood vessels and / or the renal tubular system.

    The likelihood of the development of infectious complications in this procedure is also low, because after the puncture the patient is prescribed a preventive course of antibacterial drugs.

    Sometimes patients can note such consequences of kidney puncture as nausea, fever, the appearance of a hematoma at the puncture site, redness of the urine, but usually all these phenomena are short-lived and do not require specific treatment.

    This is important! After the puncture and sclerotherapy of the cyst, the probability of complete cure is 74-100%; if the procedure was performed twice( the second one 12 hours after the first), this figure reaches 94%.

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