Kidney cysts

Cysts are fluid-filled vesicles that can occur almost anywhere in the body. The kidneys are also frequently affected. Incidentally, kidney cysts are almost always benign findings that increase with age. About one in five patients over the age of 40 already has at least one kidney cyst. The mechanism by which kidney cysts develop has not yet been clearly explained.

A kidney cyst is extremely easy to detect on ultrasound. This is why the examining doctor will usually point it out to you. However, this is no cause for concern.

A kidney cyst is normally harmless. However, if it grows very large, it can cause symptoms. This usually manifests itself as pain in one flank. On the one hand, the trigger can be urinary retention if the cyst obstructs the flow of urine by pressing on the ureter. On the other hand, the symptoms can be caused by the displacement of adjacent tissue or organs.

In the vast majority of cases, kidney cysts are completely harmless. In rare cases, cysts can become malignant. Chambers or wall thickening of the cyst are suspicious on ultrasound. In case of doubt, the urologist will arrange computed tomography or magnetic resonance imaging. Here, as with ultrasound, the cysts can be classified into categories based on certain criteria (Bosniak classification). At the lowest level, there is no suspicion of malignancy at all and no follow-up is required. If, on the other hand, there are abnormalities, the cyst should at least be monitored over time. At the highest level, nine out of ten cases are malignant tumours, which is why surgery is strongly recommended.

You cannot expect the cyst to regress. In the best case, the cyst stays the same size, but it can also grow.

Kidney cysts rarely need to be treated. The treatment is surgical. In principle, two methods are used: the cyst can either be punctured or removed completely, which is the more sustainable solution.

During puncture, the cyst is first drained with a thin catheter. A sclerosing drug should then also be injected over a few days. Nevertheless, the cyst often grows again after such treatment.

Complete removal of the cyst can be performed openly or using keyhole surgery. The Goldstadt Private Clinic offers all surgical procedures for cyst removal. Robot-assisted da Vinci kidney cyst removal is the preferred surgical method at the Goldstadt Private Clinic.

Patients are admitted for robot-assisted da Vinci kidney cyst removal on the day before the operation. The operation takes place under general anaesthesia. The robot's minimally invasive instruments are inserted into the abdominal cavity using keyhole surgery. Under three-dimensional vision, the surgeon carefully exposes the cyst and removes most of its wall. The robot-assisted surgical technique allows the kidney and its neighbouring structures to be spared as much as possible. Postoperative care takes place in the recovery room before the patient is transferred to the normal ward. The entire inpatient stay lasts approx. 5–6 days.

Thanks to 10x magnification, the anatomical structures can be visualised much better than with conventional laparoscopy. Compared with conventional (open) surgical techniques, this results in less blood loss, less pain and a shorter hospital stay.

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As with any operation, there are general risks such as bleeding, inflammation and impaired wound healing. Rare complications are damage to the kidney or ureter. Opening of the collecting system with leakage of urine is also rare. All possible risks of the surgical procedure are discussed in a detailed consultation before the operation.

As a rule, professional activities such as office work are possible again 2 weeks after the operation. Sporting activities can be resumed after 6–8 weeks.

Kidney cyst removal is performed under general anaesthesia. Due to the very small incisions in robot-assisted da Vinci kidney cyst removal, hardly any pain is to be expected after the operation.