Disposable flexible ureteroscopy for the treatment of ipsilateral parapelvic cyst with secondary renal calculi
Objective To assess the clinical effect of holmium laser lithotripsy combined with intrarenal renal cyst incision and drainage in the treatment of parapelvic renal cysts combined with ipsilateral secondary kidney stones by disposable ureteroscope.Methods From September 2019 to February 2023,58 patients in Beijing Tongren Hospital,Capital Medical University with parapelvic renal cysts combined with ipsilateral secondary kidney stones were treated with holmium laser lithotripsy and intrarenal incision and drainage of renal cysts using disposable ureteroscope.At 1,2,6 and 12 months after surgery,the patients were followed up by ultrasound and/or computed tomography(CT)to detect the recurrence of residual stones and renal cysts.Results The mean age of the patients was(39.3±15.6)years.The average parapelvic cyst size was(5.8±1.9)cm,including 54 Bosniak Class Ⅰ patients and 4 Bosniak class Ⅱ patients.The average size of kidney stones is(13.3±5.5)mm.The mean operation time was(33.4±12.1)min,and the mean length of stay was(2.3±0.7)d.Complications included transient fever(>38℃)in 3 patients and significant bleeding in 1 patient.There were no serious complications.The stone-free rates at 1 month and 2 months were 94.1%(53 cases)and 98.3%(57 cases),respectively.During 1 year of follow-up,the recurrence rate of cysts and stones was 6.9%(4 cases)and 5.2%(3 cases)respectively.Conclusions This study shows that holmium laser lithotripsy combined with intrarenal renal cyst incision and drainage in the treatment of parapelvic renal cysts combined with ipsilateral secondary kidney stones by disposable ureteroscope are safe and effective in the treatment of parapelvic cysts combined with kidney stones,with satisfactory stone removal rate and low recurrence rate of cysts.
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