Patients : I am a 55 yr old wht F with recent test results showing 3 renal
cysts (9.3 cm in AP and 7.2 cm transversely, right kidney; 9.5 cm cyst lower
pole of left kidney; 8.7mm cyst in mid-portion of left kidney. Had test
following symptoms of abdominal pain (mild,chronic); significant feelings of
bloating; unexplained wt gain; & chronic lower back pain. Labs show BUN of
30 & Creatinineof1.2; EGFR Non-AFR AM of 50: Bun/CREAT Ratio of 25.0; total
protein 8.3; Globulin 4.0; ALT (SGPT) 29. All other labs run were within normal
range... Cysts were detected with CT exam with oral and IV contrast... Could
these cysts be causing extreme fatigue/weakness; bowel elimination problems as
well as presenting symptoms previously listed? Could this be Polycystic disease?
When is surgery appropriate for renal cysts? I am very responsible with regular
checkups with my urologist (due to history of bladder cancer) and with my GP who
ordered the tests...Have not spoken to either of them since receiving the test
results but am scheduled to see both of them next week. I want to be sure I ask
the right questions and am fully informed re. the significance of these results.
Can you please address these questions? I have done extensive web research but
have not found any protocol for suregery dependent on size or numeber of
cysts.
Doctor :Small simple kidney cysts are commonly seen after the age of 50, they rarely result in symptoms and are accidentally discovered.
Large cysts on the other hand may cause complications and present with pain and deterioration of the kidney function thus may require surgical removal.
Having a history of urinary bladder cancer that was recurrent although early stage, the possibility that a mild obstruction in the urine flow out of the kidney was present. Overtime with back pressure on the kidney, renal cysts can be formed.
This could happen if fibrosis has occurred after resection of the mass in the bladder near the ureteric insertion into the bladder.
Another more serious problem to be excluded is the presence of low grade carcinomas in the urinary tract (since bladder cancer is a part of multifocal disease all through the urinary system from the renal pelvis down to the urethra). This may also cause some sort of renal back pressure and cysts formation.
Another possibility is renal stones that may also result in kidney back pressure.
Radiological examination and endoscopy is essential to exclude any lesion throughout the urinary tract. In addition removal of these cysts for diagnosis as well as for therapy may be needed.
This list of possibilities can be narrowed and more specific investigations and approach can be done only after thorough clinical history and clinical examination.
Doctor :Small simple kidney cysts are commonly seen after the age of 50, they rarely result in symptoms and are accidentally discovered.
Large cysts on the other hand may cause complications and present with pain and deterioration of the kidney function thus may require surgical removal.
Having a history of urinary bladder cancer that was recurrent although early stage, the possibility that a mild obstruction in the urine flow out of the kidney was present. Overtime with back pressure on the kidney, renal cysts can be formed.
This could happen if fibrosis has occurred after resection of the mass in the bladder near the ureteric insertion into the bladder.
Another more serious problem to be excluded is the presence of low grade carcinomas in the urinary tract (since bladder cancer is a part of multifocal disease all through the urinary system from the renal pelvis down to the urethra). This may also cause some sort of renal back pressure and cysts formation.
Another possibility is renal stones that may also result in kidney back pressure.
Radiological examination and endoscopy is essential to exclude any lesion throughout the urinary tract. In addition removal of these cysts for diagnosis as well as for therapy may be needed.
This list of possibilities can be narrowed and more specific investigations and approach can be done only after thorough clinical history and clinical examination.
