Parapelvic cyst is a kind of benign cysts originating from the renal parenchyma of renal hilus, which does not connect with the collection system. The cause of it is lymphectasia which is probably the result of chronic inflammation.
Parapelvic Cyst, mainly related to the oppression of renal
collecting system or renal pedicle arteries and complications of cysts, have
symptoms of backache, hypertension, hematuria and urinary tract infections etc.
Whether those symptoms will occur is largely relevant to the cyst’s location,
size and complications. The initial diagnosis depends on iconography examination
and the most effective method is CT. IVP also has a high accuracy in the
understanding of bilateral renal function, the morphology of renal collecting
system and complications, which can show the space occupying lesion of the renal
hilus easily and should be used as a routine examination.
In the diagnosis of the disease, B-ultrasound may easily misdiagnose it as
hydronephrosis. Thus, when B-ultrasound shows unexplained hydronephrosis, the
possible existence of Parapelvic cyst should be considered and then taken
further examination. CT scan shows that Cyst is located in the renal hilus
separated from the normal renal parenchyma. Characteristic manifestation of
Parapelvic cyst is the most low-density halo formed by renal sinus fat around
the cyst. Parapelvic cyst can be similar with hydronephrosis through parallel
running of CT scan. However, CT enhancement scan shows the pelvis and calyceal
stretching under pressure, which clearly set off the cyst. Patients can be
clearly diagnosed whether they have Parapelvic cyst or not according to the
above medical history and auxiliary examination.
The followings are the differential diagnosis of Parapelvic cyst:
1. Hydronephrosis: various conditions can cause hydronephrosis such as
internal, external, congenital or acquired urinal system factors and
hydronephrosis can occur at all ages. Sufferers often do not have obvious
clinical symptoms, but patients can have waist expansion and abdominal bump when
hydronephrosis is getting severe. People with Intermittent hydronephrosis caused
by stones can have the symptom of renal colic accompanied with vomiting, nausea,
abdominal expansion and oliguria etc. The increased kidneys can be palpated when
they have check with severe hydronephrosis, and when patients are infected at
the same time, symptoms of pyuria and even general infection can occur. The main
diagnosis methods are ultrasound, IVP, CT and MRI, etc.
2. Renal tumors are common tumors in urine system, which can be divided into
benign tumors and malignant tumors, of which the benign ones are rarely to be
seen. The benign tumors don not develop typical clinical symptoms, and when they
are getting larger, they can cause symptoms like waist and abdominal pain and
discomfort. The increased kidneys can be palpated when people have a check at
this time. The benign ones can develop clinical symptoms like hematuria,
backache and masses. The main diagnosis methods are ultrasound, IVP, CT and MRI,
etc. and they are mainly presenting as pathological changes of solid space
occupying lesions and only a few appear solid cystic characters.
Parapelvic Cyst can get regular follow-up because it is benign with small
cysts. When the diameter of the cyst is above 5cm, or the symptoms of oppression
and complications occur, the effective treatment should be taken. The surgical
methods include Laparoscopic Renal Cyst Decortication, Puncture sclerotherapy
operation under the guide of B-ultrasound and laparoscopic cystectomy, etc. The
method of Puncture Sclerotherapy operation can easily lead to complications and
the recurrence is high because the structure of renal hilus is complex and the
cyst is very deep, so this method is not proper to be adopted. The traditional
open surgery will strongly damage the body because the large incision on the
waist, and further more, patients should stay in the hospital for long because
the postoperative recovery is very slow. However, laparoscopy is worth to be
popularized because it can observe the cyst in multiple angles and have the
function of magnification so that surgery can be fully exposed and minimally
invasive and have effective hemostasis.
There is also one method with no surgery. That is Micro-Chinese Medicine Osmotherapy. The therapeutic mechanism is that the effective medicine can
inactivate the epithelial cells of cysts, which paralyzes its secretion so the
liquid in cyst would not increase. As a result, the cyst would stop growing.
Micro-Chinese Medicine Osmotherapy can promote the blood circulation on the
surface of the cysts. The cyst liquid will be discharged out of body along with
urine through metabolism. This is a method to remove cyst fundamentally so it is
rare to relapse. For more information, please contact us on line or email us at
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