From the Guidelines
Bilateral renal parapelvic cysts typically cause pain in the flank areas, located on both sides of the abdomen between the lower ribs and the hip. The pain associated with bilateral renal parapelvic cysts is usually described as a dull ache or pressure sensation in the flank areas, which may radiate to the lower back 1. This type of pain occurs because the fluid-filled cysts develop in the renal sinus near the collecting system of the kidneys, potentially causing pressure on surrounding structures. Some key points to consider about the pain caused by bilateral renal parapelvic cysts include:
- The pain may worsen when the cysts enlarge or become infected.
- Some patients might experience increased discomfort after consuming large amounts of fluid or during urination if the cysts obstruct urine flow.
- Treatment typically focuses on pain management with analgesics like acetaminophen or NSAIDs if the cysts are symptomatic.
- However, many parapelvic cysts are asymptomatic and discovered incidentally during imaging studies.
- If pain becomes severe or persistent, drainage procedures or surgical intervention might be considered, though this is relatively uncommon for uncomplicated parapelvic cysts 1. It's worth noting that the "classic triad" of symptoms, which includes hematuria, flank pain, and abdominal mass, is typically associated with locally advanced or metastatic renal cell carcinoma, rather than parapelvic cysts 1. In terms of diagnosis, imaging studies such as ultrasound or CT scans are often used to evaluate the kidneys and detect any abnormalities, including parapelvic cysts 1. Overall, the management of bilateral renal parapelvic cysts depends on the presence and severity of symptoms, as well as the size and location of the cysts.
From the Research
Painful Areas on the Abdomen for Bilateral Renal Parapelvic Cysts
The painful areas on the abdomen for patients with bilateral renal parapelvic cysts can vary, but some common locations include:
- Flank area: Patients with bilateral renal parapelvic cysts may experience flank pain, which can be severe and debilitating 2, 3, 4.
- Back area: Some patients may also experience back pain, which can be related to the location and size of the cysts 5, 3.
- Abdominal area: In some cases, patients may experience abdominal pain or discomfort, which can be related to the cysts or other underlying conditions 5, 6.
Characteristics of Pain
The pain associated with bilateral renal parapelvic cysts can be:
- Intermittent: Some patients may experience intermittent pain, which can be related to the size and location of the cysts 4.
- Constant: Others may experience constant pain, which can be severe and debilitating 2, 3.
- Sharp or dull: The pain can be sharp or dull, and may be accompanied by other symptoms such as nausea or vomiting 5, 6.
Diagnosis and Treatment
Diagnosis of bilateral renal parapelvic cysts typically involves imaging studies such as ultrasound, CT scans, or MRI 2, 5, 3, 4, 6. Treatment options may include:
- Ureteroscopic unroofing: This is a minimally invasive procedure that involves removing the cyst lining and marsupializing the cyst to the adjacent collecting system 2.
- Robotic cyst decortication: This is a surgical procedure that involves removing the cyst and reconstructing the affected area 4.
- Image-guided cyst aspiration: This is a minimally invasive procedure that involves aspirating the cyst fluid and may be repeated if necessary 6.