RENAL CYST ASPIRATION — “A Patients Perspective”
RENAL CYST ASPIRATION — “A Patients Perspective”My name is Paul and I am 38 years old. I am a teacher living in Northamptonshire with my wife and young daughter. I was diagnosed with APKD about 11 years ago following an incidental ultrasound finding during another investigation, however, I was asymptomatic at the time.
In 1995 I had severe pain in my left kidney followed by haematuria ( bleed into the urine) and, since then, I have been very aware of both my kidneys. Over the last two years I have experienced pain, mainly in my right hand side which cumulated in a referral for cyst drainage on January 14th 2003 at the Churchill Hospital in Oxford. This is an account of what this procedure entails which I hope will be of use to anyone else who has it done.
Get someone to drive you to and from the hospital; I was informed that you are not medically fit to drive following this type of procedure. I was admitted and treated on the same day with an overnight stay for initial recovery and observation. A ward doctor examined me before going to the radiology department; this was to check that I was fit enough to go ahead and take some background history for my ward notes.
I was allowed a light lunch and fluids as no general anaesthesia is involved and I would recommend that you do keep to this as I felt quite nauseous during the operation. The procedure was explained to me on the ward and I was ready with questions regarding recovery times and any possible complications. The risk of infection for this type of procedure was quoted at 1 in 10,000.
About 45 minutes prior to my radiology appointment time, the porters came to get me; they offered to push me up on the bed but I thought a good walk could be beneficial if I was going to be in bed for the best part of a day! Once in the radiology department the whole process was explained again, along with the risks and benefits, by the doctor who was going to perform the operation.
The first stage of the proceedings was to lie me on my side with a pillow under my abdomen so that the offending kidney was nearest to the doctor. (It is worth pointing out here that it is normal to only tackle one kidney at a time.) The doctor explained that he would first use the ultrasound to look at my kidney and try to identify any cysts which were unusually large, close to the capsule (membrane surrounding the kidney) or had thickening of the walls.
My cyst had two out of the three signs, it was 3.7 by 3cm in diameter and very close to the capsule. I was also asked to point to areas where I thought the pain was coming from. The target site was marked with a pen and the doctor prepared the area for the aspiration. After antiseptic had been put over the area a needle was inserted to administer the anaesthetic, this was very painful as the painkiller needs to go right to the edge of the kidney capsule. Once this was done I decided it would be better if I did not look at what was happening as I could only feel movement and pressure but no pain. After a few minutes the aspiration was complete, the doctor had extracted 20ml of red/clear fluid from the cyst and suggested that there may have been bleeding into it in the past.
The fluid would now be sent for microbiological analysis to determine if any bacteria were present and identify narrow spectrum antibiotics which would help with any infections. When I was turned over onto my back I expereinced tremendous pain shooting down into my lower gut and groin and was given pethidine (a pain killer drug) through a line in my hand to combat this.
Once back on the ward I was given oral pain relief and my blood pressure monitored half houry for two hours and occasionally after that. I had to lie completely flat for six hours and stay in bed for twenty. This of course necessitated using other methods of going to the toilet. The severe pain subsided after a couple of hours and I stayed on pain killers through the night. I was seen by a doctor the next morning and told I should be receiving an outpatient clinic appointment in four weeks. As all my observations were normal I was allowed to go home at about midday. Since arriving home I have spent two days in bed and now on day three I am moving around in short bursts. It should take about a week before I feel like I am getting over it all.
The fact remains that this is a hit and miss procedure. Many still consider cyst aspiration as experimental. Using Ultrasound to guide the needle increases accuracy, but who knows exactly which cyst is the culprit? My philosophy about all of this is the “No pain, no gain” one. I hope that my quality of life, in terms of the amount of pain I experience, will improve. Only time will tell!
Many thanks to all the medical staff at the Churchill Hospital Oxford, both on Renal Ward 7 and in the Radiology department, for their caring approach and sense of humour during my stay. Who knows, maybe someday I will be able to get this type of thing done in Northamptonshire?
NKF Controlled Document No. 200, RENAL CYST ASPIRATION — “A Patients Perspective”, written 14 October 2005. Last reviewed 19 October 2009.
The National Kidney Federation cannot accept responsibility for information provided. The above is for guidance only. Patients are advised to seek further information from their own doctor.
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Page created: 14 October 2005
Last updated: 29 April 2009