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Ultrasound of abdomen showed cyst in kidney and calculus. Next step?

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General & Family Physician
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I am a 61 yr old male who recently took an ultrasound of Abdomen.
The report says that I have a cyst measuring 2.8 x 2.3 cm in mid cortex of my left kidney. There is also a 3mm calculus noted in mid calyces. The size, shape, outlines, echotexture and pelvicalcyceal systems are normal.

Could someone please advise on what my next steps should be?

Thank you
Posted Thu, 13 Sep 2012 in Kidney Conditions
Answered by Dr. Michelle Gibson James 1 hour later

Kidney cysts are classified as simple or complex. Most are simple cysts.
Simple cysts are not usually associated with any symptoms and do not enlarge the kidney , are not associated with any distortion of the structure of the kidney and do not affect its function. They occur commonly as we get older and are found in 35-50% of persons over age 50.
To determine whether the cyst is simple or complex the radiographer would have looked the walls of the cyst (thin walls with no irregularities), it is usually spherical, with only fluid present.
Simple cysts do not become cancerous. Rarely these cysts may cause pain and if large can cause early fullness after eating.
If simple cysts cause symptoms then the fluid is usually aspirated by a radiologist or the cysts surgically removed, otherwise there is usually no treatment except for periodic ultrasounds to detect any changes in size. These may be done annually or biannually at the suggestion of your doctor.
Your cysts is more than likely simple unless indicated otherwise in the report or by your doctor.

Complex cysts is noted to have either irregularities in the walls or in the contents when investigated by imaging such as some aspects of the walls thin and others thick, separations within the walls, calcifications (calcium) visible within the cysts.
None of this was mentioned in the above report and it also stated that the size, shape,outline, echotexture was normal which is good.
Complex cysts may become cancerous and may in some cases be associated with kidney failure.
Treatment depends on the cause of the cysts but in general consists of blood pressure control,prevention of infection, treatment of any mild bleeding episodes if they occur with rest and analgesics and monitoring to assess for cancerous changes.

In terms of the stone/calculus, they are classified as small is less than 5 mm (yours is 3 mm). They may pass on their own and treatment normally involves drinking alot of fluid preferrably water ( 2 to 3 quarts) a day, pain medication may be necessary because passage of the stone can be painful.
Your doctor may also consider giving you pain medication to help the stone to pass.

So in summary, unless your doctor or radiologist indicates otherwise the cyst is likely to be a simple cyst which occurs commonly ,not associated with problems in most people. If you do develop symptoms consider going to your doctor for an assessment.
The kidney will likely pass out once you drink copious fluids, have pain medication handy in case you need it.

I hope this helps, feel free to ask any other questions
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