To report our single-center experience of retroperitoneoscopic renal cyst decortication in the treatment of symptomatic peripelvic renal cysts.

From January 2003 to July 2010, 36 patients with symptomatic peripelvic renal cysts, mean size 7.9 cm (range 5.8-12), underwent retroperitoneoscopic cyst decortication. The patients with complex renal cysts were excluded. Of the 36 patients, 2 had undergone an unsuccessful previous cyst aspiration. The Wong-Baker pain scale was used to assess the preoperative and postoperative pain scores. Radiologic success was defined as no recurrence on the most recent computed tomography scan.

Retroperitoneoscopic renal cyst decortication was successful in all patients. No open conversions or transfusions were necessary. The mean operative time was 159 minutes (range 113-189), and the mean estimated blood loss was 55 mL (range 20-78). The mean hospital stay was 3.5 days. In 2 patients, the collecting system was entered, and a double-J stent, which drained the pelvis for 4 weeks, was placed at the end of the procedure. No evidence of urine leakage was found postoperatively. Symptomatic success was achieved in 35 (97.2%) of the 36 patients, and imaging-proved success was achieved in 34 (94.4%). The mean follow-up period was 48 months (range 3-89).

Our results have confirmed that retroperitoneoscopic peripelvic renal cyst decortication is a safe, feasible, and effective procedure. It offers a favorable minimally invasive treatment option for symptomatic peripelvic renal cysts, although it remains technically challenging.