Posted by Annemarie on April 25, 1999 at 23:23:39
I was diagnosed with a cyst on my left kidney the size of a golf ball about 6 yrs ago, 1 year ago a new CT scan showed it's increase in size to about the size of a grapefruit. I had been experiencing pain in the back running down into my leg which resembled that of a herniated lumbar disc, however MRI of the lumbar spine revealed none. My urologist said that he thought it to be very unlikely, that he never heard of it. My neurosurgeon said that this could have explained the pains in my back and left leg. I am now experiencing incontinence and am wondering if this cyst could be pressing on any nerves causing this. Is there any documented cases that show such a thing? I have been told that they could aspirate the cyst, and if the symptoms subside then that would answer the question, however the cyst would only fill up again. The urologist is very hesitant to remove the cyst as it is a more invasive procedure, and stated that more than 1 out of 8 people have cysts on their kidneys. It just seems that something the size of a grapefruit is too big to leave inside my body when it could be causing so much havoc, what do you think?
Posted by HFHS M.D.-AK on April 26, 1999 at 16:51:40
Anatomically the kidneys are between the vertebral levels of L1-L3, but the lower pole of some kidneys have been shown as low as L5. The Sciatic nerve and pelvic nerves which would explain your symptoms, originate from spinal levels L4-S4. If your kidney is at a low normal level, your cyst is posterior on the lower pole although it is improbably, it is not impossible that your symptoms could be secondary to your renal cyst. On top of that, a cyst is a fluid filled space, it would naturally conform to the space with least resistance. Even if the cyst was posterior, it is more likely for the kidney to be rotated anterior rather than enough pressure generated to create a nerve impingement syndrome. I have not found a reference in the literature that identifies a kidney cyst as a cause of neurologic impingement problems.
I also asked several of our staff a Henry Ford the same question and they felt that it was very unlikely.
The only reason for a cyst to be drained or operated on, is for pain, bleeding or suspicion of cancer. You and your urologist are going to need to make the decision after considering all of the options that can account for your back and leg pain. I have seen many cysts larger than you describe and would not worry. The cyst can be followed over time with periodic CT scans or Ultrasounds.
My last comment is about operating for pain. I have operated on several people in the past for pain. The operation went well, the patient healed appropriately but now I have the same patient in my office with the same pain and a scar on his body. Just food for thought.
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