Technique

Contraindications and patient preparation are identical to those described for nephrostomy insertion (see Chapter 3g—Neph-rostogram). A single dose of a prophylactic antibiotic agent must be administered.

• A 21-22-gauge needle is inserted percutaneously under local anesthesia (1% lidocaine)

• Laparoscopic cyst de-roofing requires a general anesthetic

• When using a needle, cyst localization is achieved using a combination of USS (most common), CT, or fluoroscopy

• Once the cyst is punctured, the fluid is aspirated

■ Simple cyst fluid is clear and straw-colored

(i) Hemorrhage into a simple cyst

(ii) Traumatic puncture

(iii) Hematoma

(iv) Complex/malignant cyst

• Although many operators will terminate the procedure at this stage, injection of 1-2 ml of contrast into the cyst may help clarify the anatomy

• If no aspiration is possible, in spite of correct placement, the mass is assumed to be solid in consistency (about 25% will eventually prove to be malignant)

Was this article helpful?

0 0
Dealing With Erectile Dysfunction

Dealing With Erectile Dysfunction

Whether you call it erectile dysfunction, ED, impotence, or any number of slang terms, erection problems are something many men have to face during the course of their lifetimes.

Get My Free Ebook


Post a comment