Adult Renal Cysts: When to Intervene?

Abstract

Renal cysts are common in the adult population and can be challenging to decide which need intervention or follow‐up. Assessment based on history, examination and cross‐sectional imaging will determine the disposition for patients based on their risk of malignancy and symptoms. The Bosniak Classification is used to stratify risk of malignancy, and intervention can involve active surveillance, surgical intervention or minimally invasive treatments dependent on patient factors. Renal cysts are very common in the adult population, and increase in prevalence with advancing age. Many require no further intervention or are just surveilled. Symptoms and determining the Bosniak Classification of the cyst will influence disposition for patients. Bosniak Class I and II do not need follow or intervention unless symptomatic. Bosniak IIF and higher should be managed by a Urologist. For those that require further treatment, options can range from active surveillance, watchful waiting, surgical intervention or minimally invasive treatments, depending on patient factors and appropriate shared decision‐making.