Introduction: Renal cysts are a common clinical finding necessitating a nuanced approach to management. This study explores outcomes and patient characteristics associated with two interventions for renal cysts: aspiration of renal cyst povidone-iodine sclerotherapy and laparoscopic renal cyst deroofing. Methods: A study was conducted on patients admitted to urology and nephrology hospital at Assiut University between February 2022 and December 2022. The study population included adult patients diagnosed with renal cysts. Data included demographic information, operative times, post-operative complications, and follow-up assessments. Results: Our findings revealed the effectiveness of single session povidone-iodine sclerotherapy with a high success rate of 95% and comparable to laparoscopic deroofing (98.3%); however, the patients who underwent laparoscopic deroofing had significantly longer operative times compared to those who underwent aspiration (p < 0.001). Gender did not significantly influence operative time (p = 0.583), but age exhibited a marginal association (p = 0.0667). The overall complications rate (over a period of 6 months) has no significant difference between the two groups. Re-do procedures were infrequent in both groups. Conclusion: This study showed the outcomes of two common interventions for renal cyst management. The effectiveness of a single session povidone-iodine sclerotherapy in management of symptomatic simple renal cyst in comparison to the gold standard technique of laparoscopic deroofing which is associated with longer operative times and more invasiveness. These insights can guide clinicians in selecting appropriate interventions and managing patient expectations.

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