A nephrostomy is done to drain urine from your kidney. This needs to be done when urine cannot come out as it normally does. Specific conditions that may cause this include:
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A nephroscopy through a nephrostomy may also be used to look at the kidneys and ureters before other procedures are done, such as kidney stone removal. This may also help your doctor make a diagnosis.
Complications are rare, but no procedure is free of risk. If you are planning to have a nephrostomy, your doctor will review a list of possible complications, which may include:
Before your procedure, talk to your doctor about ways to manage factors that may increase your risk of complications such as:
Your risk of complications may also increase if you have:
You will receive a local anesthetic to numb the skin on your lower back. An IV will be placed. You will receive a sedative, pain medication, and antibiotics through this IV.
A nephrostomy is usually done in an outpatient setting. You will not need to stay in the hospital overnight. Ultrasound or x-ray images will be used to locate your kidney and guide the doctor. A needle will be inserted through your skin and into your kidney. A contrast material will be injected through the needle to better view the kidney on the x-ray. The catheter will then be placed into your kidney. The catheter will come out of your skin and be attached to a collection bag. A dressing will be placed at the insertion site. Urine will drain from your kidney into the collection bag.
After the procedure, you will be monitored for 8-12 hours to make sure the catheter is draining urine. The urine may appear bloody at first. It will clear over time.
You may feel soreness at the insertion site for several days after your nephrostomy. You will be given medication to help with the pain.
After the procedure, the staff may give you the following care to make you more comfortable and to help you recover:
You will be able to leave when your catheter is working and you are comfortable caring for it.
During your stay, the hospital staff will take steps to reduce your chance of infection such as:
There are also steps you can take to reduce your chances of infection such as:
When you return home, do the following to help ensure a smooth recovery:
After arriving home, contact your doctor if any of the following occurs:
In case of an emergency, call for emergency medical services right away.
Urology Care Foundation
National Kidney Foundation
The Kidney Foundation of Canada
Percutaneous nephrostomy tube. University of Virginia Heath System website. Available at: http://www.medicine.virginia.edu/clinical/departments/radiology/divisions/angiography/angio-pted-nephrostomy-page. Updated March 11, 2004. Accessed January 12, 2015.
Practice guideline for the performance of percutaneous nephrostomy. American College of Radiology website. Available at: http://www.acr.org/~/media/ACR/Documents/PGTS/guidelines/Percutaneous_Nephrostomy.pdf. Updated 2014. Accessed January 12, 2015.
Skolarikos A , Alivizatos G , et al. Ultrasound-guided percutaneous nephrostomy performed by urologists: 10-year experience. Urology. 2006 Sep;68(3):495-499. Epub 2006 Sep 18.
Wen X , Gao X , et al. One-step percutaneous nephrostomy in patients with a history of open nephrolithotomy: comparison with the fascial dilator system. J Endourol. 2007 Nov;21(11):1281-1285.
6/2/2011 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Mills E, Eyawo O, et al. Smoking cessation reduces postoperative complications: a systematic review and meta-analysis. Am J Med. 2011;124(2):144-154.e8.
Last reviewed January 2015 by Adrienne Carmack, MDLast Updated: 4/29/2014