A nephrostomy tube is placed to drain urine from the kidneys when there is a blockage to the flow of urine. The urine is produced by the kidneys and flows through an intricate network of tiny tube-like structures in the kidneys (tubules) to reach the ureters that connect the kidneys to the urinary bladder. The urine flows out of the urinary bladder through a narrow and short tube-like structure called the urethra. In certain conditions, the urine made inside the kidney is not able to pass to the bladder for elimination from the body. This obstruction to the flow of urine may be caused by a stone, some congenital malformation (an abnormality presence since birth), infections, or tumors. This will prohibit the removal of wastes through the urine that can harm the body. Placing a nephrostomy tube will bypass this obstruction to the flow of urine from the kidneys to the exterior of the body. The nephrostomy tube continuously drains the urine from the body into a urine drainage bag. If the nephrostomy tube is blocked, the flow of urine stops. In such a condition, you need to contact your health-care provider. They will open the blockage by flushing the tube with some solution or replacing the tube if needed. The nephrostomy tube is generally placed temporarily for a few days to months. In cases where the nephrostomy tube may be needed for a long time, the tube may be replaced by the doctor at regular intervals.
How is a nephrostomy tube placed?
Placement procedure:
- The placement of a nephrostomy tube is done by a surgeon in an operating room or in the radiology department by an interventional radiologist.
- The procedure may be done under intravenous sedation or general anesthesia (the patient sleeps through the procedure).
- The procedure may take around one hour to complete.
- The doctor will locate the kidneys under ultrasound guidance.
- They will insert a special kind of hollow needle percutaneously (through the skin) into the kidney under ultrasound guidance.
- Under fluoroscopic guidance (using live X-ray), the doctor will guide a catheter (small narrow tube) into the kidney. An X-ray shield is used to protect the patient.
- The outer end of the catheter will be connected to a urine drainage bag.
- The catheter will be secured in place on the surface of the skin using a small stitch and/or an adhesive clip or a disc.
- The doctor will place a gauze and a clear bandage over the catheter site.
- The patient will be placed under observation in the recovery area for some time after the procedure.
- Before discharge, the patient and the caregiver may be given instructions for at-home care such as keeping the bandage area dry all the time and avoiding swimming and contact or rough sports that may displace the tube.
What are the complications of a nephrostomy tube?
A nephrostomy tube placement procedure is generally safe. Some of the complications that may arise include:
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