A nephrostomy, also known as percutaneous nephrostomy, is performed to drain urine from the kidney. This procedure is necessary when urine cannot move through the ureters, bladder, and urethra as it normally does. A nephrostomy is performed by the surgical insertion of a tube directly into the kidney. The function of the nephrostomy is to temporarily drain urine either because its flow has been blocked or because normal urine flow has to be temporarily interrupted for medical reasons. The procedure allows the kidney to function properly and protects it from further damage. It also helps to clear any infection.
Reasons for a Nephrostomy
A nephrostomy may be required for a number of reasons, such as:
- Damage to the bladder or ureter
- Blockage in the ureter
- A need to evaluate kidney or ureter function
The Nephrostomy Procedure
During the nephrostomy procedure, the surgeon makes an incision in the patient's back and inserts a tube directly into the kidney. The doctor is aided by X-rays and ultrasound guidance during the surgery. Contrast dye is injected into the patient so that the surgeon can be precise in positioning the drain for urine collection. An external catheter is then attached to temporarily allow drainage of the kidney into a small bag. Once the stent is confirmed to be functioning adequately, the nephrostomy catheter may be removed. The bag into which the urine drains is small enough to be hidden under clothing and will not be noticeable.
Risks of a Nephrostomy
While a nephrostomy is a safe procedure, there are certain risks associated with any operation. The patient should be aware of the following possible complications:
- Excessive bleeding
- Blood clots
- Adverse reactions to anesthesia or medications
- Postsurgical infection
- Damage to adjacent organs
- Breathing problems
- Loss of kidney function
Factors that may increase the risk of complications include:
- Liver failure
- Use of blood thinners
- Long-term illness
Recovery from a Nephrostomy
The patient will be hospitalized for a few days following a nephrostomy. The urine draining from the nephrostomy tube will contain blood. A nurse will remove the clots and irrigate the catheter a few times each day to make sure that the urine drains out of it freely. There will be pain and soreness in the area and also in the deeper tissues of kidney which may be relieved by pain medication. The patient will be instructed to rest and to avoid sudden jerky movements and strenuous activity for at least two weeks or until the nephrostomy tube is removed.