Percutaneous nephrostomy is a therapeutic procedure in which a catheter is placed through the skin into the renal collecting system (fluid containing inside of the kidney) with the assistance of image guidance.
Percutaneous nephrostomy is an alternative to surgery and drains urine from the kidney. A tube is placed through the skin on the back into the kidney to divert urine to the outside of the body. The procedure is performed by a doctor called an interventional radiologist.
Why do I need a percutaneous nephrostomy?
In most instances, the goal is to relieve a blockage of the kidney or its drainage system (ureter). Stones, tumors or scarring may cause a narrowing or stricture, blocking the flow of urine from the kidney to the bladder. Urine collecting in the kidney can be harmful but a percutaneous nephrostomy provides relief by diverting the obstructed urine to the outside of the body. Another reason for performing a nephrostomy is to help prepare you for a procedure, such as stone removal on your kidney, or to divert flow above a urine leak.
What is a percutaneous nephrostomy procdure like?
The actual procedure will take one to two hours. You will be given pain medication during or just before the procedure. You may have an intravenous line inserted before the procedure. After you are given a local anesthetic, the interventional radiologist will insert a small needle into your kidney. Through this needle, contrast will be injected so that your urinary tract will be visible and the drainage tube or catheter will be placed. This catheter will remain in place to drain urine to a drainage bag. The catheter is secured to your back to hold it in place and then a dressing is applied to the catheter entry site.
How do I prepare for the procedure?
Do not eat anything for four hours before the procedure. You may drink clear liquids and take your usual medication. If you are a diabetic, talk to your doctor about decreasing your insulin dose the day of the procedure. If you are on Coumadin, you should contact your doctor to have it stopped two to three days before the procedure.
What will happen after the percutaneous nephrostomy?
After the procedure, you will return to your hospital room for bed rest. Your nurse will check the tube. The urine will drain outside of your body into the drainage bag which will be secured to your leg so you can move about as usual. You or the nurse can empty the drainage bag by loosening the spout at the bottom of the bag and empty. You should keep the skin around your nephrostomy catheter clean and dry. You can take a shower but you should tape plastic wrap or a plastic bag around the bandage. Don't worry about getting the drainage bag or tubing wet since they can be dried with a towel. Change the bandage at least every other day. At that time, clean the area around the catheter with a cotton swab dipped in hydrogen peroxide.
Problems that May Occur:
- If the skin around the catheter becomes red and sore, you likely have a skin infection and should clean the site and change the bandage more frequently. Apply some antibiotic ointment to the skin when you change the bandage. If it does not clear in two days, please call us at (941) 917-7893.
- If you develop a fever or back pain, you may have a kidney infection and you should call us immediately at (941)917-7893.
- If your catheter begins to leak around the skin site onto the bandage, it needs to be changed. If this occurs at night, call the Radiology Department the next morning for an appointment at (941) 917-1316. If your catheter has been capped and you have a drainage bag, connect the catheter for external drainage.
