Percutaneous nephrostomy is a procedure performed to drain urine from a kidney through a drainage tube into a bag. It is performed when a ureter (the tube that drains urine from the kidney to the bladder) is blocked, and urine cannot drain from the kidney as it normally does. A percutaneous nephrostomy allows the kidney to function properly by allowing urine to drain, and protects the kidney from further damage. It also helps to clear up infection by keeping the kidney clear from retaining urine. It may be performed in patients who have the following:
● Stone blocking the ureter
● Damage to the bladder or ureter
● Blockage in the ureter
● Urethral stricture
● Tumors causing blockage
● Abscess or infection.
The Percutaneous Nephrostomy Procedure
During percutaneous nephrostomy, the interventional radiologist uses imaging for guidance, to make a small incision in the patient's back, and inserts the tube directly into the kidney. Contrast dye is then injected into the patient so that the drain for urine collection can be accurately positioned to maximize effective drainage. An external catheter is then attached toallow drainage of urine into a small bag. Once the tube is functioning adequately, the nephrostomy catheter may be removed. The drainage bag into which the urine collects is small enough to be hidden under clothing, and should not be noticeable. It will need to be emptied every few hours or as it fills up with urine.
Risks of Percutaneous Nephrostomy
Although percutaneous nephrostomy is considered a safe procedure, there are certain risks associated with any operation:
● Bleeding at incision or kidney
● Blood clots
● Damage to surrounding structures
● Breathing problems
● Loss of kidney function
● Adverse reactions to medications
Recovery from Percutaneous Nephrostomy
The patient may be kept overnight in the hospital following percutaneous nephrostomy. The urine draining from the nephrostomy tube may contain blood including small clots, and the catheter is monitored to make sure that the urine drains out of it without difficulty. A patient usually has some pain and soreness, which may be relieved by analgesic. The patient is instructed to rest and to avoid sudden jerky movements and strenuous activity for 1-2 weeks, or until the nephrostomy tube is removed. It may be difficult to lay on back while having nephrostomy tube and patient may need to sleep on their side.