Pronounced: Purr-cue-TAY-knee-us Nef-RAW-stow-me
A nephrostomy is a procedure in which a catheter (tube) is placed into the kidney. The catheter is guided into the kidney by CT scan or ultrasound .
A nephrostomy is done to drain urine from your kidney. This needs to be done when urine cannot come out through the ureters, bladder, and urethra as it normally does. Specific conditions that may cause this include:
A nephrostomy may also be used to look at the kidneys and ureters before other procedures are done, like kidney stone removal. This may also help your doctor make a diagnosis.
Complications are rare, but no procedure is completely free of risk. If you are planning to have a nephrostomy, your doctor will review a list of possible complications, which may include:
Factors that may increase the risk of complications include:
You will receive a local anesthetic to numb the skin on your lower back. An IV (needle in your vein) will be placed. You will receive a sedative, pain medicine, and antibiotics through this IV.
A nephrostomy is usually done in an outpatient setting, and you will not need to stay in the hospital overnight. The procedure is done either by a doctor called an interventional radiologist or a urologist. First, you will be asked to lie on a special x-ray table. An IV will be placed to give you medicine to help you relax. Your lower back will be washed with an antiseptic. Next an anesthetic will be injected into your lower back. 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. The doctor will inject contrast material 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. At first the urine may appear bloody, but it will clear over time.
15-30 minutes
You may feel soreness at the insertion site for several days after your nephrostomy. Your doctor will give you medicine to help with the pain.
After the procedure, the staff may give you the following care to make you more comfortable and to help your recovery:
You will be able to leave when your catheter is working and you are comfortable caring for it.
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 911.
RESOURCES:
American Urological Association Foundation
http://www.urologyhealth.org/index.cfm
National Institute
of
Diabetes and Digestive and Kidney Diseases
http://www.niddk.nih.gov/
National Kidney Foundation
http://www.kidney.org/
CANADIAN RESOURCES:
Health Canada
http://www.hc-sc.gc.ca/index_e.html
The Kidney Foundation of Canada
http://www.kidney.ab.ca
References:
Nephrostomy. Encyclopedia of Surgery website. Available at: http://www.surgeryencyclopedia.com/La-Pa/Nephrostomy.html. Accessed September 21, 2009.
Percutaneous nephrostomy tube. University of Virginia Heath System website. Available at: http://www.healthsystem.virginia.edu/internet/radiology/angio/angio-pted-nephrostomy.cfm. Accessed September 21, 2009.
Practice guideline for the performance of percutaneous nephrostomy. American College of Radiology website. Available at: http://www.acr.org/SecondaryMainMenuCategories/quality_safety/guidelines/iv/percutaneous_nephrostomy.aspx. Accessed September 21, 2009.
Professional Guide to Diseases. 9th ed. Ambler, PA: Lippincott Williams & Wilkins; 2009.
Savitsky D. Kidney stones. EBSCO Health Library. Available at: http://www.ebscohost.com/thisTopic.php?marketID=15&topicID=81. Last reviewed November 2008. Last updated November 17, 2008. Accessed September 21, 2009.
Skolarikos A , Alivizatos G , Papatsoris A , Constantinides K , Zerbas A , Deliveliotis C . Ultrasound-guided percutaneous nephrostomy performed by urologists: 10-year experience. Urology. 2006 Sep;68(3):495-9. Epub 2006 Sep 18.
Wen X , Gao X , Li X , Lu M , Cai Y , Qiu J , Xiao C . One-step percutaneous nephrostomy in patients with a history of open nephrolithotomy: comparison with the fascial dilator system. J Endourol. 2007 Nov;21(11):1281-5.
Last reviewed October 2009 by Adrienne Carmack, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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