Your kidneys make urine, a fluid made of liquid wastes filtered from your blood. This fluid travels down your ureter tubes to your bladder, and from there, it passes through the urethra and out of your body. Sometimes, your urine flow doesn’t work the way it should. This is when your doctor may suggest you get a short-term procedure called a nephrostomy tube.
What Is a Nephrostomy Tube Procedure?
A nephrostomy tube, also known as a nephrostomy catheter or percutaneous nephrostomy, drains urine directly from your kidney into a bag outside your body. The tube runs from your kidney to a small medical cut in your skin. From here, the tube connects to a valve called a stopcock, which connects to a drainage bag that collects the urine.
The medical procedure often happens at an outpatient clinic where you go home to rest the same day. If you need more care and monitoring afterward, your doctor may recommend getting the procedure in the hospital. This way, you are admitted to the hospital and can receive extra attention if needed.
In either case, the doctor who performs the procedure is called an interventional radiologist. Their full medical team works carefully to reduce the risks for nephrostomy tube complications. To help place the tube into your kidney, they use images from:
Who Needs a Nephrostomy Tube?
There are several reasons why your doctor would recommend that you get a nephrostomy tube.
What Can You Expect With a Nephrostomy Tube Procedure?
When you make the appointment, your doctor will give you a few instructions. These instructions begin about a day before your medical procedure.
You shouldn’t eat anything within 6 hours of the procedure or drink anything within 2 hours. Sometimes, you might receive instructions to stop eating after midnight the day of your procedure. Since the procedure uses imaging devices, you’ll need to remove all jewelry and piercings and change into a hospital gown.
You start the procedure by lying down on your stomach on the table. This position helps the doctor reach your kidneys. You receive local anesthesia to numb the skin above the kidney, so you remain awake during the procedure. You may also receive a sedative to help you relax.
If your doctor asked for contrast dye, you’ll get the injection in your kidney and nearby blood vessels. Contrast dye is a specific dye that helps doctors see your blood vessels and organs more clearly on images. CT scans and x-rays use iodine- or barium sulfate-based dye, and MRIs use gadolinium-based dye.
To reduce risks for nephrostomy procedure complications, a nurse monitors your blood pressure, breathing, and heart rate while the interventional radiologist completes the procedure. They make a cut in your skin and use a needle to feed the guide wire and catheter tube through. Using x-rays, ultrasound, or MRI images, the doctor inserts the tube into your kidney. The other end of the tube extends outside your body and attaches to the drainage bag. The doctor will put clear dressing over top of the incision to help keep the tube in place.
The procedure runs about one hour but can take longer. You’ll go to a recovery room for several hours or to your hospital room if staying overnight.
How to Care for Your Nephrostomy Tube
Caring for your nephrostomy tube is very important. You need to keep the tube and bag clean, empty the bag often, and avoid any activity that could knock the bag or tube loose. Following those steps can help reduce the risks for nephrostomy tube complications.
You empty the bag every day but sometimes several times a day depending on how quickly your kidneys filter waste. Some people may need to empty their drainage bag every 2 to 3 hours. Look at the bag and make sure you empty it when it reaches half-full. Each day, look in a mirror to make sure the dressing is clean and that the area doesn’t look red or inflamed. The tube should not feel loose either.
Reducing Nephrostomy Tube Complications
Although this procedure is somewhat common, it is always temporary. This is because the risk of catheter complications increases the longer you have a nephrostomy tube in place. However, the risk of complications is somewhat low, with a 7% to 10% percent chance of minor complications and a 2% to 5% chance of major complications.
Signs of potential nephrostomy tube complications include:
- Cloudy, bloody, or strong-smelling urine
- Pain, swelling, or redness at incision site
- Pain while urinating
- Pain in side or lower back
- Drainage bag not filling with urine
Here are some complications you could get from a nephrostomy tube:
- Kidney infection
- Urinary tract infection (UTI)
- Kidney damage
- Blood vessel damage
- Other organ damage
- Urine leaking into your abdomen
- Punctured lung
- Blood clots
Some complications are minor and easy to treat, while others can be life-threatening and need immediate medical care. If you get any symptoms or are worried that your nephrostomy tube isn’t working right, call your doctor right away. If you feel severely ill, go to the nearest emergency room for medical treatment.