Nephrostomy is a procedure that creates an artificial passage (opening) in the kidney to allow urinary drainage. Once the passage is created a catheter, a small flexible, rubber tube, will be put in place for the drainage and a drainage bag connected to the catheter for collection. This can be a temporary or permanent solution depending on the situation.
A nephrostomy is needed when a blockage develops that hinders urine from exiting the kidneys through the ureter and into the urinary bladder. If this problem is not resolved, the pressure of the fluid would rise within the urinary system and ultimately the kidneys would be impaired. When the kidneys are functioning properly they regulate body fluid and blood pressure, as well as, blood chemistry and waste products. If there is damage to the kidneys then the body cannot function properly.
Nephrostomies may also be used to remove or dissolve kidney stones. They may also be used if a hole has developed in the ureter and will be needed until this hole heals. Sometimes nephrostomies are also used in preparation for surgery or another procedure involving the kidney or ureter. A nephrostomy is essentially a “doorway” in to the collecting system of the kidney and is used for all sorts of treatments, as well as drainaged of a blocked kidney (hydronephosis).
Urinary tract obstructions can be caused by numerous reasons; the most common though is from cancer. Some of the other complications could include infection, kidney stones, tumors, or anatomic anomalies. Interventional radiologists are trained in minimally invasive (nonsurgical) treatments such as nephrostomy. Minimally invasive treatment options normally only need local anesthesia, which is the best option for those with impairment in the renal (kidney) system.
Interventional radiologists utilize fluoroscopy “real-time” image guidance or CT guidance to view exactly where the nephrostomy needs to be placed. Once you have been taken to the procedure room and changed, the area where the nephrostomy will be placed will be cleaned and clean sheets will be put into place. A numbing agent will be injected into the site and you also be given a medication for the pain and to help you relax. A needle will be inserted through the skin into the kidney. A contrast dye will then be injected to ensure the needle is in the exact location where the nephrostomy catheter needs to be placed. A catheter will then be placed in the kidney to create the artificial passage for drainage. The nephrostomy catheter site will be cleaned once more and a dressing applied.
The urine will be collected in an external storage, or drainage bag, that can be emptied when appropriate. This bag can be attached to your leg with two rubber straps to keep it out of your way.
Following the procedure you will be moved to a recovery area to be monitored.
You may not go swimming and sponge baths are suggested to keep the dressing dry and clean. You may take a shower if you can cover the area with plastic, such as Saran Wrap. The dressing should be changed every three days or when it becomes spoiled. Empty the bag before it becomes completely full.
For further care directions please consult your physician.