Nephrostomy Tube Placement/Percutaneous Nephrostomy
Nephrostomy tube placement, also referred to as percutaneous nephrostomy, is a procedure in which a tube is inserted into one or both kidneys to drain urine.
When the kidneys are healthy, they filter wastes from the blood and produce urine to rid the body of these wastes. The urine that is produced by the kidney passes through a tube-like structure, called the ureter, into the bladder, where it is held until it is excreted from the body. But when there is a blockage of one or more of the ureters, urine cannot flow as intended. Nephrostomy tubes help drain urine from the kidney to prevent a buildup of urine, as well as the development of health complications like hydronephrosis or swelling of the kidney.
At MedStar Washington Hospital Center, nephrostomy tube placement is performed by an interventional radiologist. Our interventional radiologists are part of a multidisciplinary team dedicated to providing tailored treatment to patients diagnosed with a wide range of renal conditions.
Why Nephrostomy Tube Placement Is Performed
Sometimes, the flow of urine from the kidneys to the ureters can become blocked. This can occur due to:
- A blood clot
- Injury to either the kidney or the ureter
- Kidney stones
- An infection
- A tumor
What to Expect During Nephrostomy Tube Placement
Nephrostomy tube placement generally takes less than an hour to complete. This procedure is performed using an intravenous sedative and a local anesthetic, meaning that patients will not be fully asleep, but will feel very relaxed and will experience no pain.
Once the sedative and local anesthesia have been administered, the interventional radiologist positions the patients on their abdomen in order to access the kidney. The radiologist then uses real-time ultrasound imaging to locate the area of the kidney where the nephrostomy tube will be placed. Next, they’ll carefully guide a needle through the skin and to the kidney before replacing it with a catheter or nephrostomy tube, and securing it with a disc to keep it in place. The other end of the nephrostomy tube remains outside of the body and is connected to a bag, where urine is collected.
Risks and Benefits of Nephrostomy Tube Placement
Nephrostomy tube placement is performed to provide relief of symptoms and health problems associated with a blockage of the kidneys or the ureters, such as:
- Kidney failure
Nephrostomy tubes can be placed temporarily to restore proper function of the kidneys while doctors treat the underlying cause of the blockage, after which the tube can be removed.
Interventional radiologists at MedStar Washington Hospital Center are highly skilled and experienced in the minimally invasive placement of a nephrostomy tube. This image-guided procedure provides various benefits to patients, such as:
- A smaller incision
- Faster recovery time
- A shorter operating time
Nephrostomy tube placement is a relatively safe procedure with a low risk of complications. The most common complications associated with the procedure include bleeding and infection.
How to Prepare for Nephrostomy Tube Placement
Certain medications, like insulin, may need to be adjusted the day of the procedure. Patients should disclose all current medications to their radiologist, and follow all instructions pertaining to their medications. Additionally, patients will be instructed to stop eating and drinking for at least eight hours before the procedure.
Post Nephrostomy Tube Placement
Patients can typically return home the same day. Before being released, the medical team will provide instructions for the patient on how to care for the tube, including how to empty the drainage bag. Patients will also be given information on identifying signs of complications, such as a change in urine color. It’s important for patients to follow all instructions as explained by the medical team in order to reduce the risk of complications with a nephrostomy tube.