Why is this procedure done?
The kidneys remove waste from the blood through urine. Normally, the urine drains through a narrow tube into the bladder and out of the body. This tube is a ureter. Some diseases may block the flow of urine. This can damage the kidneys and cause infection. A percutaneous nephrostomy is a procedure to make another pathway for the urine. A tube is put through the skin and into your kidney to let urine drain out of the body. This procedure is used: ‚
- When the tubes are injured in an accident
- To treat a block in the kidneys or anywhere in the urinary tract
What will the results be?
Urine is able to get out of the body even when the urinary tract is blocked or damaged. ‚
What happens before the procedure?
- Your doctor will take your history. Talk to your doctor about:
- All the drugs you are taking. Be sure to include all prescription and over-the-counter (OTC) drugs, and herbal supplements. Tell the doctor about any drug allergy. Bring a list of drugs you take with you.
- Any bleeding problems. Be sure to tell your doctor if you are taking any drugs that may cause bleeding. Some of these are Coumadin ‚ ®, ibuprofen, Aleve ‚ ® (naproxen), or aspirin. Certain vitamins and herbs, such as garlic and fish oil, may also add to the risk for bleeding. You may need to stop these drugs as well. Talk to your doctor about them.
- When you need to stop eating or drinking before your procedure.
- Your doctor will do an exam and may order:
- You will not be allowed to drive right away after the procedure. Ask a family member or a friend to drive you home.
What happens during the procedure?
- Once you are in the operating room, you will be given a drug to make you sleepy. It will also help you stay pain free during the surgery. The staff will put an I.V. in your arm to give you fluids and drugs. You may be awake or asleep for the procedure.
- The doctor will clean your back with an antiseptic. If you will be awake during the procedure, you will feel a slight pinprick on your back when the doctor gives you the drug to numb your skin. Your doctor will use an x-ray machine or ultrasound to decide where to put the nephrostomy tube.
- The doctor will put a needle into your kidney. You may feel some pressure. A special dye may be put into the kidney using this needle. Then, the doctor will put in a guidewire that will position the tube inside your kidney. After placing the tube correctly, the doctor will remove the guidewire. Your doctor may stitch the tube onto your skin to hold it in place.
- The doctor will clean the area, position the tube, and place a clean bandage on the wound opening. Your doctor will attach the tube to a drain bag.
- The procedure takes 30 to 60 minutes.
What happens after the procedure?
- You will go to the Recovery Room for a few hours. Your doctor may give you drugs for pain.
- You may go home when the doctor tell you to.
What care is needed at home?
- Ask your doctor what you need to do when you go home. Make sure you ask questions if you do not understand what the doctor says. This way you will know what you need to do.
- You may have some clear to light yellow drainage around the drain tube wound for a few days. This is normal. It is also normal to see some blood in the urine drain bag for a few days.
- Take your drugs as ordered by your doctor.
- You may still need to pass urine. Your doctor will explain how your bladder will work even with a nephrostomy tube.
- Keep your wound clean and dry for the first 24 hours. Wash your hands before and after changing your bandage.
- Change your bandage each day for 2 weeks or when it gets soaked. Be careful not to pull the tube out. Check to make sure that the stitches holding the tube are secure. Gently clean the skin around the drain tube with a cotton ball soaked with water.
- You may take a shower after 48 hours or when your doctor tells you to. Keep your wound dry when you shower. Wrap the tube and drain bag with plastic before you shower. Do this each time you shower and until the wound fully heals. You may wash your healed wound with mild soap and water during showers.
- Do not soak in a tub or hot tub while the tube is in place.
- Always secure your tubes. Tape them 2 inches below the dressing.
- Empty your urine bag when it is full or when needed. Wear gloves when draining the urine bag. Replace your urine bag each week.
- Always keep the drain bag below the level of your kidney to prevent urine from the tube from going back into the kidney. Urine backing into the kidney can cause a kidney infection.
What follow-up care is needed?
- Your condition needs close watching. Your doctor may ask you to make visits to the office to check on your progress. Be sure to keep these visits.
- Your doctor will tell you if you need other tests.
- If you have stitches or staples, you will need to have them taken out. Your doctor will often want to do this in 1 to 2 weeks.
- Your doctor will tell you how long you need to have the nephrostomy tube.
What lifestyle changes are needed?
- Slowly add to your activity. Talk to your doctor about the right amount of activity for you.
- When moving, like getting up from a chair or bed, try to make sure that your tube and urine bag are in place and they are not being pulled on. Always check the drain tube for kinks.
- Drink 6 to 8 glasses of fluids each day to keep the kidney flushed. This will lessen the chances for problems, like infection.
What problems could happen?
- Bleeding
- Infection
- Kidney failure
- Tube being pulled out
When do I need to call the doctor?
- Signs of infection. These include a fever of 100.4 ‚ °F (38 ‚ °C) or higher, chills, wound that will not heal.
- Signs of wound infection. These include swelling, redness, warmth around the wound; too much pain when touched; yellowish, greenish, or bloody discharge; foul smell coming from the cut site; cut site opens up.
- Urine changes in color or has a bad smell
- Urine does not drain into the bag for more than 6 hours
- More blood in urine than usual, or bleeding that happens all of a sudden
- Very bad pain in your belly
- Tube is loose or falls out
- Health problem is not better or you are feeling worse
Helpful tips
- You will still need to pass urine if your other kidney is working.
- Ask your doctor about special gear or clothing for nephrostomy patients. This can make moving and traveling easier.
- Loop your tube to form a C shape when you secure it on to your back. This can help if you accidentally pull on your tube.
Where can I learn more?
National Institutes of Health Clinical Center ‚
http://www.cc.nih.gov/ccc/patient_education/pepubs/percneph.pdf ‚
Consumer Information Use and Disclaimer
This information is not specific medical advice and does not replace information you receive from your health care provider. This is only a brief summary of general information. It does NOT include all information about conditions, illnesses, injuries, tests, procedures, treatments, therapies, discharge instructions or life-style choices that may apply to you. You must talk with your health care provider for complete information about your health and treatment options. This information should not be used to decide whether or not to accept your health care providers advice, instructions or recommendations. Only your health care provider has the knowledge and training to provide advice that is right for you. ‚
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Copyright ‚ © 2015 Clinical Drug Information, LLC and Lexi-Comp, Inc. ‚