Percutaneous Nephrostomy

Percutaneous nephrostomy is performed to drain urine from a kidney. It is usually performed when a ureter is blocked, and urine cannot leave the kidney as it normally does. A percutaneous nephrostomy allows the kidney to function properly, and protects it from further damage. It also helps to clear up infection.

Possible candidates for percutaneous nephrostomy have kidney stones that are blocking the ureter or bladder. Other possible candidates are those with the following:

• Damage to the bladder or ureter
• Blockage in the ureter
• Urethral stricture
• Tumors causing blockage

A percutaneous nephrostomy may also be performed to evaluate kidney or ureter function.

The Percutaneous Nephrostomy Procedure

Percutaneous (through the skin) urinary procedures help drain urine from your kidney and get rid of kidney stones.  A percutaneous nephrostomy is the placement of a small, flexible rubber tube catheter through your skin into your kidney to drain your urine. It is inserted through your back or flank.

During the intervention, you will lie on your stomach on the X-ray table. You will be given an intravenous painkiller or sedative. The doctor will disinfect the part of the skin on which the intervention is performed. After that, with the help of X-rays or ultrasound, they will decide which is the most suitable place to perform the intervention. The part of the skin on which the intervention is performed will be numbed due to the use of local anesthesia, after which the doctor inserts a thin needle into the kidney.

When doctor is sure that the needle is in the right place, he will place a wire through the needle – a guide to the kidney, which enables adequate placement of a urinary catheter. After that, the urinary catheter is fixed to the surface of the skin and connected to the urine drainage bag.

Drainage catheter placement steps:

• You will lie on your stomach.
• The part of the skin on which the intervention will be performed will be disinfected
• You will be given an intravenous sedative
• The doctor will determine the place of the intervention with the help of X-rays or ultrasound
• The doctor will insert a needle into the skin. The nephrostomy catheter is then inserted through a needle into your kidney.
• You may feel pressure and discomfort when the catheter is inserted.
• A special type of X-ray is used to check that the catheter is in the right place.
• The urinary catheter is fixed to the surface of the skin and connected to a urine drainage bag.

Risks of Percutaneous Nephrostomy

Percutaneous nephrostomy placement is a safe procedure that solves the problem instead of performing a more extensive intervention. Complications that occur do not happen often and are usually not severe. It may happen that the place of intervention hurts (you can take a painkiller in consultation with a doctor). The most serious complication that can occur is the impossibility of adequate placement of the drainage catheter. If this problem occurs, surgery may be needed. There may be bleeding from the kidneys or an infection (which can be adequately treated with antibiotics).

Although percutaneous nephrostomy is considered a safe procedure, there are certain risks associated with any operation:

• Bleeding
• Blood clots
• Infection
• Damage to adjacent organs
• Breathing problems
• Loss of kidney function

As with any type of surgery, there is also a risk of adverse reactions to anesthesia, or medications associated with the procedure.

Recovery after drainage catheter placement

After the intervention, you will spend a few hours in the hospital in the recovery room. During this time, our team will monitor your pulse and blood pressure, to make sure that the intervention went without serious complications.

When a drainage catheter (nephrostomy) is placed in the kidney, a urine collection bag is attached to the other end of the catheter. Drained urine may contain blood, and a catheter is monitored to make sure urine comes out freely. The patient usually feels mild pain in the area of ​​the incision and the deeper tissues of the kidneys, which can be relieved with painkillers.

With a nephrostomy, you will be able to function completely normally. It is very important that you do not make sudden movements, e.g. to get up abruptly from a chair and forget you have a nephrostomy. The patient is advised to rest and avoid sudden movements and strenuous activity for at least 2 weeks. It is necessary to empty the contents of the bag regularly, so that it does not become too heavy. If your healthcare professionals tell you, you may need to measure the total amount of urine collected in 24 hours at certain times. The bag can easily be hidden under clothes so that you can carry out your activities without hindrance. How long a nephrostomy will last depends on the reason it was placed. Just removing the drainage catheter is not painful.