Nephrostomy is a procedure that is performed to drain urine from the kidney. It is often performed when a ureter is blocked and urine cannot leave the kidneys as it normally does. When a patient is in sepsis and OJ stenting is not possible due to ureteric stricture or impacted stone. A nephrostomy allows the kidney to function properly and protects it from further damage. It also helps to clear any infection.
- Urinary obstruction caused by stones or benign strictures where stenting failed.
- Urinary obstruction caused by tumours. This can be caused by tumors in the renal pelvis or the ureter, as well as external compression. This is most common with cancers of the pelvic region in females.
- Treatment of complications related to renal transplants.
- In order to heal fistulas, urine is diverted from the renal collecting system. Fistulas are abnormal connections between the collecting system and other structures. e.g. bowel, vagina.
- Access for other procedures such as retrieval of stone and ureteral stent placement.
- Pyonephrosis - Kidney filled with pus.
- Tuberculosis of the urinary tract.
- Ureteric injury if the patient is in sepsis.
Before the Procedure
- You will have blood tested to determine how well your blood clotting function, HIV, HBsAg, HCV and prothrombin time (PT) test.
- You should inform the doctor of all medications that you are taking, including any herbal supplements.
- Inform the doctor of any allergies, especially to local or general anesthetic medications, contrast materials (also known as X-ray dye), or latex gloves.
- You will be informed to fast after midnight, the night before the procedure, and if you are a diabetic patient, your doctor will tell you how to adjust your medications and insulin dose on the day of the procedure.
- You may be given a gown to wear during the procedure.
- You may need to arrange for someone to drive you home safely after the procedure.
During the Procedure
- The procedure is carried out while you are lying on a special X-ray bed on your stomach or slightly on your side. This allows the urologic surgeon access to your kidney.
- A doctor or nurse may administer medications or sedation through the cannula in your vein. An antiseptic solution is used to clean the skin over the kidney, and sterile drapes are placed around the area.
- Special equipment constantly monitors your pulse, heart rate, oxygen level, and blood pressure.
- Before starting the nephrostomy, the doctor will use a portable ultrasound machine (C-Arm machine) to check the obstructed kidney and decide where to place the catheter within the kidney. To gain access to the kidney, a series of guide wires and catheters are used. All of this is aided by X-rays and contrast dye to provide images.
- Once in place, the catheter will exit through the skin over the kidney, and the doctors use sutures or stitches to keep the tube in place.
- The nephrostomy tube also has a locking mechanism that coils inside the kidneys to keep the tube in place.
- The doctor connects the tube to the drainage bag outside the body, which collects urine.
After the Procedure
- You will be returned to the recovery room as soon as the procedure is completed and it is safe to shift you. It is completely normal for you to require additional pain relief for the next day or two. It is also normal for most patients to pass some blood in their urine for a few days.
- As each patient's case is unique, there is no definitive time for when the nephrostomy should be removed. You will have regular blood tests and possibly more ultrasounds or CT scans to help you decide. You may even need to have the catheter replaced before it is finally removed. A catheter has a lifespan of about three months. It is changed to avoid occlusion and to reduce the risk of infection.
Nephrostomy can have several benefits, including:
Relief of symptoms:
Nephrostomy can help relieve symptoms such as pain, swelling, and pressure caused by a blocked or damaged urinary system.
Improved kidney function:
By allowing urine to drain properly, nephrostomy can help improve kidney function.
Prevention of infection:
Nephrostomy can help prevent infections by allowing urine to drain out of the body.
Nephrostomy can help increase a person's comfort and quality of life by relieving the symptoms and allowing them to move and sleep more comfortably.
Monitoring kidney function:
Nephrostomy can allow for regular monitoring of kidney function, which can be important in managing certain conditions.
Although nephrostomy is considered a safe procedure, there are certain risks associated with any operation:
- Blood clots
- Damage to adjacent organs
- Breathing problems
- Loss of kidney function
Care at Medicover
Our urologic surgeons at Medicover Hospitals have extensive experience performing nephrostomies on our patients as well as knowledge of advanced technologies. We follow NABH norms and make sure all aseptic precautions are taken care. Our urologic surgeons at Medicover employ a multidisciplinary approach to accurately diagnose and treat renal conditions. We offer a wide range of therapeutic procedures using cutting-edge technology with advanced C-arm and latest ultrasonagraphy machines to achieve the best possible results.