Nephrostomy Tube Placement

(also called Percutaneous Nephrostomy)

Your kidneys are two bean-shaped organs in your lower back. They filter 120 to 150 quarts of blood every day to produce one to two quarts of urine. Your kidneys are connected to the bladder (which stores urine until you urinate) by thin tubes called ureters. Sometimes, a kidney stone, blood clot, or tumor can cause a blockage in one of the ureters. A nephrostomy is the placement of a catheter (a thin, hollow tube) to relieve the blockage and collect urine in a bag outside your body until the cause of the blockage is rectified.

What happens during a nephrostomy?

You will have already discussed the treatment options with the physician doing the procedure. Prior to your procedure, we’ll take you to a preparation area where our nurses will start an IV in your arm and give you any medication that may be required prior to your procedure.

When it’s time to begin, we’ll take you to a special room that is similar to an operating room. We often use conscious sedation, or moderate anesthesia, during a nephrostomy procedure. In this case, you’ll remain slightly awake throughout the procedure. We will monitor your pulse, blood pressure, and your breathing throughout the procedure.

During the procedure, you’ll lie on your stomach on a table and we’ll clean the area where the catheter will enter your body with a special solution to minimize infection. We’ll place sterile drapes over your body and an interventionalist will apply a local anesthetic on your back where we’ll make a small incision.

Using a needle and imaging with dye (fluoroscopy), ultrasound, or both, to guide us, we’ll insert a needle and then a guide wire into the kidney and use it to place the catheter, which will be left in place until the blockage is resolved. Sometimes the catheter will be inserted all the way into the bladder. We’ll secure the end of the catheter to a bag outside your body, which will catch urine. After the procedure, we will teach you how to flush and drain your catheter and change the dressing. You’ll need to empty the drainage bag regularly. You will either be admitted to the hospital or need to have someone drive you home following your procedure.

After your procedure, your interventionalist will review the results of your nephrostomy with you and your physician so he or she can discuss the next steps with you. We may ask you to return so the interventionalist can check how well you have done after your procedure, and to see if you need any other procedures to make you better.