What is a nephrostomy tube?

Urinary collection bag.

A nephrostomy tube is a small rubber tube that is placed through a hole in the skin and that extends into the kidney. The tube allows direct drainage of the kidney. Often called a percutaneous nephrostomy tube, the device is connected to a collection bag that collects and measures urine output. The tube allows urine to bypass blocked or damaged ureters to avoid the risk of infection or irreversible damage that backflow of urine causes to a patient with a blockage or leakage.

Nephrostomy tubes are inserted into the kidneys using ultrasound for guidance.

There are several reasons why this device might be prescribed in a patient’s plan of care. A urologist or nephrologist may need direct access to the upper urinary tract for various procedures. Kidney stones or other blockages can stop the flow of urine from the kidneys through the ureters and into the bladder. This can cause pain and a condition known as hydronephritis. A nephrostomy tube goes around the blocked area, allowing urine to leave the body.

A nephrostomy tube allows direct drainage of the kidney.

Injury or disease of the ureter or bladder that causes a hole or leak also requires placement of a nephrostomy tube surgically. The tube allows urine to drain directly, preventing leakage of urine into the abdominal cavity. These tubes may be placed in order to prepare for procedures or surgery on the kidneys, bladder, or ureters. This allows doctors to treat kidney injuries, illness, or stones, while also allowing the kidney to drain urine from the body. Patients with renal pelvis tumors or similar problems may require placement to more effectively deliver chemotherapy treatments to the renal collection system.

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A nephrostomy tube may be a temporary solution to treating kidney stones.

Placement of a nephrostomy tube is a simple surgical procedure, but requires precise actions and careful monitoring. After insertion of an IV tube, the patient is placed on an X-ray table, lying on his stomach. The patient is monitored using medical equipment for adequate blood pressure, oxygen levels and heart rate. Usually, the insertion point is thoroughly cleaned with an iodine-based soap and the area is numbed with the injection. A nurse or anesthetist is present to administer medications to help the patient relieve pain and sedation.

Conscious sedation and local anesthetics may be administered prior to beginning the nephrostomy tube placement procedure.

A radiologist uses an X-ray or ultrasound to locate the patient’s kidney. A needle is inserted into the kidney and an X-ray dye is injected before the nephrostomy catheter is inserted. After insertion, the site is healed with a sterile dressing. The catheter is connected to a drainage bag that can be attached to the patient’s leg with rubber straps to provide patient privacy. Other people are often not even aware that a patient has a nephrostomy tube installed.

A nephrostomy tube is usually a temporary solution to a urinary tract condition or a surgical aid. In most cases, the tube stays in place just long enough for an obstruction to clear or for a leak from a tear or hole to heal. Generally, the tube, catheter, and injection site are checked by a physician every four weeks, or as the situation warrants, until the tube is removed. Removal is a simple procedure that only takes about five minutes.

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