A nephrostomy tube is a thin, flexible catheter inserted through the skin into the kidney to drain urine directly from the organ into an external collection bag. It provides an alternative pathway for urine when the normal urinary tract is obstructed or impaired. Its primary purpose is to relieve pressure on the kidney, preserve kidney function, and prevent complications from urine buildup. The tube is typically placed in the lower back, directly into the kidney’s urine-collecting system.
Why Nephrostomy Tubes Are Used
Nephrostomy tubes are used when the natural flow of urine from the kidney to the bladder is blocked or compromised. This blockage can occur due to various medical conditions, including kidney stones, tumors in the urinary tract, and infections causing swelling. Other reasons include scar tissue, injury to the kidney or ureter, or congenital conditions affecting the urinary system. By diverting urine, the tube helps alleviate pressure within the kidney, preventing further damage, managing pain, and allowing time for underlying issues to be treated. It can also be inserted to access the kidney for procedures like stone removal or to manage urine leakage after surgery.
Duration of Nephrostomy Tube Placement
The duration a nephrostomy tube remains in place varies widely, depending on the specific medical condition and treatment plan. Many tubes are temporary, serving as a short-term solution to relieve an acute blockage or infection. Some patients, however, may require long-term or even permanent placement. For temporary use, the tube might be in for days, weeks, or months, often until the underlying cause of the blockage, such as a kidney stone or infection, is resolved. If a permanent blockage cannot be corrected, or if a patient is not a candidate for other interventions, the tube may be needed indefinitely.
Factors influencing the duration include the nature of the kidney problem, the success of treatments aimed at resolving the obstruction, and the patient’s overall health. For instance, tubes placed due to cancer-related blockages might be long-term, requiring replacement every few months to prevent clogging and infection. Long-term use increases the risk of complications like infection, but it is sometimes necessary to maintain kidney function and quality of life. Healthcare providers make the decision for temporary or long-term placement based on continuous assessment of the patient’s condition and response to treatment.
Daily Life with a Nephrostomy Tube
Living with a nephrostomy tube involves specific care routines to ensure proper function and prevent complications. Patients learn to manage the drainage bag, which collects urine from the kidney. This bag must be emptied regularly, typically when it is half to two-thirds full, to prevent it from becoming too heavy and pulling on the tube. Maintaining hygiene is important, requiring daily cleaning of the skin around the tube insertion site with soap and water, and changing the dressing regularly. Handwashing is important before and after touching any part of the tube or bag to minimize infection risk.
Activity levels may need adjustment; strenuous exercise, heavy lifting, and activities that could tug or dislodge the tube should be avoided. Showering is permitted after a day or two, but bathing or swimming is often discouraged to prevent infection at the site. Patients should also monitor for signs of potential problems, such as fever, unusual pain, leakage around the tube, or changes in urine color or odor, and contact their healthcare provider if these occur.
When a Nephrostomy Tube is Removed
A nephrostomy tube is removed once the underlying issue that necessitated its placement has been resolved and normal urine flow is restored. This might occur after a kidney stone has passed or been removed, an infection has cleared, or a surgical repair of the urinary tract is successful. Improved kidney function and the absence of complications also indicate readiness for removal.
The removal procedure is straightforward and often performed in an outpatient setting. A local anesthetic is applied to numb the area where the tube exits the skin. The healthcare provider then gently removes the tube. After removal, a dressing is applied to the site, and patients are advised to rest, avoid strenuous activities, and keep the area clean and dry for a few days to promote healing. Follow-up care is often needed to ensure the kidney continues to function properly.