A nephrostomy tube is a thin, flexible catheter inserted through the skin of the back directly into a kidney. Its primary purpose is to divert urine directly from the kidney into an external drainage bag when the normal urinary pathway, such as the ureter, is blocked or compromised. This intervention becomes necessary for various reasons, including kidney stones, infections, trauma, tumors, or strictures that impede urine flow. By draining urine, the tube helps protect the kidney from damage and can alleviate pain and pressure caused by urine buildup.
Typical Duration of Placement
The duration a nephrostomy tube remains in place varies considerably, depending on the patient’s underlying medical condition and the specific reason for its insertion. For temporary conditions, such as an acute kidney stone causing a blockage, the tube might be needed for only a few days to weeks until the obstruction is resolved. In contrast, individuals with chronic conditions like certain cancers, permanent strictures, or congenital urinary tract issues may require the tube for months or even years as a long-term management solution. The healthcare provider determines the specific duration, aiming to keep the tube in place only as long as medically necessary.
When a Nephrostomy Tube Needs Attention
It is important to recognize signs indicating a potential problem with a nephrostomy tube that require prompt medical evaluation. Symptoms of infection around the tube site include fever, chills, increased pain, redness, or swelling. Changes in urine, such as it becoming cloudy, foul-smelling, or bloody, or a significant decrease in urine output, may signal a blockage within the tube. Leakage of urine around the insertion site or the tube appearing to move out of its proper position are also concerns.
Replacement and Removal
Nephrostomy tubes are not designed for indefinite placement and require periodic replacement to maintain their function and prevent complications. Routine exchanges are scheduled every two to three months for silicone tubes, or three to six months, to reduce the risk of infection, encrustation, and blockage. This proactive approach helps prevent biofilm formation, bacterial colonization, and tube obstruction. Both the replacement of an existing tube and its final removal are performed as outpatient procedures. During removal, a local anesthetic is applied to the site, and the tube is gently withdrawn, followed by the application of a dressing.
Living with a Nephrostomy Tube
Managing a nephrostomy tube daily involves several practical steps to ensure comfort and prevent complications. The insertion site requires regular care, including cleaning with mild soap and water and changing the dressing every two to three days, or more frequently if it becomes wet or soiled. While showering is generally permissible, bathing or swimming should be avoided to prevent water from entering the tube site.
Patients should secure the drainage bag below the level of the kidney to facilitate proper urine flow and empty it when it is about half full to prevent excessive weight from tugging on the tube. Strenuous activities, heavy lifting, and sudden movements should be limited to prevent accidental dislodgement of the tube. Staying well-hydrated is also important for kidney health and urine production.