A nephrostomy tube is placed through the skin of the back directly into the kidney’s urine-collecting system. Its main function is to reroute urine flow when the normal pathway, the ureter, is blocked or compromised. By diverting urine away from the obstruction and into an external collection bag, the tube protects the kidney from damage and helps prevent or treat infection from urine backup. The duration the tube stays in place depends on the underlying medical issue it addresses.
Why the Tube is Placed
A nephrostomy tube is necessary when the natural flow of urine from the kidney to the bladder is impeded. Blockages can be caused by various conditions, including kidney stones, tumors, scar tissue, or external compression from cancer. Tubes are often categorized as either a short-term or a long-term solution based on the cause of the obstruction.
Temporary placement is common when a blockage is expected to resolve quickly, such as before a planned stone removal procedure or to treat an acute infection called pyelonephritis. The tube may only be needed for a few days to weeks while awaiting definitive surgical correction or until swelling subsides. Once the kidney is functioning normally and the ureter is clear, the tube can be removed.
The need for a nephrostomy tube can be chronic, requiring long-term drainage for many months or even years. This happens when the obstruction is permanent or cannot be safely fixed, such as in advanced cancer that compresses the ureter or when patients are not suitable candidates for complex reconstructive surgery. The purpose of the tube in these situations is to preserve kidney function.
Standard Duration and Replacement Procedures
While the underlying condition may be temporary or chronic, the nephrostomy tube itself has a limited lifespan. The standard duration a tube stays in place is between two to three months, though some protocols may extend this to four months. This fixed replacement schedule is necessary because the tube material, often silicone or polyurethane, is exposed to urine.
Over time, this exposure causes mineral deposits to form on the tube walls, a process called encrustation. These deposits can narrow the tube’s inner diameter, leading to a partial or complete blockage. A clogged tube prevents urine drainage, risking severe kidney infection or loss of kidney function. The material can also degrade, making it brittle and difficult to remove safely if left for too long.
To maintain effective drainage and prevent complications, a routine exchange procedure is performed. During this outpatient visit, the existing tube is removed and a new one is inserted through the same tract, often guided by imaging techniques like fluoroscopy. This scheduled replacement ensures a clear, functioning tube is always in place, which is important for individuals with a chronic need for drainage.
Warning Signs and When to Seek Care
While scheduled replacements are routine, certain unexpected changes require immediate medical attention to prevent serious complications. One urgent concern is a sudden cessation of urine output into the drainage bag, especially if no urine has collected for a couple of hours. This signals a blockage in the tube that can quickly lead to a buildup of pressure in the kidney.
Severe pain in the flank or lower back that is not relieved by pain medication should prompt an immediate call to the healthcare provider. Signs of infection include fever, chills, or urine that is cloudy, foul-smelling, or bloody after the initial post-procedure period. Leakage of urine around the tube’s insertion site indicates the tube may be blocked or dislodged.
If the nephrostomy tube falls out or is pulled out, do not attempt to reinsert it. The site should be covered with a clean dressing, and the care team should be contacted immediately. Because the tract from the skin to the kidney can close quickly, prompt professional re-insertion is necessary to ensure the kidney can continue to drain.