A nephrostogram is a medical imaging procedure that provides detailed views of the kidney’s internal drainage system and the ureter, which carries urine from the kidney to the bladder. This diagnostic tool helps assess urine flow and identify potential issues within these structures. The procedure involves a contrast material that makes the urinary tract visible on X-ray images, allowing for a precise evaluation of the kidney and its associated tubes.
Understanding a Nephrostogram
This diagnostic imaging procedure specifically visualizes the renal collecting system and the ureter. Its primary purpose is to evaluate the patency and integrity of these structures, providing information about how urine drains from the kidney. A contrast material is introduced directly into the kidney’s collecting system, typically through an existing nephrostomy tube. Its flow is observed using real-time X-ray imaging, known as fluoroscopy, allowing doctors to see the internal anatomy and function of the urinary tract. The diagnostic imaging component is identified by CPT code 74475.
Reasons for the Procedure
A nephrostogram is often recommended when blockages or abnormalities are suspected within the urinary tract. For instance, it can help pinpoint the exact location and cause of an obstruction, such as kidney stones, blood clots, or tumors impeding urine flow. The procedure also assesses the healing and integrity of the urinary system following surgery or injury, evaluating for potential leaks or narrowing (strictures). Furthermore, it can also investigate recurrent or persistent urinary tract infections when other diagnostic methods are inconclusive. This detailed visualization helps guide treatment plans.
The Procedure Explained
Preparation for a nephrostogram involves specific instructions from your healthcare team. These may include refraining from eating or drinking for several hours and discussing medications, especially blood thinners.
During the procedure, you will lie on an examination table, often on your stomach or side. A medical professional will gently inject contrast material through the existing nephrostomy tube, a thin tube previously placed into the kidney to drain urine.
As the contrast flows through the kidney and ureter, a specialized X-ray machine uses fluoroscopy to capture real-time images. This allows the doctor to observe the contrast material’s movement and identify any areas of concern. While the injection is generally not painful, you might feel a sensation of fullness or mild pressure in your kidney area.
The entire imaging process usually takes about 30 to 60 minutes. The initial placement of a percutaneous nephrostomy tube, if not already present, is a separate procedure identified by CPT code 50430.
After the Nephrostogram
Following a nephrostogram, you will typically be monitored for a short period to ensure there are no immediate reactions to the contrast material. This observation period usually lasts for about one to two hours. You will be encouraged to drink extra fluids to help flush the contrast from your system.
Most individuals can resume normal activities quickly, though strenuous activity might be restricted for a day or so. The healthcare team will provide instructions on how to care for the nephrostomy tube site, if applicable, to prevent infection.
A radiologist, a doctor specializing in medical imaging, will review the images and prepare a detailed report. Your referring physician will then discuss these results with you, explaining any findings and outlining the next steps for your care.
Important Considerations
After your nephrostogram, it is important to be aware of certain signs that warrant contacting your healthcare provider. You should report any unusual pain that worsens at the nephrostomy tube site or in your back or side. Additionally, monitor for any signs of infection, such as fever, chills, or redness and swelling around the tube insertion point. Any significant changes in the color or amount of urine draining from the tube, or any leakage around the tube, should also be reported promptly.
Maintaining good hydration is generally encouraged after the procedure, unless otherwise advised by your doctor. You may be given specific instructions regarding activity levels and hygiene to ensure proper recovery and prevent complications.