A nephrostomy tube is a medical device designed to drain urine directly from a kidney. This thin, flexible catheter provides an alternative pathway for urine when the normal urinary system is obstructed. The tube channels urine from the kidney into a collection bag located outside the body. This intervention helps maintain kidney function and prevent potential complications arising from urine buildup.
Understanding the Placement Location
Nephrostomy tubes are positioned directly into the kidney’s collecting system, the renal pelvis. This placement bypasses blockages in the urinary tract, ensuring efficient urine drainage. The tube is inserted through the skin, typically on the patient’s back or flank, passing through layers of muscle and kidney tissue to reach the renal pelvis. The tube then exits the body through a small incision made on the skin and connects to a drainage bag.
Why Nephrostomy Tubes Are Needed
Nephrostomy tubes are often required when the flow of urine from the kidney is obstructed. Conditions such as kidney stones, tumors within the kidney, ureter, or nearby organs like the bladder or prostate, and strictures (narrowing) of the ureter can all impede urine drainage. Trauma or injury to the urinary system can also necessitate placement. Draining urine prevents complications such as kidney damage, infection, or severe pain. When urine cannot drain properly, it can back up into the kidney, leading to swelling, a condition known as hydronephrosis. This can impair kidney function and lead to serious infections.
The Placement Procedure
The insertion of a nephrostomy tube is a minimally invasive procedure, performed by an interventional radiologist or urologist. Imaging guidance, such as ultrasound or fluoroscopy, is used to ensure precise and safe placement within the kidney. Local anesthesia numbs the insertion site, with sedation provided to help the patient relax. A small incision is made in the skin, through which a needle is advanced into the kidney’s collecting system. A guide wire is then threaded through the needle, and the nephrostomy tube is placed over this wire into its final position. The procedure takes between 30 to 90 minutes.
Living with a Nephrostomy Tube
Living with a nephrostomy tube involves specific care routines to ensure proper function and prevent complications. Daily care includes keeping the insertion site clean and changing dressings regularly, every few days or when soiled. The drainage bag must be emptied when it is about half full, and it should always be kept below the level of the kidney to promote proper drainage. Patients should monitor for signs of potential complications, such as fever, severe pain that does not improve, pus or unusual discharge from the site, or significant changes in urine color (e.g., bright red blood). Leakage around the tube or a decrease in urine output could indicate a blockage or dislodgement, requiring prompt medical attention. Depending on the underlying condition, the tube may be temporary or remain in place for an extended period, necessitating regular follow-up appointments for tube changes.