A nephrostomy tube is a thin, flexible medical device designed to drain urine directly from a kidney. It helps manage situations where the normal flow of urine is disrupted. This tube diverts urine into an external drainage bag, allowing the kidney to function without harmful fluid buildup.
The Specific Site of Placement
A nephrostomy tube is placed directly into the kidney, specifically targeting the renal pelvis, where urine collects before moving into the ureter. The external entry point is on the side or lower back, passing through the skin. This placement allows for direct access to the kidney’s collecting system, ensuring effective drainage. The tube extends from the body, secured to the skin.
Why a Nephrostomy Tube is Placed
Nephrostomy tubes are placed when there is an obstruction or impairment in the normal flow of urine from the kidney to the bladder. Common reasons include kidney stones blocking the ureter, tumors compressing the urinary tract, strictures (narrowing) of the ureter, trauma, or infections. These can lead to hydronephrosis, a swelling of the kidney due to urine backup. When urine cannot drain, pressure builds within the kidney, which can lead to damage or infection. The nephrostomy tube helps preserve kidney function.
How the Tube is Inserted
Nephrostomy tube insertion is a minimally invasive procedure, typically performed by an interventional radiologist, with patients usually receiving a local anesthetic at the insertion site on the back or side, and sometimes a sedative. The radiologist uses image guidance, such as ultrasound or fluoroscopy (live X-ray), to locate the kidney and guide a thin needle through the skin into the renal pelvis. A guide wire is then threaded through the needle, which is removed, and the tube is advanced over the guide wire into the kidney. Once positioned, the tube is secured to the skin, often with stitches or an adhesive device, and connected to a drainage bag. The procedure generally takes between 30 minutes to an hour and a half.
Living with a Nephrostomy Tube
Individuals living with a nephrostomy tube need to manage it carefully to prevent complications. The tube is connected to an external drainage bag that collects urine and must be kept below the level of the kidney to ensure proper drainage. Patients are instructed on how to empty the bag, and how to maintain cleanliness around the insertion site to prevent infection. While the tube may be temporary, some individuals may require it for an extended period, necessitating periodic tube changes, usually every few months. Patients should contact their healthcare provider if they notice signs of infection, such as fever, redness, or swelling around the site, or if the tube stops draining or becomes dislodged.