Information for Patients

Normally, urine drains from your kidneys through a narrow tube called the ureter into your bladder.  If this is obstructed and the passage is hindered, a nephrostomy tube might help you.  It helps to relieve a build-up of urine in the kidney and prevents the kidney from being damaged.

This procedure is done in the radiology department, where a catheter is put directly into your kidney through the skin of your back.  The urine will be drained into a bag.  This is usually not a permanent solution and the removal of the tube is also performed in the radiology department. You receive a local anaesthetic, so that the location of the catheter insertion is pain free.

A nephrostomy is always performed as an inpatient procedure, so you will have to stay in hospital at least overnight.  Also, you may be required to come into the hospital the day before the procedure, if you are not already an inpatient. 

We typically recommend that you do not eat or drink anything 6 hours before the procedure, as sedation may be given. 

A routine blood test to ensure that your blood clotting is adequate will be undertaken, and you will be given some antibiotics.

Take all medication as normal. If you are an asthmatic or suffer from angina please bring your inhaler(s) and medication with you.

If you are taking medicines such as blood thinners (warfarin, aspirin or clopidogrel), these may need to be altered around the time of your scan.  Contact your GP or please feel free to telephone us if you have any questions or concerns about your medications. 

The following investigations involve exposure to x-rays.  X-rays consist of a type of radiation known as ionising radiation.  The doses that are used in medical x-rays are very low and the associated risks are minimal.  We keep the doses as low as possible and make sure that the benefits of having the x-ray outweigh any risk. 

Furthermore, the contrast dye that is used contains iodine, which some people are allergic to.  If you have had an allergic reaction to x-ray contrast in the past of if you have a known allergy to iodine, please let us know. 

The contrast dye can affect kidney function, but a pre-procedure blood test will be performed to assess your kidneys' function.

Although the risks of developing complications from having a nephrostomy is low, there are a few possible complications that you must be aware about, including infection, bleeding or leaking of urine within the abdomen.  You will, however, be monitored very closely, so that if any problems may arise, it will be picked up and treated straight away.

You will be given an epidural and a sedative, which is medication to help you relax.  You will, however, be awake during the procedure.  If you need more sedative, you will have a cannula in your arm in case.   In the procedure room, you will lie on your stomach on the x-ray table. 

Monitoring equipment will be hooked up and you may be given some sedation at this point in time. 

The radiologist and nurse will wear sterile gowns and gloves, and your back will be then covered with sterile towels.  A small area of skin on your back will be left bare, but will be cleaned with antiseptic, which may be a bit cold. 

The radiologist will use x-rays to identify the kidney and to determine where the best place is to put in the tube.  You will receive some local anaesthetic (which may sting a bit, but lessens quickly), and a fine needle will access the kidney.

A small guide wire and a small plastic tube will be inserted,  and once the tube is in place, the guide wire is removed.  The tube will be secured to the skin and a drainage bag will be attached to the catheter.

Typically, this procedure does not hurt, but if you do experience some pain, there will be a nurse of another member of staff who monitors you.  

You will be taken back to the ward on a trolley and the nurses will monitor your vital signs on a regular basis to make sure that you are feeling well.  You may need to stay in bed for a short while until your vital signs are stable. 

You can eat and drink straight away. 

The nurses on the ward will teach you how to care for your tube and how to empty the bag. 

Should you go home within 24 hours after the procedure, we highly recommend that you find someone to drive you home or that you take a taxi. 

Once home, rest quietly for a day or two. Lie on the settee, prop your feet up and try to relax a little.  Drink plenty of fluids.