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A nephrostomy tube is a small rubber tube that is placed through a hole in the skin and that extends into the kidney. The tube allows direct drainage from the kidney. Often called a percutaneous nephrostomy tube, the device attaches to a collection bag that collects and measures urine output. The tube allows urine to bypass blocked or damaged ureters in order to avoid the risk of infection or irreversible damage that the backflow of urine causes for a patient with a blockage or leak.
There are several reasons this device might be prescribed in a patient's plan of care. A urologist or nephrologist might need direct access to apart of the upper urinary tract for various procedures. Kidney stones or other blockages can stop the flow of urine from the kidneys through ureters and into the bladder. This can cause pain and a condition known as hydronephritis. A nephrostomy tube bypasses the blocked area, allowing urine to leave the body.
Injury or illness of the ureter or bladder that causes a hole or leak also calls for surgical placement of a nephrostomy tube. The tube allows urine to drain directly, avoiding the leakage of urine into the abdominal cavity. Such tubes might be placed in order to prepare for procedures or surgery on the kidney, bladder or ureters. This allows doctors to treat injury, illness or kidney stones while still allowing the kidney to drain urine from the body. Patients with tumors of the renal pelvis or similar issues might require placement in order to most effectively deliver chemotherapy treatments to the renal collection system.
Placement of a nephrostomy tube is a simple surgical procedure, but it requires precise actions and careful monitoring. After an intravenous tube has been inserted, a patient is placed on an X-ray table, lying on his or her stomach. The patient is monitored through medical equipment for appropriate blood pressure, oxygen levels and heart rate. Generally, the insertion point is cleaned thoroughly with an iodine-based soap, and the area is numbed through injection. A nurse or anesthesiologist is present in order to administer medications to help the patient with pain relief and sedation.
A radiologist uses an X-ray or ultrasound to locate the patient's kidney. A needle is inserted into the kidney, and an X-ray dye is injected before the insertion of the nephrostomy catheter. After insertion, the site is dressed with a sterile dressing. The catheter is connected to a drainage bag that can be secured to the patient's leg with rubber straps in order to give the patient privacy. Other people often won't even know that a patient has a nephrostomy tube in place.
A nephrostomy tube generally is a temporary solution to a condition of the urinary tract or a surgical aid. In most cases, the tube is in place only long enough for an obstruction to clear or for a leak from a tear or hole to heal. Generally, the tube, catheter and injection site are checked by a physician every four weeks, or as the situation warrants, until the tube is removed. Removal is a simple procedure that takes only about five minutes.