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What is a Nephrostomy Tube?

Mona D. Rigdon
Mona D. Rigdon

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.

Urinary collection bag.
Urinary collection bag.

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.

Nephrostomy tubes are inserted in the kidneys using an ultrasound for guidance.
Nephrostomy tubes are inserted in the kidneys using an ultrasound for guidance.

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 nephrostomy tube allows direct drainage from the kidney.
A nephrostomy tube allows direct drainage from the kidney.

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 may be a temporarily solution to treat kidney stones.
A nephrostomy tube may be a temporarily solution to treat kidney stones.

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.

Discussion Comments

anon1004192

Any tips for sleeping when the tube is on your right side? Is there a way to use pillows around your body that can improve sleeping?

wilsanborn

No one talks about what to do if you are single without help. I have been cut down to 1 bandage every 7 weeks. The doctor ordered two, but the healthcare company refuses it. My insurance approved two visits and said there is nothing more they can do. help! What do other people do? I have had this for nine years now and had care by family for a few years and then they could no longer help. Home health did four years and now I am being cut back - possibly out.

anon999427

I had nephrostomy tube for 7 weeks. My doctor removed it in his office. First of all he did not have the tool to remove it so he asked me to drive to the kidney stone center in Orlando to pick up the tool and bring it back to him, which I did. Once back the doctor did not explain anything to me just asked me to lie on the table, and within a matter of 3 minutes he yanked the tube out. It was excruciating pain for about five minutes. When I got on my feet I was very disoriented and walked as if drunk.

The doctor said pain would go away and there was no need for pain meds. However, it was a day later before the pain became less. I was taking 1000 mg of Tylenol every 5 hours. I need my left kidney done but will not go back to this doctor.

anon346702

I just had a percutaneous nephrostomy tube removed after being in place for one week. Its temporary placement was primarily for the insertion of a stent in the ureter. I was very nervous about the removal of this tube since its placement and that of the stent were done under anesthesia. The removal was done under localized numbing. The doctor did give me an ativan prior to the procedure (I had a driver) and the staff and doctor were very comforting and straightforward with what was going on. The prep took much longer than the removal itself. With the removal I felt pressure more than pain and in the end realized that I was more anxious than necessary.

Prior to the procedure I looked for any type of posts regarding removal and found none so I decided to post my story in hope of helping calm some one else down prior to this procedure.

anon248053

When you are grieving, you always want someone to blame for what is happening to your loved one. You need to remember this person was already suffering from some condition that required a tube to be placed. You or your loved one signed some type of paper giving you every possible complication that could happen.

Sometimes, things happen and no one is to blame. It just happens and you cannot accept it. No amount of money or punishment will make you feel better. Oh, and it will happen again to someone, somewhere, no matter what you do. We accept some things for what they are.

anon150018

My 36 year old daughter had these tubes put in each kidney and now has an antibiotic-resistant bacteria which could well have been the result of it being on one of the tubes. It was aggravated by bed rest as well as movement to and from the bed and we are just disgusted. We are going to pursue it with the hospital to determine if they can prove it was not their fault. She has stage 4 cancer as well.

anon149852

I have no comment. My sister is going though Nephrostomy tube. I would like to know what is that? and what is contact to the kidney and bladder. I have a few more questions.

healthnwell

@donbri5 -- Unfortunately if you've got a kidney catheter, it is pretty certain at some point you will get an infection. The key to help prevent infections is to keep the catheter and surrounding area clean, clean, clean.

Disposable catheters are better than reusable ones for then you don't need to reuse and risk the chance of infection. When inserting or removing, always make sure your hands are clean. Also, keeping hydrated can help. Call the urologist at the earliest sign of infection.

donbri5

Can kidney catheters cause infection, and if so what can be done to help to stop infections from happening?

extrordinary

Though it sounds kind of scary, any properly trained friend or family member can change a nephrostomy tube dressing -- I know because I had to do it for my Mom!

In case you're curious, here's what you're getting into changing a nephrosomy tube dressing. First, the dressing should be changed 1-3 times per week. You have to wash your hands before and after taking off old dressing, and you should probably wear gloves.

You take a cleaner like Betadine or Chlorhexadime and rub it gently around the tube for about a minute. Let the skin air dry, then put on a clean dressing of split gauze over the tube, and you'll be good to go.

Oh, but you do have to be careful with this -- if there's any leakage, call your urologist immediately.

peasy

Though removing a nephrostomy tube (or kidney stent) is usually a quick and painless procedure, it isn't something that you can just do yourself. A stent removal should be done by either a urologist or a trained nurse with urology experience just in case something goes wrong.

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    • Urinary collection bag.
      By: Rob Byron
      Urinary collection bag.
    • Nephrostomy tubes are inserted in the kidneys using an ultrasound for guidance.
      By: jeff gynane
      Nephrostomy tubes are inserted in the kidneys using an ultrasound for guidance.
    • A nephrostomy tube allows direct drainage from the kidney.
      By: London_England
      A nephrostomy tube allows direct drainage from the kidney.
    • A nephrostomy tube may be a temporarily solution to treat kidney stones.
      By: airborne77
      A nephrostomy tube may be a temporarily solution to treat kidney stones.
    • Conscious sedation and local anesthetics may be administered before the nephrostomy tube placement procedure begins.
      By: Tyler Olson
      Conscious sedation and local anesthetics may be administered before the nephrostomy tube placement procedure begins.