Percutaneous nephrostomy is a vital medical procedure used to drain urine directly from the kidney when normal urine flow is blocked. It is commonly performed in emergency situations, but can also be planned in patients with persistent urinary obstruction.
Understanding what is percutaneous nephrostomy, how the procedure works, why it is needed, and what to expect can help patients and families make informed decisions.
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What is Percutaneous Nephrostomy?
A percutaneous nephrostomy is a minimally invasive procedure in which a thin, flexible tube called a nephrostomy tube, is inserted through the skin into the kidney. Its purpose is to drain urine when the normal urinary pathway from kidney to bladder through ureter is blocked. The tube helps relieve pressure in the kidney, prevent infection, and protect kidney function.
Why is a Percutaneous Nephrostomy needed?
There are several medical conditions that may obstruct urine flow and require nephrostomy placement. Some of the common indications include:
- Kidney stones: Large stones can block the ureter, causing urine to back up into the kidney.
- Ureteric obstruction: This can occur due to inflammation, injury, scarring, or congenital abnormalities.
- Tumours: Cancer of the bladder, prostate, kidney, cervix, or pelvic organs may compress or invade the ureter.
- Severe urinary tract infections: Complicated infections can cause swelling that prevents proper drainage.
- Trauma: Injury to the urinary tract may require temporary diversion of urine.
- Post surgical drainage: Sometimes nephrostomy tubes are placed after urological or abdominal surgery to allow proper healing.
- Hydronephrosis: Swelling of the kidney caused by fluid build-up due to obstruction.
A nephrostomy is often performed urgently when kidney function is at risk or when pain and infection are severe.
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How is a Percutaneous Nephrostomy performed?
This procedure is typically carried out by an interventional radiologist under AI powered ultrasound and X-ray guidance. The procedure generally takes 20–40 minutes, depending on complexity. Here is what happens step by step:
- Preparation: Preparation starts with local anaesthetic used to numb the skin. Sedation may be given to help the patient relax. The patient lies on their stomach or side.
- Imaging Guidance: Ultrasound and fluoroscopy help the radiologist locate the kidney and identify the safest access point.
- Needle Insertion: A fine needle is carefully inserted into the kidney’s collecting system.
- Guidewire Placement: A guidewire is passed through the needle to secure access.
- Tube Insertion: A nephrostomy tube is advanced over the guidewire into the kidney.
- Drainage: The tube is connected to a drainage bag, allowing urine to flow freely.
What are the benefits of Percutaneous Nephrostomy?
A nephrostomy tube provides immediate relief from obstruction and helps protect kidney function. The key benefits include:
- Rapid reduction of kidney pressure
- Prevention of further damage to the kidney
- Improved drainage and reduction of infection risk
- Pain relief in cases of acute blockage
- Allows further treatment, such as removing stones or treating tumours
- Minimally invasive with quick recovery
What are the risks and complications?
Although generally safe, the procedure carries some risks. Most complications are manageable with timely medical care. Let us understand some of them:
- Bleeding at the insertion site
- Infection
- Tube displacement or blockage
- Urine leakage around the tube
- Mild discomfort or bruising
- Injury to surrounding structures
Aftercare and Nephrostomy Tube Management
Proper care of the nephrostomy tube is crucial in reducing infection risk and ensuring good kidney function. Nephrostomy tubes may need to be replaced every 6–12 weeks, depending on clinical need.
- Keep the tube and dressing clean and dry
- Empty the drainage bag regularly
- Avoid pulling or twisting the tube
- Monitor for signs of infection: fever, redness, increased pain
- Drink plenty of fluids (unless advised otherwise)
- Attend regular follow-up appointments for tube checks or replacement
How long will the tube stay in place?
The duration varies depending on the underlying condition:
- A few days for temporary blockage
- Several weeks or months during cancer treatment
- Until definitive surgery or stone removal is completed
- Your urology or radiology team will determine the appropriate timeline.
Alternative Treatments to Percutaneous Nephrostomy
Depending on the cause of obstruction, alternatives may include:
- Ureteric stent placement
- Stone removal (URS, PCNL, ESWL)
- Catheterisation
- Medical management of infections or inflammation
- Surgical reconstruction in severe cases
Conclusion
In conclusion, Percutaneous nephrostomy is a highly effective and minimally invasive procedure designed to relieve kidney obstruction and protect long-term kidney health. By restoring proper drainage, reducing pain, and preventing infection, it plays a crucial role in managing many urological conditions.
If you are facing any kind of urinary obstruction, a nephrostomy may be an essential step towards recovery and long-term wellbeing. Book a consultation with the best healthcare specialist and get cured early.
FAQs
1. What is percutaneous nephrostomy?
A percutaneous nephrostomy is a procedure where a thin tube is inserted through the skin into the kidney to drain urine when the normal urinary pathway is blocked.
2. Why is a nephrostomy tube needed?
It is used to relieve blockage caused by kidney stones, tumours, infections, or ureteric obstruction, helping protect kidney function and reduce pain.
3. How is the procedure performed?
Under local anaesthetic and imaging guidance, a small needle is inserted into the kidney, followed by placement of a drainage tube connected to a bag.
4. What are the risks of a nephrostomy?
Risks include bleeding, infection, tube blockage, leakage around the tube, or displacement — though most complications are manageable.
5. How long does a nephrostomy tube stay in?
It varies by condition: a few days for short-term obstruction or several weeks to months if ongoing drainage or treatment is required.
