Nephrostomy Tube

Urine is produced in the kidney and flows down a small tube called the ureter into the bladder. Sometimes the flow of urine is blocked due to stones, infection, congenital abnormalities or trauma. To restore the flow, a small catheter (tube) can be placed through the skin of the lower back into the kidney. Urine will then drain into a small bag. A nephrostomy tube may be in place for days, weeks or months.

About this Treatment

About this Treatment

How do we perform a nephrostomy tube insertion?

Using ultrasound, the interventional radiologist will locate the kidney and insert a special hollow needle through the skin into the kidney. Using live X-ray (fluoroscopy) for guidance, the doctor will guide a small catheter into the kidney. The portion of the catheter on the outside of the skin will be connected to a drainage bag. A small stitch (suture) and/or an adhesive clip will hold the catheter in place on the surface of the skin. Your child will be protected by an X-ray shield.

Will my child be awake during the procedure?

No. We will use either intravenous sedation or general anesthesia so your child isn't awake.

How long will the procedure take?

Approximately one hour.

Will my child be in any pain?

Your child will not feel pain during the procedure but some patients may feel discomfort around the catheter insertion site for a few days following the procedure.

What are the risks?

The procedure is considered low-risk. However, potential complications include:

  • Bleeding
  • Infection
  • Injury to the kidney, ureter or bladder
  • Allergic reaction to the X-ray dye (contrast reaction)
Pre and Post Operative Care

Pre and Post Operative Care

How do my child and I prepare for the procedure?

We encourage good communication between you and your child, including the necessity and overview of the procedure as well as ensuring them that you are close by the whole time. Holding them or their hands until they leave for the procedure is a great way to provide support.

You will be given specific instructions along the way but you may need to arrive a few hours before the scheduled procedure to have some blood tests done. When you arrive at the hospital, a doctor will review the procedure and associated risks, after which you will sign a consent form. When we are ready to get started with the procedure, a nurse will place an intravenous line to deliver sedating medications and you will be allowed to accompany your child in the operating room until they are asleep, after which you will be escorted to a waiting room.

What happens after the procedure?

Nurses will monitor your child in the recovery area for a couple hours for successful recovery from any sedating medicaitons, if any, and any immediate complications. The doctor may decide to have your child admitted to the hospital for an overnight stay. As mentioned, there may be some discomfort around the catheter insertion site for some days following the procedure, which is easily relieved by over-the-counter medications. It is important to keep the bandage surrounding the tube clean and dry.

When can I remove the bandages?

Do not remove the bandage and keep it clean and dry at all times. Please contact our department if the bandage is becoming loose or falls off. The bandage should be changed once a week and an appointment should be made to have this done unless a family member has been trained in changing the bandage.

Can my child bathe?

We will place gauze and a clear bandage over the catheter site. In addition, the catheter will be secured with a locking device (StatLock®), which must not be removed. The bandage must remain dry and in place at all times. You may sponge-bathe your child, but must keep the site dry.

How and when will the nephrostomy tube be removed?

Removing the nephrostomy tube is faster and easier. First, stitches are cut from the skin and the catheter is pulled out from the body. Pressure is applied to the insertion site during removal and for a few minutes after to minimize any bleeding that may occur. We will place a bandage that you can remove after 48 hours. All tubes remain in place for a time period determined by the managing physician but typically until the underlying disease has been treated properly.

Are there any activity restrictions?

Your child must avoid activities, such as contact sports or rough playing, which may result in a pull to the catheter and damage to or loss of the catheter.

CONTACT CNMC IMMEDIATELY IF YOUR CHILD EXPERIENCES ANY OF THE FOLLOWING:

•Redness, pain, swelling, or bruising at the needle insertion site.

•Fever higher than 101o Fahrenheit or 38o Celsius.

The department of Interventional Radiology can be reached at: 202-476-3791, Monday through Friday, between 8 a.m. and 5 p.m.

At all other times please call 202-259-8643, which is the on-call pager. Follow the instructions and wait for a call back.


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