Nephrostomy Tube Placement

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Percutaneous nephrostomy (PCN) tube is a catheter (plastic tube) that is inserted through your skin into your kidney. The nephrostomy tube is placed to drain urine from your body into a collecting bag outside your body.

Need to Know

Nice to Know
  • You will be asked to sign a consent form before the procedure is performed
  • Do not eat or drink anything at least eight hours before the procedure
  • Tell your radiologist about any allergies, especially to local or general anesthetics and contrast materials (“x-ray dye”)
  • Bring a list of medications you are currently taking and their dosages
  • If you are taking a blood thinner or aspirin product, the physician will instruct you when to stop taking these medications
  • If you are diabetic, the physician will give you insulin and/or anti-diabetic medication dosing instructions
  • Inform your radiologist if you are pregnant
  • You should plan to have someone take you home after the procedure
  • Before your procedure, you will meet with your Jefferson Radiology Physician or mid-level provider for a consultation
  • Wear comfortable, loose-fitting clothing
  • You will be given a gown to wear during your treatment
  • You will be relaxed during the procedure and can go home after a recovery period
  • Most patients feel minimal discomfort after the procedure

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How Does It Work?

You may need a percutaneous nephrostomy tube when something is blocking the normal path that your urine takes to leave your body. Urine from your kidneys passes through thin, narrow tubes called ureters. Your ureters are connected to your bladder where urine is stored for a time before you urinate. When your ureters get blocked by stones or blood clots, urine stays in your kidneys and will cause problems. The nephrostomy tube is put in to drain your urine directly from your kidneys. You may need this tube if you have pelvic tumors, damage to the urinary system, prostate cancer, or other conditions.

You may need one nephrostomy tube or two tubes if you need one for each of your kidneys. To place a percutaneous nephrostomy tube, a tunnel is made from your lower back through and into your kidney. Through this tunnel, the tube is placed and left in to drain urine from your kidney into a drainage bag.

What Happens — Before, During, and After?

A clinical staff member will bring you into the pre-procedure area and ask you to change into a gown. An intravenous (IV) line will be inserted into a vein in your hand or arm. Your doctor will greet you, review the procedure, and answer any questions you may have. You will be brought into the procedure room, and you will be positioned on the procedure table. You will be connected to a monitor for your heart rate, blood pressure, and pulse.

The technologist will sterilize, and cover the area of your body where the catheter will be inserted with a surgical drape. A local anesthetic is administered to numb the area where the catheter will be placed. Once the area is numb, your doctor will make a small incision and using image guidance insert a needle into your kidney. You might feel some pressure as the wire and catheter are inserted but you should not feel any serious discomfort. When the collecting system is entered in your kidney a catheter will be placed and left to drain. The other end of the nephrostomy tube will remain outside your body to drain urine into a bag. The tube is secured into place at the skin surface with a stitch. A drainage bag will be attached to the catheter. The procedure takes approximately 1 hour.

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How Should I Prepare?

There are things you can do to make your experience more comfortable, and many of these will depend on your individual preferences. You might like to keep a list of questions or – as you’re doing now- educate yourself about the procedure.

You will need to get a blood test to check your liver and kidney functions.

Another important part of your preparation will be guided by your doctor:

  • Your doctor may ask you to stop taking aspirin, non-steroidal anti-inflammatory drugs (NSAIDS), or blood thinners (such as Coumadin, Warfarin, Plavix, Fragmin) for a time before the procedure.

Some of your preparation will need to be timed to the procedure:

  • The day before the procedure (or the Friday before, if you’re scheduled for a Monday procedure), a clinical staff member from the Interventional Radiology Department will call you. The clinical staff member will give you any additional instructions, and will ask if you have any questions.
  • In the 8 hours before the procedure, do not drink fluids or eat food.
  • You may take the medications with a sip of water
  • When you arrive, make sure the clinical staff member and radiologist know about any allergies you may have, especially allergies to local anesthetics (such as lidocaine), general anesthetics, or x-ray dye (contrast media). If there’s any chance you might be pregnant, tell your radiologist.
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What Should I Bring?

  • Wear comfortable, loose-fitting clothes
  • Wear comfortable shoes
  • Avoid bringing jewelry or valuables
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What Are the Benefits and Risks?

The benefits of Nephrostomy Tube Placement could be:

  • Relief of symptoms such as pain, fever, chills and kidney failure caused by blockage of the urine
  • The placement of the catheter may be temporary until the underlying causes treated or occasionally may represent a permanent solution

Risks you should be aware of include:

  • Nephrostomy placement is a safe procedure, performed instead of surgical placement of the drain
  • The two most frequent complications are bleeding and infection. Commonly, your urine will be tinged with blood for several days after the drain has been placed. No further treatment is usually required

Keep in mind that this information is general. Your radiologist is the best source of information about how these risks and benefits may apply to you

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Additional instructions if your nephrostomy tube is connected to a drainage bag

If your tube is connected to a drainage bag, urine made by the kidney will drain into the bag. If your other kidney is working, you will urinate in the usual manner. Do not be alarmed if you urinate less or not at all.

The extension tubing and drainage bag will be changed when you come to the hospital for a routine change. You may need to change these before your clinic visit. Reasons to change the tubing and bag are if the bag or tubing has a foul odor or a lot of build up inside.

Supplies you will need:

  • Urine Leg Bags
  • Nephrostomy Extension Tubing
    - Gather all supplies needed
    - Wash your hands well with soap and water for 30 seconds
    - Connect the new urine leg bag to the tubing
    - Unscrew the clear tubing from the nephrostomy tube in your back
    - Discard the old tubing and bag
    - Connect the new tubing and bag by screwing the clear extension tubing back onto the nephrostomy tube
 

If you’re nephrostomy tube is clamped:

No urine will drain from the tube if it is clamped off. There will be no drainage bag on your tube. Urine made by your kidney will drain through the ureters and down into your bladder and will leave your body when you urinate.

When to call the doctor:

  • Redness at the site
  • Greenish drainage at the site
  • New swelling at the site
  • A temperature greater than 100.5°F for two readings taken 4 hours apart
  • Shaking chills
  • Foul-smelling urine
  • Decreased urine output from your drainage bag
  • Cloudy urine with a sediment
  • Pain at your tube site
  • Pain in your side
  • Your stitches come out or break
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