What is a percutaneous nephrostomy?
A kidney or a ureter (tube leading from the kidney to the bladder) can become blocked. This may be due to kidney stones, tumors, or other causes. The blockage can cause a backup of urine in the kidney. Percutaneous nephrostomy is a procedure that places a drainage catheter (a long, thin, hollow plastic tube) in the kidney so the urine from the kidney can drain to prevent pain, infection, and kidney damage. The procedure is done by a specially trained doctor called an interventional radiologist.
Before the Percutaneous Nephrostomy
- No food or liquids for 6 hours prior to the procedure. However, you may take all regular medications as scheduled with small sips of water.
- It is required that you arrange for a relative or friend to drive you home after the procedure.
- Report any medications you are taking to the radiology nurse, including “blood thinners”, such as aspirin, Plavix, Lovenox, Coumadin, Pradaxa, Xarelto, or Eliquis. Your physician may advise you to stop taking a “blood thinner” for a specific period of time before your procedure.
- Prior to your procedure, your blood will be tested to determine if your blood clots normally.
- Report any allergies to the radiology nurse, especially those to iodine contrast (x-ray dye) or local anesthetic medications.
- Women should always inform the x-ray technologist if there is any possibility that they are pregnant. Many imaging tests are not performed during pregnancy so as not to expose the fetus to radiation.
During the Percutaneous Nephrostomy Procedure
- A nurse will insert an intravenous (IV) line into a vein in your hand or arm so that medication can be given intravenously to help you relax.
- You will be positioned face down lying on your stomach on the CT table and images will be taken to find the best location for drain placement.
- The skin of your back is cleaned with an antiseptic solution and the area is covered with a large sterile sheet.
- You will feel a slight pin prick when the local anesthetic (numbing medicine) is injected in the skin of your back.
- Using CT or ultrasound as a guide, the radiologist puts a drainage catheter (a long, thin, hollow plastic tube) through the skin and into the kidney to allow for drainage of the urine.
- A bag will be attached to the catheter to collect the urine as it drains.
Potential Risks and Complications
- Bleeding at the procedure site
- Infection at the procedure site, including in the kidney
- Urine leak
- Problems due to iodine contrast, including allergic reaction or kidney damage
- Injury to an adjacent organ, nerve, blood vessel, or muscle
After the Percutaneous Nephrostomy
- The catheter and drainage bag will remain in place until the problem that caused the buildup of urine is treated. This may be as little as a day or as long as weeks to months. The bag is taped to you so you can walk around.
- During the time the catheter is in place:
- Keep the skin around the catheter clean and dry.
- Be careful not to move or dislodge the catheter. Make sure that the drainage bag is taped securely to you.
- Empty the drainage bag often. This keeps the weight of the bag from pulling on the catheter.
- Get plenty of rest for the remainder of the day after your drainage. You may return to light activity the day after the procedure.
- If sedation medications were given, please review the following:
- You have been given a medicine that causes temporary drowsiness, clumsiness, and poor judgment. For the remainder of the day, do not drive, operate machinery or make important decisions; and avoid dangerous activities, including bicycling, swimming, or working at heights.
- You may temporarily feel sick, weak, or dizzy. This is normal. Some people will vomit if they eat too soon. As soon as you feel like you can drink without vomiting, you should try water, juice, or soup. You can progress to solid foods if the fluids do not cause nausea and you are feeling well.
- Avoid heavy lifting or strenuous labor for 3 days after your drainage.
- Mild pain, discomfort, or bruising at the procedure site is expected. You may take over-the-counter Tylenol for any pain you may experience.
Call your doctor if you have any of the following:
- Signs of infection at the procedure site, such as redness, swelling, or a fever.
- The urine stops draining from the tube, or the tube moves or comes out.
- If the urine becomes cloudy or smells bad.
- Bleeding from the procedure site.
- Worsening, severe pain near the procedure site.
If any further questions or complications arise and you do not know what to do, please call the radiology department at Summit Healthcare at 928-537-4375, ext. 6549. For questions after hours please ask for ext. 6332.