Nephrostomy Tube

Your kidneys make urine by filtering toxins out of the blood. Urine then flows from your kidney through the ureter and into your bladder. When your bladder is full, it lets your body know to empty it. Sometimes, the flow of urine from the kidney to the bladder is blocked. This can cause a backup of urine in the kidney and kidney damage.

“Nephro” means kidney. A nephrostomy tube is a tube placed through the skin and into the kidney. Urine then flows from the kidney into a bag outside the body. You may have one (unilateral nephrostomy) or two nephrostomy tubes (bilateral nephrostomies) depending on if one or two of your ureters is blocked. If you have a tube for each kidney, you may no longer pass urine as you normally would.

How do I prepare for the procedure?

Your provider will go over how to prepare for a nephrostomy tube placement, like if or when you need to stop eating or taking your medications before the procedure

How is the nephrostomy tube placed?

A nephrostomy tube is often placed in the Interventional Radiology (IR) department by a doctor called an Interventional Radiologist. They may also be placed in the operating room (OR). You may or may not be asleep during the procedure and you may need a short hospital stay. Your provider will go over your procedure and what will happen, but in general:

• An IV will be placed in your hand or arm. You may be given antibiotics to prevent an infection and medication to keep you calm or to help you sleep. Medications may also be used to numb the area.
• You will lie on your stomach.
• You will be hooked up to monitors to track your heart rate and blood pressure.
• An incision (surgical cut) will be made in your back or flank (side of stomach) to insert the imaging tools, needle, and wire to help find where the tube should go. When the tube is in the right place, the imaging tools, needle, and wire are removed leaving the tube. The tube is then attached to a drainage bag. Imaging or a dye test may be used to make sure it is in the right place.
• The tube may be stitched to your skin and the area will be covered with a bandage.

You will be monitored for a few hours after it is placed. You may be able to go home the same day, or you may need to stay in the hospital for a few days.

How do I care for the nephrostomy tube?

Before you go home, your care team will review any changes you need to make. You can often go back to your normal activity and diet. They will also talk to you about how to care for your tube and about the supplies needed to empty the collection bag. Often, care includes:

• Wash your hands before and after touching the tube.
• Clean the incision area with soap and water. Be gentle and pat dry.
• Change the dressing as instructed, often every 3 days or when it gets wet or dirty.
• Do not bathe or go into a pool or hot tub. Ask your provider when you can start showering.
• It is common to have some blood in your urine for a few hours to days after the nephrostomy tube has been placed. If the blood continues or worsens you should call your provider.
• Empty the bag as needed. Ask if you should use a collection container to measure how much urine you are making. You may also be able to use a larger bag overnight.
• You may want to secure your tube and drainage bag to your thigh using an elastic band.

Ask your provider about specific directions to care for your nephrostomy tube.

When should I call my healthcare provider?

Call your provider if you have:

• Bleeding, drainage, redness, or pain at any of the incision areas.
• Fever. Your care team will tell you at what temperature you should call.
• There is no urine in the collection bag, it changes in color (darker color, cloudy, bloody, puss), or has an odor. It is common to have some blood in your urine for a few hours to days after the nephrostomy tube has been placed.
• You have new or worsening pain.

A nephrostomy tube may be placed for a short period of time or may be used long-term to help with symptom management. Talk to your provider about any questions or concerns you may have about this procedure.