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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 drains the urine from the kidney to prevent pain, infection, and kidney damage. The procedure is done by a specially trained doctor called an interventional radiologist.

Outline of person showing kidneys, ureters, and bladder. Cross section of kidney showing buildup of urine inside, blockage in kidney, and blockage in ureter.

Preparing for the Procedure

  • Do not eat or drink anything for 6 hours before the procedure.

  • Tell your radiologist what medications, herbs, or supplements you take; if you are, or may be, pregnant; or if you are allergic to contrast medium or other medications.

  • Plan to have a relative or friend drive you home after the procedure. 

During the Procedure

  • You change into a hospital gown.

  • An IV (intravenous) line is put into your hand or arm to give you fluids and medications. You will then lie on your stomach on an X-ray table. You may be given medication to help you relax and make you feel sleepy.

  • The skin on your lower back is numbed with an injection of local anesthetic.

  • Using ultrasound or X-ray images as a guide, the radiologist inserts a needle through your lower back into your kidney. Contrast medium (X-ray dye) may be injected through this needle into the kidney. This fluid makes the kidney easier to see on X-ray images. The X-ray images can show exactly where the kidney or ureter is blocked.

  • The needle is then replaced with a drainage catheter (thin tube). The catheter is attached to a drainage bag, which collects the urine that drains from the kidney.

  • The entire procedure takes about 1 to 2 hours.

Potential Risks and Complications

  • Kidney infection

  • Bleeding of the kidney

  • Urine leak

  • Skin infection around the catheter site

  • Blockage of the catheter

  • Problems due to contrast medium, including allergic reaction or kidney damage

After the Procedure

The catheter will stay 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 your leg 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 your leg.

  • Empty the drainage bag often. This keeps the weight of the bag from pulling on the catheter. Call your doctor if the urine becomes cloudy or smells bad.

 

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