Has your doctor told you that you need to have a tube inserted into your kidney? Or has a family member or friend had to do something like this? The name may sound a little scary, but this is actually a very important thing to do to protect your kidneys. Don't worry, we'll talk about everything in simple terms: what is a nephrostomy tube, why is it inserted, and how to care for it.
Simply put, what is this Nephrostomy tube?
A nephrostomy tube is a thin, flexible tube used to drain urine (pee) from your kidney. A doctor inserts this tube through your back, through the skin, into your kidney. The other end of the tube is then connected to a urine collection bag (nephrostomy bag). So the urine from your kidney drains directly into this bag.
Normally, urine produced by the kidneys travels down the ureters, collects in the bladder, and then exits the body through the urethra. But sometimes something can block this journey. That's when this tube is inserted to create an alternative route for the urine to exit.
Most of the time, this is a temporary solution . However, some people may have to keep the tube in place for months, or even years. This depends on the medical condition that caused you to have the tube inserted.
Why do we need to put a pipe like this?
There are several reasons why urine can stop flowing out of the kidney. If urine gets stuck inside, it can back up and cause the kidney to swell and start to get damaged. This condition is called Hydronephrosis . A Nephrostomy tube is placed to prevent this.
See the table below for the main reasons for this.
| Reason | Simple Explanation |
|---|---|
| Kidney stones | Stones can get stuck in the urinary tract and block the path. |
| Infections | Severe infections can cause the kidneys to swell and block the urinary tract. |
| Tumors or Cancer | Cancerous tumors in or around the kidneys, bladder, prostate, or prostate gland can cause the urethra to become blocked. |
| Scar tissue | Scarring from old surgeries or infections can cause the urethra to become narrow. |
| Swelling after surgery | Due to temporary swelling after kidney surgery. |
| Conditions that come from birth | Some people may be born with certain defects in their urinary system. |
How do you prepare before this surgery?
Your doctor will tell you exactly how to prepare for this.
- You may be asked to fast (abstain from eating or drinking) for a few hours before surgery.
- You should definitely tell your doctor about all the medications you take, as well as any allergies you may have, especially blood thinners .
What happens during the surgery?
This is a procedure that usually takes about an hour and is performed by an interventional radiologist.
1. First, you will be given a hospital gown and made to lie on your stomach (with your back facing up) on a table.
2. You may be given intravenous sedation to help you relax and not feel any pain. In addition, a numbing medicine will be given to the area where the tube will be inserted. This is done by giving young children and some adults general anesthesia , which puts them completely asleep.
3. The doctor will use an ultrasound or X-ray machine to find the exact location of your kidney.
4. Then, a small needle is inserted through the skin into the kidney, and a wire is passed through the needle. The nephrostomy tube is then placed over the wire and into the kidney. Sometimes a special liquid (`contrast dye`) is given and an X-ray examination (`Fluoroscopy`) is done to see if the tube is in the right place.
5. Finally, the exposed end of the tube is attached to the urine bag and secured with a small stitch or a dressing to prevent the tube from slipping out of the skin.
What should I be careful about after surgery?
You will be monitored for a few hours after the surgery and will be allowed to go home if everything goes well. However, some people may need to stay in the hospital for a day. Be aware of these things after you go home.
- Pain: It is normal to feel some pain and discomfort at the site of the tube for a few days. Take painkillers as prescribed by your doctor. Some people find it easier to place their hand over the tube when climbing stairs or bending over.
- Activities: Avoid running, jumping, or heavy lifting for a few days. Doing these things can pull the tube or cause the bag to come loose.
- Cleanliness: It is very important to keep the area where the tube was inserted clean and dry at all times to prevent infection. Therefore, avoid bathing or swimming. It is okay to shower after 48 hours, but the dressing should be changed immediately afterwards.
- Urine color: It is normal for the urine in the urine bag to have a slight pink tint (like orange juice) for the first couple of days. However, if the urine is dark red (like beetroot juice) , it is a cause for concern.
How do you take care of this pipe at home?
Proper care of the tube is essential to prevent infection. The hospital will give you instructions on this. The most important thing is to wash your hands thoroughly with soap and water or use hand sanitizer before and after touching the tube, bag, or dressing.
Examining the tube and surrounding skin
Check these things daily:
- Is the tube bent or stuck anywhere? If so, the urine won't go into the bag.
- Is the area where the tube meets the skin red, swollen, or showing signs of infection ?
- Is there blood in the urine in the urine bag?
- Is the dressing wet, dirty, or loose ? It should always be clean and dry.
Emptying the urine bag
- For urine to drain properly, the urine bag should always be placed below the kidneys .
- Empty the bag when it is about half full . Don't wait until it is completely full.
- If you see a hole or leak in the bag, put in a new bag.
Changing the dressing
You should change the dressing at least twice a week , or whenever it gets wet or dirty. You may need to get help from a family member for this. The hospital will teach you how to do this and provide you with the necessary supplies.
When should I call the doctor?
If there is any problem, for example, if it feels like urine is not going into the bag, inform your doctor immediately. In addition, if you have any of the following symptoms, be sure to seek medical advice.
| Feature to pay attention to | Description |
|---|---|
| See a doctor immediately. | |
| Dark red blood | If you see dark red blood (like beetroot juice) in the urine bag (light pink is normal in the early days). |
| Pus or yellow fluid | If you see pus-like fluid from the tube insertion site or in the urine bag. |
| Urine leakage | If urine leaks from the skin around the tube insertion site. |
| Fever | If the body temperature is above 101 Fahrenheit (38.3 Celsius) for more than 24 hours. |
| Severe pain | If you have severe pain at the site of the tube that does not subside despite taking medication. |
| If the pipe is loose | If the tube is accidentally dislodged, either completely or partially, go to the hospital's Emergency Department (ETU) immediately. |
Living with a nephrostomy tube can be a little emotionally difficult at times. But remember, this is something that is done to protect your kidneys and save your life. It is usually temporary. Talk openly with your family and doctor about your concerns and feelings.
Take-Home Message
- A nephrostomy tube is a safe procedure to protect your kidneys in the event of an obstruction to urine flow.
- To prevent infection, it is essential to always keep the insertion site clean and dry.
- Remember to always place the urine bag at a level lower than your kidneys.
- If you notice warning signs like severe pain, fever, or dark red blood in your urine, call your doctor without delay.
- It's normal to feel some emotional discomfort when living with this condition. But remember, this is essential for your health and is often temporary.
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