Overview

This information is about putting a small tube called a nephrostomy catheter through the skin into your kidney to drain urine (pee). 

The aim of this information is to help answer some of your questions about having a nephrostomy catheter inserted. It explains:

• the benefits of a nephrostomy catheter 
• the risks of a nephrostomy catheter 
• how to prepare for the procedure 
• what happens during the procedure 
• what happens after the procedure 

If you have any more questions or concerns, please speak to a doctor or nurse caring for you in the interventional radiology (IR) department.

About a nephrostomy catheter

Usually, urine drains from the kidneys through a narrow tube (the ureter) into your bladder. If the ureter gets blocked and urine cannot pass into your bladder, doctors may recommend putting in a nephrostomy catheter.

We put the catheter (thin, small tube) directly into the kidney through the skin on your back. Urine then drains through the tube into a bag outside your body.

The drainage bag is not usually a permanent solution. We can replace it with a small, plastic tube called a ureteric stent, which connects the kidney to the bladder.

In adults, the procedure is usually done under a local anaesthetic. You stay awake for the procedure, but we give you a medicine to make a specific area of your body numb.

Benefits of a nephrostomy catheter

The nephrostomy catheter lets urine drain from the kidney. It works by temporarily moving urine away from the blocked area of the ureter into a bag outside your body.

If you have a nephrostomy catheter while your ureter is blocked:

• the kidney can keep working in the usual way
• this helps to treat infection in a blocked kidney

Risks of a nephrostomy catheter

Serious complications after having a nephrostomy catheter inserted are very rare. However, as with any procedure, there are some risks involved. We explain these risks before asking for your permission (consent) to do the procedure.

The most common risks are listed in this section.

Infection

It is possible to get an infection, but we give you antibiotics before the procedure to help prevent this.

Blood in the urine

It is common to have blood in your urine after the procedure. This usually lasts for 1 to 2 days and is not serious. Heavy bleeding is rare.

Problems with the catheter

The nephrostomy catheter can become blocked, fall out or stop working properly. You need to be careful not to knock the tube out of position. If you notice any problems, it is important to tell your doctor immediately.

Radiation risks

During the procedure, you are exposed to X-rays. They are a type of radiation called ionising radiation. This may cause cancer many years or decades after you are exposed to it.

You might have some skin redness after the procedure that feels like sunburn. We do not expect this to be permanent. The redness might be harder to notice on brown and black skin. 

Interventional radiology (IR) is when we use medical imaging guidance to do minimally invasive procedures. The amount (dose) of radiation from these procedures is generally low. More complex procedures might involve a medium (moderate) dose of radiation.

The IR doctor and radiographer (health professional who specialises in medical imaging) make sure that:

• your radiation dose is kept as low as possible
• the benefits of having X-rays during your procedure are greater than the radiation risks

Radiation and pregnancy

Radiation can be harmful for an unborn baby. If you are or think that you might be pregnant, it is important to tell a member of your medical team before the procedure. We cannot do any procedure that involves radiation if you are pregnant.
 
If you can become pregnant from sex, you need to use protection (contraception) from the first day of your period until your appointment. This means that you will not be pregnant when you have the procedure.

If the first day of your period has already passed, please contact the interventional radiology (IR) department. We can then give you another appointment within the first 10 days of your period. 

We ask you to sign a pregnancy declaration form before the procedure.

Other treatment options

Sometimes, we can put a small, plastic tube called a ureteric stent through your bladder and into your kidney. The stent holds a blocked ureter open and allows urine to drain from the kidney into the bladder. However, this is not suitable for everyone.