A Brief Guide to Nephrostomy

Nephrostomy is a procedure where an ostomy or artificial opening is made near the upper part of the urinary system to allow the drainage of urine. Sometimes due to conditions like cancer, the ureter that connects the kidneys to the urinary bladder gets blocked causing pressure to build up. This build up of pressure can damage the kidneys. Hence it is required that an ostomy be made near the ureter to drain the urine and prevent it from collecting and building pressure. A nephrostomy tube is inserted into the ureter that is then connected to a drainage bag. The catheter helps in draining the urine from the ureter without it reaching the bladder. Surgeries can also be performed sometimes to remove the blockage but mostly, doctors recommend going for an ostomy.

Why Does One Need Nephrostomy?

There are a number of reasons one might have to go for a nephrostomy. Since nephrostomy refers to draining the urine because of the blockage of the ureter, we will discuss the reasons the ureter gets blocked:

  • Injury to the kidney or ureter
  • Congenital condition
  • Infections

Rehabilitation For Nephrostomy

Rehabilitation in case of nephrostomy basically involves using nephrostomy tubes, placing and removing catheters, using drainage bags, and maintaining the ostomy and its apparatus.

  1. Nephrostomy Tube - This tube is placed within the ostomy during surgery. The surgeon makes an artificial opening near the ureter and places a nephrostomy tube within it. The ostomy is then sealed so that no leakage exists. Dressings are required later on to see to it that there is no leakage. The nephrostomy tube is just like any other catheter but is designed specifically to be used for nephrostomies.
A Brief Guide to Nephrostomy A Brief Guide to Nephrostomy
Rusch Four Wing Tip Malecot Nephrostomy Catheter With Funnel End Bard Bardex Malecot Nephrostomy Catheter
 
  1. Drainage Bags - These bags are connected to the nephrostomy tube and are responsible for collecting the urine that is drained via the tube. They come in different capacities and can be worn or attached to the bed depending on the choice of the user. Drainage bags need to be replaced to avoid spillage. They also need to be washed regularly.
A Brief Guide to Nephrostomy A Brief Guide to Nephrostomy
Remington Medical 600ml Nephrostomy Drainage Bag
 
Merit Medical Clear Nephrostomy Drainage Bag
 
  1. Managing Ostomy - Managing the ostomy includes cleaning the bags and tubes, disinfecting the ostomy on a regular basis and seeing to it that the foul odor of the ostomy is taken care of. There are a number of items that help with this, which includes straps, pessaries, connectors, etc.

Types of Nephrostomy Tubes or Catheters

There are two situations where two different catheters have to be used, which are:

  • Basic Nephrostomy Catheter - This is used when the blockage in the ureter cannot be bypassed. Thus the catheter passes through the skin and into the renal pelvis. One end loops over here and the other end is attached to a drainage bag

A Brief Guide to Nephrostomy 

  • Nephro-Ureterostomy Catheter - These catheters are used when the blockage can be bypassed by the surgeon. It is passed through the blockage region and then into the drainage bag

A Brief Guide to Nephrostomy 

Caring For A Nephrostomy

Caring for a nephrostomy includes a lot of important things that one must check off their list to ensure a safe and healthy management of nephrostomy:

  • Make sure that the dressing around the ostomy is clean and dry, if not, then replace it immediately with a clean dressing
  • If there are leakages, then look for the source and seal the source using dressing.
  • Check if the tube is correctly inserted and isn’t loosely fitted in the ostomy
  • Make sure that the dressing or other apparatus you use is skin friendly
  • The tube should be clean and straight and shouldn’t have any bends or twists
  • The urine should not seep out of either the tube or the bag
  • Change the bag immediately when you feel that it has reached its maximum capacity
  • Never touch the ostomy with naked hands, always use a pair of exam gloves
  • Always drain the bag before sleeping so that there aren’t any problems while sleeping

Complications One Might Face With Nephrostomy

Each and every treatment has complications if one doesn’t follow the correct method of treatment and post-treatment care. Nephrostomy also can result in a lot of complications if the ostomy is not taken care of properly:

  • Excess fever
  • Chills
  • Urine that is pink or red
  • Urine that is dark and smells bad
  • Pain on the side and lower back
  • Inflammation and redness near the ostomy
  • Irritation and rashes along the ostomy and near the drainage bag

Removing a Nephrostomy Tube

Once the blockage in the ureter has been cleared, the doctor proceeds with a procedure that removes the nephrostomy tube. The tube is gently pulled out and the ostomy is sealed using a dressing. You should never pull or tug in the tube while it is in the ostomy. You might have to rush to the hospital or contact the doctor if any of the following things happen:

  • The drainage is poor
  • The urine is being collected in the bag
  • There is sever redness or inflammation around the ostomy
  • The tube falls out suddenly
  • There is bleeding near the ostomy
  • There is a foul smell near the ostomy
     

Ostomy care is a very personal thing and maintaining discreetness during this is very important to some people. Nephrostomy deals with a very intimate organ and system and hence caring for it is very important. The right kind of rehab and care can make your experience with nephrostomy less painful and faster.

 

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