A1. The tubes draining your kidneys sometimes become blocked, for example, by a stone or a blood clot and infection may be present. This is a procedure to insert a catheter through the skin and into the kidney in order to drain it. The catheter drains the kidney into a collecting bag outside the body.
A2. Your doctors will have discussed the possible treatment options with the interventional radiologist (X-ray doctor) responsible for performing these procedures. There will be an opportunity for you to discuss the treatment with your doctors and with the interventional team. This is a good time to mention any allergies or other conditions you have. You will only be asked to sign a consent form after you have fully considered all the advice given. If you do not want to undergo this treatment, then the procedure will be taken no further.
Q3. What preparation will I need?
A3. You will need to be admitted to hospital in order to undergo this treatment. A small plastic cannula will be inserted into your arm to enable us to inject antibiotics and pain relief. You will probably be asked not to eat for four hours beforehand though you may be allowed to drink some water. You will be asked to wear a hospital gown and will be taken to either the X-ray department or operating theatre.
Q4. What happens during a Nephrostomy drainage?
A4. You will be asked to lie on a table, flat on your stomach. Monitoring equipment will be attached to you and oxygen given if required. Your skin will be cleaned with antiseptic and local anaesthetic (see below) will be injected into the skin and tissues surrounding the kidney. A fine needle is inserted into the kidney and guide wire passed through it, enabling the catheter to be positioned correctly. This catheter will then be fixed to the skin and a drainage bag attached to it. The length of the procedure can vary, but normally takes approximately one hour.
- Your radiologist will ask you to keep quite still while the injections are given.
- You may notice a warm tingling feeling as the anaesthetic begins to take effect.
- Your procedure will only go ahead when you and your radiologist are sure that the area is numb.
- If you are not having sedation, you will remain alert and aware of your surroundings.
- Your radiologist is always near to you and you can speak to him/her whenever you want to.
A5. There may be some discomfort during injection of the local anaesthetic but following this you should feel very little apart from some pushing. Pain relief will be given through the tube in your arm if required.
A6. On your return to the ward, you will stay in bed and the nurses will monitor you regularly for several hours. You will then be able to move gently around the ward. The drainage bag remains attached to you, which will be emptied frequently and the contents measured. The length of time that the drain remains in place will depend on your condition and will be discussed with your doctor.
A7. Nephrostomy drainage is a very safe procedure but there are two main complications occurring in less than 5% of cases: leakage of urine from the kidney and bleeding around or into the kidney. The urine leak may require placement of another tube through the skin to drain the fluid away. There is often a very small amount of bleeding but significant bleeding may lead to blood transfusion and, very rarely, to a small operation to block the bleeding artery.
Should you have any suggestions or concerns, please make these known to the person conducting your examination, or by letter addressed to:
The Departmental Manager
Newcastle upon Tyne
Tel: 0191 282 1099
All Newcastle Hospitals Switchboard Tel: (0191) 233 6161
If you need to turn to someone for on-the-spot help, advice and support, please contact the Patient Advice and Liaison Service (PALS) on:
How to get to the Freeman Hospital - Freeman Hospital is to the east of the City of Newcastle upon Tyne with public transport services close by. Buses are available to and from the city centre which deliver passengers direct to the main hospital entrance. A clearly sign-posted car park is provided for patients and visitors for which a charge applies.
(Please see Patient and Visitor Guides for map details to all X-ray Departments)
Information Produced by: Dr Phil Haslam, Clinical Directorate of Radiology