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Nephrostomy

Synonym: Percutaneous Nephrostomy

What is Nephrostomy?

Nephrostomy or Percutaneous Nephrostomy is a procedure that involves inserting a tube (Nephrostomy tube) or a catheter through the skin inside the kidney to drain urine. Nephrostomy tube or catheter can be kept patent by inserting a stent inside it. Nephrostomy can be temporary or permanent. Nephrostomy is a kind of 'Interventional Radiology' procedure.

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Where can I get Nephrostomy?

Country Cost with MedSolution
India (Please inquire for price)
All prices are in US dollars and include the cost of the procedure and minimum hospital stay. Estimates and minimum hospital stay will vary depending upon individual needs and requirements.

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Why is Nephrostomy performed?

Nephrostomy is usually performed when one of the ureters is blocked and the urine that is produced by the kidney cannot flow forward. As a result the back pressure of accumulated urine can cause damage to the kidney tissue and result in kidney failure. Nephrostomy can also be performed to access the kidney stone in the upper part of renal pelvis, that way it can either be dissolved chemically or by Intracorporeal Shortwave Lithotripsy (ICSWL).

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Who is an ideal candidate for Nephrostomy?

If you have a stone in your ureter that is large and / or of abnormal shape like stag horn calculus in the renal pelvis which either needs to be dissolved chemically or by Intracorporeal Shortwave Lithotripsy (ICSWL, if you have a stricture in your ureter that hampers the passage of the stone thus causing complete blockage and back pressure on the kidney, if there is a retroperitoneal tumour that is pressing on the renal pelvis or ureter causing your ureter to kink, if you have a tumour of the renal pelvis that has been resected and needs local chemotherapy, then you are an ideal candidate for Nephrostomy.

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How do I prepare for Nephrostomy?

Inform your doctor if you are diabetic, if you have any bleeding disorder or if you are taking medications that may prevent your blood from clotting. Ask your doctor about any special instructions to prepare for Nephrostomy. You will be instructed not to eat or drink any thing for atleast 4 hours before the Nephrostomy procedure. Since all medical procedures have a small risk of injury, you will need to sign a consent form before the test. Do not hesitate to ask your doctor about any concerns you might have. You may be asked to give a urine sample before the test to check for infection. You will probably stay in the hospital for 2 - 3 days and arrange for some one to to help you at home after the Nephrostomy.

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What does the procedure of Nephrostomy involve?

The entire procedure may take about an hour. Nephrostomy is performed in the operating theatre under stringent sterile conditions. Nephrostomy will be performed under local anesthesia and sedation to relieve anxiety, pain and discomfort during the procedure. You will lie flat on your stomach on the operating table. A small tube will be inserted through your back into your kidney below the twelfth rib. Contrast material will be injected through this needle to visualize your urinary tract so that the Nephrostomy tube or catheter will be placed. This catheter will remain in place to drain urine in a drainage bag. The catheter will be secured by a tape and a dressing will be applied to the catheter entry site.

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What is the recovery like following Nephrostomy?

The urine draining from your Nephrostomy tube will be bloody for the next few days. Your nurse will remove the clots and irrigate your catheter a few times each day to make sure that it is patent and the urine drains out of it freely. Keep the Nephrostomy wound and the skin around it clean. There will be pain and soreness in the area and also in the deeper tissues of kidney which can be relieved by pain medication. You will be instructed to take it easy, avoid sudden jerky movement and strenuous activities for the next 2 weeks. Do not play any sports until the Nephrostomy tube comes out.

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What is the outcome of Nephrostomy?

Nephrostomy is very successful to provide temporary relief to pressure build up due to obstruction. Permanent Nephrostomy may require dilatation periodically over longer periods of time. Percutaneous Nephrostomy is an essential procedure for relieving urinary tract obstruction.

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B . R . A . N . D . of Nephrostomy

Benefits of Nephrostomy

  • Nephrostomy is a safe procedure to drain urine from your kidney and can provide you with timely relief from urinary tract obstruction. Failure to perform Nephrostomy on time can result in damage to the renal parenchyma due to back pressure and may lead to renal failure.

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Risks of Nephrostomy

  • Infection at Nephrostomy site
  • Perforation of renal calyces or pelvis
  • Excessive bleeding
  • Pleural effusion, hydrothorax, or pneumothorax
  • Allergic reaction to the dye
  • Redness and soreness of skin around the catheter
  • Leakage of catheter around the Nephrostomy site

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Alternatives to Nephrostomy

  • Open Kidney surgery to access and correct the obstruction to flow of urine

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Now or Never

  • Kidney condition needing a Nephrostomy would be an urgent one and there is no point in wasting any time. Therefore, timely Nephrostomy is the only way to go to prevent long term and permanent damage to the kidney tissues.

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Decision to have Nephrostomy

  • Having Nephrostomy as a pre-planned procedure provides you with the opportunity and time to discuss the deatails about this operation with your surgeon and make an informed decision. The information provided in this article is meant to help you acquire the needed information before signing the consent form.

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Keywords: Kidney Stones, Bladder Stones, Cystitis, Urinary Tract Infection, Hematuria (Blood in urine), Urethral Stricture, Ureteroscope, Prostate Enlargement, Cystoscope, Intravenous Pyelography (IVP), Urinary Incontinence, Ureteral Stricture, Overactive Bladder, Urinalysis, Bladder Catheter, Painful Urination, Pelvic Pain, Iinterstitial Cystitis, Urinary Blockage, Narrowing of the Urinary Tract, Stone in the Urinary Tract, Bladder Cancer, Bladder Biopsy, Kidney Tumor, Urinary Tract Obstruction, Kidney Failure, Kidney Function, Renal Hypertension

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