Nephrostomy insertion

Urine normally drains from your kidneys into your bladder through a narrow tube (ureter). The ureter can become blocked, stopping the urine draining into your bladder. In this case you may need a nephrostomy inserted. This is a small thin tube that is inserted directly into your kidney through the skin of your back, so that urine can drain out into a bag. This is normally a temporary solution and can be exchanged for a stent, a small plastic tube, which sits in the ureter helping the kidney to drain the urine into the bladder.

You have a blockage in your ureter which means you are unable to pass urine normally. This can cause damage to the kidney. This procedure allows urine to drain from the kidney externally into a bag.

The consultant in charge of your case, and the Interventional Radiologist (the doctor who specialises in Imaging Procedures) who will be carrying out the Nephrostomy Insertion will have discussed the situation, and feel that this is the best treatment option. However, you will also have the opportunity for your opinion to be taken into account and if, after discussion with your doctors, you do not want the procedure carried out, you can then decide against it.

A specialist doctor called an Interventional Radiologist. Interventional Radiologists are experts in using X-ray equipment and in microsurgical techniques.

In the Imaging Department, in an Interventional Radiology (IR) Procedure Room which is designed for these specialised procedures. You will be checked into the department by a nurse, who will ask some medical questions and fill out some paperwork. The Interventional Radiologist will then explain the procedure. This will give you the opportunity to ask any questions or raise any concerns. Only if you are happy to continue with the procedure will you be asked to sign the consent form.

It is performed in the IR procedure room.

• You will lie on a special x-ray table usually on your front or side.

• You will have a needle put into a vein in your arm so we can administer antibiotics and pain killers if required.

• Your back is cleaned and you will be covered in sterile drapes. The radiologist will inject local anaesthetic to numb the area. This may sting at first before numbing the area.

• The radiologist will use ultrasound and imaging guidance to place a plastic tube (drain) into your kidney. They will make sure they are in the right place by injecting x-ray dye through the drain. Once they are in the correct place the drain will held in place with a dressing and sometimes also a stich. The drain will be attached to a bag to collect the urine.

To prepare for the procedure you will need to make sure you do the following:

You will need to have a blood test before your procedure.

Please let us know if you are taking any antiplatelet medicines (for example, Aspirin, Clopidogrel) or any medicines that thin the blood (for example, Warfarin), as these may need to be stopped temporarily before the procedure. Call the IR department for advice as soon as you get your appointment letter on 01273 696955 extension 4240 or 4278 and ask to speak to one of the IR nursing team.

If you are taking medicines for diabetes (for example metformin) or using insulin, then these may need to be altered around the time of the procedure. Call the IR department on the numbers above for advice as soon as you get your appointment letter.

You cannot eat or drink anything (except water) for four hours before your procedure. You can drink water up to two hours before your procedure.

You will be admitted to a hospital ward post procedure for monitoring.