change of nephrostomy

This is when the tube that you have in your kidney to drain urine externally into a bag needs to be changed.

Your nephrostomy tube requires changing on a regular basis for a number of reasons:

• The urine can become gritty and block the tube.
• The tube can become a source of infection if left in too long.
• The tube may have become dislodged.

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 exchange 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 a special 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 come and talk to you about the procedure. You will have the opportunity to ask any questions or raise any concerns, and 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. The area around your Nephrostomy will be 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 inject x-ray dye into the tube to make sure it is still in the right place, a small wire will then be inserted down the tube.
• Your Nephrostomy will be removed and the new one placed over the wire that is in place. The wire will then be removed and then a dressing applied to hold it in place and a bag will be attached.

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 withheld 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 will need someone to take you home after the procedure is finished.