Urinary System

Percutaneous Nephrostomy & Replacement

The kidneys produce urine, which is drained through the ureters into the bladder, before passing through the urethra and leaving the body. Sometimes cancer in the lower abdomen can block one or both of the ureters. When this happens, urine can’t leave the kidney, causing damage.


A nephrostomy allows urine to be drained through a tube inserted through the skin on your back and into the kidney. Using an X-ray or ultrasound, your doctor will find the best place within the kidney to place the tube. The doctor numbs your back with a local anesthetic and inserts a fine guidewire into the kidney. The guidewire helps the doctor place the nephrostomy tube correctly. Stitches hold the tube securely in place, and it’s connected to a urine collection bag which can be worn under your clothing. Your nurses will give you advice and support on looking after your nephrostomy outside of the hospital.

Some people will need the nephrostomy for only a short time, while others may need to keep it permanently. Schedule your free consultation with us today to receive more information.

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People with cancer may need a nephrostomy if the cancer is blocking one or both ureters. If a ureter becomes blocked, urine can’t flow through from the kidney to the bladder, which causes urine to build up in the kidney. When this happens the kidneys can’t work properly and they may gradually stop working. This can make you feel very unwell unless it’s treated immediately. You may need one nephrostomy tube or two depending on whether one or both ureters are blocked.

Your ureters are more likely to become blocked if you have a cancer that started in the lower tummy (pelvis) and has spread within that area. For example, in women, this may be a cancer of the bladder, cervix, womb or ovaries. In men, it may be a cancer of the prostate or bladder. In both men and women, it may be a cancer of the colon or rectum. Occasionally, a cancer that started in another part of the body spreads to the pelvis and blocks one or both ureters. You’ll usually have a scan to find out exactly where the blockage is.

Before you have a nephrostomy, your doctor will explain its aims to you and the possible side effects or complications. You’ll be asked to sign a form giving your permission (consent) to have the procedure. Make sure you ask any questions you have and if there’s anything you don’t understand let the staff know so that they can explain. You may also want to talk things over with family or friends.


A nephrostomy tube is usually put in under local anesthetic during a short stay in the hospital. The procedure is done by a radiologist – a doctor who specializes in diagnosing and treating disease using x-rays and scans. It’s usually done in the x-ray (radiology) department as the doctor will use x-ray or an ultrasound scanning to guide them as they place the nephrostomy tube in the kidney. It can take up to 30-60 minutes.

Before the procedure, a fine tube (cannula) may be put into a vein in your arm. Sometimes a drip (infusion) is attached to the cannula to give you fluids. Through the cannula, you may be given intravenous antibiotics to reduce the risk of getting an infection. You may also be given a sedative to help you relax.

You’ll usually be asked to lie flat on your stomach on an x-ray table. When you’re comfortably positioned, the doctor will inject some local anesthetic into the skin on the side of your back. Once the area is numb the doctor gently inserts a fine needle into the kidney and then puts a guidewire through the needle. The doctor uses the guidewire to place the nephrostomy tube in the correct position in the kidney. The tube is kept securely in place with stitches so it won’t come out and is connected to a bag outside the body that collects the urine.

When the nephrostomy tube is being put into the kidney it may hurt a little for a short time. You may be given a painkiller through the cannula in your arm. Remember to let the doctor or nurse know if you’re in any pain or feeling anxious.

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If you have been recommended for percutaneous nephrostomy & replacement, make an appointment with our specialists for an evaluation. If you need treatment, the experienced physicians at Precision VIR will create an individualized plan to help you get the best results.

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