When the kidney is widened (dilated ) it becomes under pressure. This pressure affects the function of the kidney and reduces its working capacity. The causes of kidney dilatation are the block of the ureter with a stone or tumour, The narrowing (stenosis) of the ureter at its junction with the collecting system of the kidney (pelvis) or its compression from outside due to any reason.

To save the function of the kidney, it is important to release it. This is done through the insertion of a tube inside the dilated part to drain it and to reduce its pressure (Nephrostomy).

Nephrostomy can be done for diagnostic causes like the visualisation of the collecting system of the kidney using contrast medium and x-rays or to measure the pressure inside the collecting system. It is also done as a treatment where it is important to reach a stone inside the kidney to destroy or remove it.

nephrostomy catheter	hygienic catheter valve

special leg trousers for the urine bag	urine bags for leg

Who qualifies for the operation?

Patients who have renal stones, or obstruction of the ureter leading to dilatation of the kidney.

How does the operation work?

The patient is put on the abdomen. The kidney is controlled by ultrasonography to define the dilated area. The side of the body is disinfected. The area and the tract are injected with  local anaesthesia.

A special needle is pushed through a 3 mm wound under ultrasonography control into the dilated part. When fluid comes out, contrast dye is injected to be sure that the needle is in the dilated area. The central part of the needle is removed and a guiding wire is inserted to assure the tract.

The canal is then widened over the guide wire using Teflon dilators. The nephrostomy catheter is then inserted into the right place and its fixing balloon is filled with saline fluid. It is also fixed to the skin with a small suture. The nephrostomy catheter is connected to a collecting urine bag.  The wound is dressed.

incision

Frequently asked questions FAQ:

1. How is the nephrostomy drained?
   
   It is connected to a special urinary bag which is put in a trouser to be inconspicuous and to facilitate movement.
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2. Is the life with nephrostomy painful?
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   No it is not. You feel no pain after the operation.
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3. How to care for nephrostomy?
   
   The urinary bag must be evacuated and washed when full. The catheter must be changed every 6 weeks. The catheter must be washed and disinfected externally. The wound must be cleanly dressed.
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4. What are the complications of nephrostomy?
   
   The most important complications are blockage of the nephrostomy catheter, formation of Calcium stones, dislodgement and infection. Bleeding may appear immediately after the insertion of the catheter or later on. This must be immediately reported to your urologist.
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5. How to recognise the complications?
   
   The most important complains indicating complications are wetness of the wound, flank pain, fever, feeling of sickness.
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6. What to do if any of the above signs appear?
   
   You should consult your urologist immediately.
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7. How to avoid the complications of nephrostomy?
   
   It is mandatory to be sure that urine flows out of the catheter. Take the medications for acidification of the urine to avoid the deposition of Calcium crystals around the catheter. Clean the catheter and the urine bag with soap, water and disinfectant and keep it clean.
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8. Does the nephrostomy interfere with sex?
   
   No you can practice your life normally with nephrostomy.
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9. Can nephrostomy be on both sides?
   
   Yes, in rare cases it can be inserted in both kidneys.