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Nephrostomy Surgery

Nephrostomy surgery is a vital procedure designed to alleviate urinary blockages and preserve kidney function by directly diverting urine from the kidneys to an external collection bag. This intervention is essential for patients whose natural urine flow is impeded by conditions like kidney stones, tumours, or strictures. If you are experiencing symptoms such as pain, infection, or other complications related to urinary obstruction, consult with Pristyn Care’s team of experienced urologists. We specialise in performing precise nephrostomy procedures using the latest techniques. Book your appointment today for comprehensive care and a tailored treatment approach.

Nephrostomy surgery is a vital procedure designed to alleviate urinary blockages and preserve ... Read More

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    Dr. Amit Kumar Kundu (B52Q6JrqNl)

    Dr. Amit Kumar Kundu

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    Dr. Raju R

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    location icon Konanakunte Cross, 21/7, Vasanthapura Main Rd, Mango Garden Layout, Bikasipura, Bengaluru, Karnataka 560062
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What Is Nephrostomy Surgery?

Nephrostomy surgery involves the placement of a thin tube, known as a nephrostomy tube, directly into the kidney to drain urine directly from the kidney into an external collection bag. This procedure is typically performed by a urologist or an interventional radiologist under imaging guidance. 

Nephrostomy is necessary when the normal flow of urine is obstructed due to conditions such as kidney stones, tumours, or strictures. The surgery provides a crucial alternative route for urine to bypass blockages in the urinary tract, thereby alleviating pain, preventing infection, and preserving kidney function. This intervention is particularly beneficial in cases where immediate relief from urinary obstruction is required to prevent further complications.

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What Are The Types Of Nephrostomy Surgery?

Nephrostomy surgery primarily involves the percutaneous nephrostomy procedure. Here are the key details:

Percutaneous Nephrostomy

This is the standard procedure used in most nephrostomy surgeries. It involves placing a catheter directly into the kidney through the skin. This method is typically performed under local anaesthesia, combined with imaging guidance such as ultrasound or fluoroscopy to ensure accurate placement of the catheter. 

Percutaneous nephrostomy is crucial for relieving urinary obstruction, providing a pathway for urine to exit the body when ureters are blocked due to stones, tumours, or strictures. This procedure is renowned for its effectiveness in emergency situations where rapid decompression of the kidney is necessary to preserve renal function.

Diagnosis Before Nephrostomy Surgery

Before proceeding with nephrostomy surgery, a comprehensive diagnosis is important to determine the underlying condition causing urinary obstruction. The diagnostic methods include:

  • Ultrasound Imaging: This non-invasive technique helps visualise the kidneys and urinary tract to detect blockages or stones.
  • Computed Tomography (CT) Scan: A more detailed imaging method that provides cross-sectional images of the kidneys, helping to identify obstructions, stones, or masses.
  • Magnetic Resonance Imaging (MRI): Used in special cases where detailed images are required without exposure to radiation.
  • Intravenous Pyelogram (IVP): This involves the injection of a contrast dye followed by X-rays, which highlight the urinary system’s structure and any blockages.
  • Urine Tests: To check for signs of infection or other kidney-related issues.
  • Blood Tests: To evaluate kidney function and detect any signs of infection or other abnormalities.

These diagnostic tools are essential for planning the appropriate surgical approach and ensuring that the procedure addresses the specific needs of the patient.

What Is The Procedure For Nephrostomy Surgery?

The nephrostomy procedure is typically carried out under local anaesthesia and image guidance to ensure precision and safety. Here is what one can expect during the steps of this surgical procedure:

  • Preparation: The patient will undergo pre-operative assessments, including blood tests and imaging studies, to plan the approach. The patient is placed in a prone position (lying face down) on the operating table to provide the surgeon access to the kidney area.
  • Anaesthesia: Local anaesthesia is administered at the site where the catheter will be inserted to minimise discomfort.
  • Imaging Guidance: Ultrasound or fluoroscopy is used to visualise the kidney and surrounding area, helping the surgeon place the catheter accurately.
  • Catheter Insertion: A needle is first inserted through the skin into the kidney’s collecting system. A guide wire is passed through the needle, and then a catheter is threaded over the wire into the kidney.
  • Placement Check: The position of the catheter is checked using imaging. Once confirmed, the guide wire is removed.
  • Securing the Catheter: The catheter is secured to the skin to prevent movement and the external end is connected to a drainage bag.
  • Post-Procedure Care: The patient is monitored for several hours post-surgery. Instructions on catheter care, signs of infection, and when to contact healthcare services are provided before discharge.

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Who Is The Right Candidate For Nephrostomy Surgery?

Nephrostomy surgery is a critical intervention for certain medical conditions that impede normal urine flow. The right candidates for this surgery typically include patients who:

  • Have Urinary Tract Obstructions: Individuals with blockages such as kidney stones, tumours, or strictures that do not respond to other treatments may require a nephrostomy to prevent kidney damage.
  • Need Urinary Diversion: Patients who cannot pass urine naturally due to injury, surgery, or other abnormalities in the urinary tract.
  • Are Undergoing Certain Cancer Treatments: Those who require relief from ureteral obstruction caused by tumours pressing on the urinary tract.
  • Have Infected or Non-functioning Bladder: In cases where the bladder is not functioning properly or is infected, nephrostomy can divert urine directly from the kidneys to assist in treatment and recovery.

This procedure provides a vital alternative for urine drainage, ensuring that kidney function is preserved while underlying conditions are managed or treated.

What Are The Benefits Of Nephrostomy Surgery?

Nephrostomy surgery offers several significant benefits, particularly for patients experiencing severe urinary blockages. Here are the detailed benefits of undergoing this surgical procedure:

  • Immediate Relief from Symptoms: The primary benefit of the nephrostomy procedure is the immediate alleviation of pain and discomfort caused by urinary blockages. By diverting urine directly from the kidneys, it reduces pressure, swelling, and the risk of infection in the urinary tract.
  • Preservation of Kidney Function: By bypassing blockages in the urinary system, nephrostomy prevents long-term damage to the kidneys due to backed-up urine, thus maintaining renal health.
  • Alternative to Surgery: For patients who are not candidates for more invasive surgeries due to their medical condition or the location of the blockage, nephrostomy provides a less invasive alternative.

Facilitates Further Treatment: It can be used as a temporary measure to manage urinary issues while preparing a patient for future surgery or treatment for the underlying cause of the obstruction.

How To Prepare For Nephrostomy Surgery?

Preparing for nephrostomy surgery involves several steps to ensure the best outcomes and the lowest risk of complications. Here’s how patients can prepare for this procedure:

  • Medical Evaluation: Undergo a thorough medical evaluation, including blood tests, kidney function tests, and imaging studies to assess the urinary tract’s condition.
  • Medication Review: Discuss current medications with your doctor as some may need to be paused, especially blood thinners, to reduce the risk of bleeding during the procedure.
  • Fasting: Patients are generally required to fast for several hours before the surgery to prepare for anaesthesia.
  • Arrange for Transportation and Post-care: Since the procedure can involve sedation, arrange for someone to drive you home and help with aftercare.

What Are The Recovery Tips and Precautions To Follow After Nephrostomy Surgery?

Recovery after nephrostomy surgery is crucial for optimal outcomes and minimising complications. Here are essential tips and precautions:

  • Monitor the Catheter and Drainage Bag: Ensure the catheter is securely attached and the drainage bag is functioning properly to prevent infections and leaks.
  • Pain Management: Follow your doctor’s advice on pain management, which may include prescribed painkillers to handle discomfort in the initial days after surgery.
  • Hygiene and Care: Keep the catheter site clean and dry. Follow instructions for dressing changes or cleaning the area to reduce infection risk.
  • Activity Restrictions: Avoid heavy lifting, vigorous exercise, and other activities that might dislodge the catheter. Gradually increase activity as recommended by your healthcare provider.
  • Hydration: Stay well-hydrated to help flush the kidneys and maintain urine flow, which aids in recovery and prevents further complications.
  • Regular Follow-ups: Attend all follow-up appointments to monitor your progress and adjust the treatment plan as necessary. These visits are crucial to ensure the catheter remains in place and to discuss any issues that arise.
  • Signs of Complications: Be aware of signs such as fever, unusual pain, swelling, or changes in urine output, and contact your healthcare provider immediately if these occur.

Adhering to these recovery tips will aid in a smoother recovery process, ensuring the success of the nephrostomy surgery and the health of the urinary tract.

Potential Risks Or Complications Associated With Nephrostomy Surgery

While nephrostomy surgery is a crucial procedure for relieving urinary blockages and preserving kidney function, it carries potential risks and complications, like any surgical intervention. Here are the key risks associated with this procedure:

  • Infection: The insertion of a nephrostomy tube can introduce bacteria into the kidney or surrounding tissues, leading to infections that may require antibiotic treatment.
  • Bleeding: There is a risk of bleeding both during and after the surgery, especially if the patient has a bleeding disorder or is on blood-thinning medication.
  • Tube Displacement: The nephrostomy tube may become dislodged or blocked, necessitating a return to the hospital for repositioning or replacement.
  • Injury to Surrounding Organs: There is a small risk of injury to surrounding organs such as the liver, spleen, or intestines during the tube insertion.
  • Urine Leakage: Urine may leak around the tube site, causing discomfort and requiring further medical attention.

Allergic Reactions: Some patients may react to the anaesthesia or contrast dye used during the procedure, which can range from mild itching to severe reactions.

What Is The Cost Of Nephrostomy Surgery In India?

The cost of nephrostomy surgery in India can vary widely. The cost variation is influenced by:

  • Hospital Type: The choice of hospital, whether it is a private or government facility, significantly affects the cost.
  • Surgeon’s Expertise: Highly experienced surgeons or specialists may charge more for performing the procedure.
  • Location: Costs can vary based on the city or region, with metropolitan cities often having higher rates.
  • Type of Anesthesia: The cost may differ based on whether local or general anaesthesia is used.
  • Post-Surgery Care: Extended hospital stays and necessary post-operative care can add to the overall expenses.

Is Nephrostomy Surgery Covered Under Insurance?

In India, nephrostomy surgery is generally covered under health insurance policies, especially if it is deemed medically necessary. Coverage can include the costs of the surgery, hospital stay, and necessary medications. 

However, the extent of coverage can vary based on the specific insurance policy terms. It is less likely to be covered if the procedure is performed as part of experimental treatment or if performed at a hospital not included in the insurer’s network. Patients should consult their insurance provider to understand the specifics of what is and isn’t covered under their plan.

Frequently Asked Questions on Nephrostomy

How long does nephrostomy surgery typically take?

The duration of the surgery can vary, but most nephrostomy procedures are completed within 1 to 2 hours.

What are the psychological impacts of living with a nephrostomy tube?

Patients may experience anxiety or depression due to lifestyle adjustments. Professional counselling and supportive care are recommended.

When can normal activities be resumed after nephrostomy surgery?

Patients can usually resume light activities within a few days but should avoid strenuous activities for several weeks.

How often does the nephrostomy tube need to be replaced or adjusted?

Tube maintenance varies, but adjustments or replacements are generally required every few weeks to months, based on medical advice.

How is the success of nephrostomy surgery measured?

Success is typically gauged by relief of symptoms, proper functioning of the nephrostomy tube, and absence of serious complications.

Can nephrostomy be a permanent solution?

While typically temporary, nephrostomy can be a long-term solution depending on the underlying health issues.

Is it possible to travel with a nephrostomy tube?

Travel is possible but requires careful planning to manage the catheter and address any potential emergencies.

How does nephrostomy impact long-term kidney health?

If managed properly, nephrostomy should not negatively affect long-term kidney health and can prevent further damage from obstructions.

Can children undergo nephrostomy surgery?

Yes, nephrostomy surgery can be performed on children if medically necessary, with special considerations for their size and developmental stage.

What is the difference between nephrostomy and urostomy?

Nephrostomy vs Urostomy differs in their purpose and procedure. Nephrostomy involves a temporary tube directly into the kidney to drain urine, used for bypassing blockages. Urostomy is a permanent surgery that diverts urine to an external pouch via an abdominal opening.

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Medically Reviewed By
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Dr. Amit Kumar Kundu
8 Years Experience Overall
Last Updated : January 2, 2025