Where Is Your Kidney Located In The Body Picture – A nephrostomy allows urine (peeing) to drain from the kidney if there is a blockage in the urinary system.
A nephrostomy is a tube that allows urine to drain from the kidney through an opening in the skin of the back.
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Where Is Your Kidney Located In The Body Picture
A thin, flexible tube passes through the opening and into the kidney. This is called a nephrostomy tube or catheter. The urine drains through the tube into a bag outside your body. The bag has a tap so you can empty it. You may still pass some urine normally even when you have a nephrostomy.
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The kidneys are in the back of the body, one on each side, just below the ribcage. Kidneys are bean-shaped. They are just above the level of the navel. The kidneys filter your blood to get rid of waste products and turn them into urine (peeing).
Urine moves from each kidney through a fine tube called a ureter to the bladder, where it is stored. The bladder is in the lower abdomen (belly). This area is called the pelvis.
When you are ready to pass urine, it leaves the bladder through a tube called the urethra. The urethra opens in front of the vagina or at the tip of the penis.
You may need a nephrostomy if cancer or cancer treatment affects one or both ureters. If the ureter becomes blocked, urine (urine) cannot flow from the kidney to the bladder. This leads to accumulation of urine in the kidney. When this happens, the kidney can slowly stop working.
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You may need 1 or 2 nephrostomy tubes depending on whether one or both ureters are blocked. If you only have 1 tube, this is called a unilateral nephrostomy. If you have tubes in both ureters, this is called a bilateral nephrostomy.
Cancers that start in the lower abdomen (pelvis) are most likely to block the ureters. These include cancer of:
Sometimes a cancer that started in another part of the body spreads to the pelvis and forms a tumor. This can block 1 or both ureters. You usually have a scan to find out exactly where the blockage is.
Your doctor will explain how long you are likely to have a nephrostomy tube. They may remove it if cancer treatment clears the blockage. Sometimes the doctor places a tube called a stent in the ureter. The stent keeps the ureter open so it is no longer blocked. This means that the nephrostomy tube can be removed.
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If cancer treatment or a stent does not clear the blockage, the nephrostomy tube is left in place. The doctor changes it every 3 to 4 months to stop the blockage. Changing a nephrostomy tube is a very quick procedure.
You usually have a local anesthetic to place a nephrostomy. Most people only stay in hospital for a short time. The doctor usually performs the procedure in the X-ray (radiology) department. The doctor, called a radiologist, uses X-rays and ultrasound scans to help them place the nephrostomy tube into the kidney. It may take 30 to 60 minutes.
Your doctor or nurse will insert a fine tube called a cannula into a vein in your arm. They can use this to give you:
You lie on your stomach on an X-ray table. When you’re comfortable, the doctor injects a little local anesthetic into the skin on the side of your back.
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When the area is numb, the doctor carefully pushes a fine needle through the skin and into the kidney. Then they put a guide through the needle. The doctor uses the guide wire to place the nephrostomy tube into the kidney. They use stitches or bandages to hold the tube in place.
The nephrostomy tube may also have a locking system. This is wound inside the kidney to keep the tube in place. The doctor connects the tube to a drainage bag outside the body that collects the urine (pee).
You may feel discomfort when the doctor places the nephrostomy tube into the kidney. Tell them if you have any pain or feel anxious. They can give you pain medication through a cannula in your arm.
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You are cared for in a hospital ward and usually have to stay in bed for a few hours. Nurses will check that the nephrostomy tube is draining urine (peeing). They will also check your blood pressure, pulse and temperature. Sometimes the doctor may do a test to check the position of the tube in the kidney. This is done by injecting a dye called contrast into the tube. This can be seen on an X-ray.
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You may have some blood in your urine for about 2 days after the nephrostomy is placed. Blood in the urine is called hematuria. The area where the tube is inserted may be uncomfortable. You will take regular pain medication. Any pain or discomfort usually improves after about a week.
Doctors and nurses will check you regularly for any problems. This means that if you have any, they can be treated right away.
While you are in the hospital, the nurses regularly check the tube and empty the bag. They will show you how to care for your nephrostomy. They can show you how to empty and change the drainage bag and will change the dressing. They will also tell you how long you should wait before taking a bath or shower.
You may decide to change the dressings yourself. Your nurse can show you how to do this. It may help to have a family member or close friend with you so they can help you when you get home.
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The nurses at the hospital will arrange for you to see a nurse practitioner at your GP’s office or for a district nurse to visit you at home. The nurse or district nurse will check the tube and change your dressing. They will also make sure you have enough drainage bags.
Before you go home, the nurse will tell you who to contact if you are concerned that something is wrong with the nephrostomy. If the tube comes out or urine stops coming out, contact them immediately. You should also contact them immediately if:
Your nephrostomy tube will be on the side of your back. The tube is attached to a drainage bag. You usually wear the bag under your clothes and fasten it on your hip. Or you may have a pouch that sticks to the skin directly over the tube.
It is important to always keep the bag lower than the kidney. This helps the urine (pee) to drain. At night, you can attach a larger drainage bag that does not need to be emptied until morning.
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Once you’re home, you’ll be able to hang out like before. You should avoid sudden movements that can pull the tube. At first, bending over or climbing stairs may be uncomfortable. Place your hand on the nephrostomy when you need to move, in a way that feels uncomfortable. This can help prevent the tube from pulling out. It may take you some time to find the most comfortable sleeping position.
It’s natural to worry about managing a nephrostomy at home. With help and support, people usually get used to it. Here are some important things to remember:
Having a nephrostomy can affect the way you feel about your body (body image). Some people feel embarrassed and uncomfortable about other people seeing it. These feelings are a natural part of learning to cope with a nephrostomy. They usually improve with time.
If you find you are still having trouble coping, ask your GP or hospital doctor for help.
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Everyone has their own way of dealing with difficult feelings. Some people find it helpful to talk to someone. This could be:
Joining our online community can be a good way to share experiences with people who understand what you’re going through.
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