Nephrostomy/Nephroureteral Stent Placement/Revision/Removal
The ureter drains urine from the kidney to the bladder. It can be blocked by many diseases, but it is most commonly blocked by either a stone or tumor. This blockage can cause urine to build up within the kidney, resulting in pain, infection, and kidney dysfunction.
Blockages can often be treated by urologists who can place a draining tube inside the ureter with a small scope advanced from the urethra into the bladder or by surgically bypassing the blockage. In other cases, however, interventional radiologists can treat a blockage by placing a drain through the patient’s back into the kidney collecting system (called a nephrostomy tube) or through the patient’s back, kidney collecting system, and ureter into the bladder (called a nephroureteral tube). These tubes may be used to treat the blockage in the short and long term and may also help urologists perform subsequent procedures to break up/remove stones.
Under ultrasound and x-ray guidance, a needle is advanced across the back and kidney into the kidney collecting system. Contrast is injected to look at the collecting system/ureter and evaluate the location of the blockage. Then, a wire is advanced through the needle into the collecting system, the needle is exchanged for a catheter, and the wire is removed. This catheter is left is in place to drain urine.
The procedure has a moderate risk of bleeding, infection, and damage to nearby organs. If possible, patients should refrain from eating and drinking for 6 hours prior to the procedure and will be given medications to help them relax (i.e. moderate sedation). The procedure is typically reserved for inpatients, who will then remain in the hospital overnight after their procedure.
