What Is a Nephrostomy Tube?
A nephrostomy tube is a small tube placed through the skin of the back directly into the kidney so urine can drain into an external bag. It is commonly used when the normal urine pathway from kidney to bladder is blocked by a stone, tumour, ureteric narrowing or another cause. It may be inserted urgently when obstruction is associated with infection or kidney dysfunction. A nephrostomy can be temporary or require scheduled changes. The tube must remain secured and draining; if it falls out, suddenly stops draining, or you develop fever with flank pain, seek urgent medical advice.
Why is a nephrostomy needed?
Urine normally flows from the kidney through the ureter into the bladder. If the ureter is blocked, pressure can build in the kidney and kidney function can deteriorate. When infection is present behind a blockage, drainage can become an emergency.
A nephrostomy bypasses the ureter and drains urine directly from the kidney.
Common reasons for nephrostomy
- Obstructing ureteric/kidney stone with infection.
- Ureteric obstruction from cancer.
- Severe ureteric stricture.
- Urinary leakage after surgery or injury.
- Access for certain kidney procedures.
- When an internal ureteric stent cannot be inserted or is unsuitable.
How is a nephrostomy inserted?
The procedure is usually performed by an interventional radiologist or urologist using ultrasound and/or X-ray guidance. Local anaesthetic is used to numb the skin, and sedation may be given when appropriate.
A needle is guided into the kidney’s collecting system, a wire is placed and the tract is used to position a drainage tube. The tube is secured to the skin and connected to a bag.
Nephrostomy vs DJ stent
Both can drain a blocked kidney.
A DJ stent is internal and connects kidney to bladder. A nephrostomy exits through the back and drains to an external bag. The best option depends on infection, anatomy, urgency, stone/tumour location, anaesthesia suitability and which route can be established safely.
What can I expect after insertion?
Mild soreness around the tube and some blood-tinged urine can occur initially. Urine should continue to drain into the bag.
Your team will show you how to secure the tube, empty the bag and care for the dressing.
How to care for a nephrostomy at home
- Wash hands before and after handling the bag or dressing.
- Keep the tube well secured and avoid traction.
- Keep the drainage bag below kidney level when possible.
- Check for kinks.
- Empty the bag before it becomes heavy.
- Follow the dressing-change instructions given by your team.
- Do not flush the tube unless you have been specifically trained and prescribed a flushing plan.
What if the tube stops draining?
First check for obvious kinks, closed taps or a full bag. If drainage remains absent—especially with flank pain, fever or leakage around the tube—contact your medical team urgently.
Do not forcefully flush a blocked nephrostomy on your own.
What if the nephrostomy falls out?
This can be urgent because the tract can begin to close and the kidney may become obstructed again. Cover the site with a clean dressing and seek prompt hospital assessment. Do not attempt to reinsert the tube yourself.
Can I shower with a nephrostomy?
Your team may permit showering with a protected dressing, but soaking the tube site is usually avoided. Keep the dressing dry/secure according to instructions and inspect the site afterwards.
How long can a nephrostomy stay?
The duration depends on the underlying problem. If it remains long term, the tube requires scheduled exchange because it can block, encrust or become infected. Keep the exchange appointment.
If a nephrostomy suddenly stops draining
First look for simple external problems: is the tubing kinked, is the bag positioned so urine can drain, and has the tube been pulled or the dressing changed position? If drainage does not resume—especially with flank pain, fever or chills—contact the treating team promptly.
| Do not push the tube back in, probe it with an object or flush it unless your urology/interventional-radiology team specifically taught you to do so. A displaced nephrostomy may need urgent replacement. |
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When to seek urgent help
- Fever or shaking chills.
- Nephrostomy stops draining.
- Tube falls out or is significantly displaced.
- New severe flank pain.
- Large increase in leakage around the tube.
- Heavy bleeding/clots.
- Increasing redness, swelling or pus at the skin site.
FAQs
Is a nephrostomy a surgery?
It is a minimally invasive image-guided procedure, usually performed through a small puncture rather than a surgical incision.
Does urine still come through the bladder?
It may. If only one kidney is drained by nephrostomy, the other kidney can still drain to the bladder. Some urine from the nephrostomy kidney may also reach the bladder depending on the degree of obstruction.
Can I sleep with a nephrostomy bag?
Yes. Secure the tube and position the bag so drainage continues without pulling.
Can a nephrostomy be converted to a stent?
Sometimes, depending on the cause of obstruction and anatomy. Your urologist/interventional radiologist will decide.
Related reading
- What Is a DJ Stent?
- Fever After Urology Surgery
- How to Prevent Infection After Urology Surgery
- Travel After Urology Surgery
- Red Flags After Urology Surgery
- Urologist in Latur
References
- British Association of Urological Surgeons (BAUS). Percutaneous insertion of a nephrostomy tube. Patient leaflet, 2023 https://www.baus.org.uk/patients/information_leaflets/75/percutaneous_nephrostomy_tube_insertion