Caring for Your Nephrostomy Tube

Overview
Your kidneys are part of your urinary
system and work to produce urine.
Normally, the urine that is produced flows
from the kidneys into a tube called a
ureter. The ureter connects your kidneys
to your bladder. When enough urine has
collected in your bladder, you feel the
need to urinate. Urine passes from the
bladder, through your urethra, and out of
your body.
Sometimes there is a block in your urinary
system and urine can’t flow as normal.
Blockages can be caused by a number of
things, including:
 kidney stones
 injury to the kidney or ureter
 an infection
  a congenital condition that you’ve had
since birth
A nephrostomy tube is a catheter that’s
inserted through your skin and into your
kidney. The tube helps to drain urine from
your body. The drained urine is collected
in a small bag located outside of your
body.

Placing the nephrostomy tube

The procedure to place your nephrostomy
tube typically takes less than an hour and
will be performed while you’re sedated.

Before your procedure

Prior to having your nephrostomy tube
placed, you should be sure to do the
following:

 Talk to your doctor about any

medications or supplements that
you’re taking. If there are medications
you shouldn’t take prior to your
 procedure, your doctor will instruct you
on when to stop taking them. You
should never stop taking medications
without speaking to your doctor first.
 Be sure to adhere to any restrictions
set by your doctor regarding food and
drink. For example, you may be
restricted from eating anything after
midnight the evening before your
procedure.

During your procedure

Your doctor will inject an anesthetic at the
site where the nephrostomy tube is to be
inserted. They’ll then use imaging
technology such as ultrasound, CT scan,
or fluoroscopy to help them place the tube
correctly. When the tube has been
inserted, they’ll attach a small disk to your
skin to help hold the tube in place.

Caring for your tube

Your doctor will instruct you on how to
care for your nephrostomy tube. You’ll
have to inspect your tube on a daily basis
as well as empty any urine that has
collected in the drainage bag.

Inspection of your nephrostomy tube

When you inspect your nephrostomy tube,
you should check the following:
 Verify that your dressing is dry, clean,
and secure. If it’s wet, dirty, or loose, it
will need to be changed.
 Check your skin around the dressing
to make sure there’s no redness or
rash.
 Look at the urine that has collected in
your drainage bag. It shouldn’t have
changed in color.
 Be sure there are no kinks or twists in
the tubing that leads from your
dressing to the drainage bag.
Emptying your drainage bag
You’ll need to empty your drainage bag
into a toilet when it’s approximately
halfway full. The amount of time between
each emptying of the bag can vary from
person to person. Some people will need
to do this every few hours.

Flushing your tubing

You typically need to flush your tubing at
least once a day, but you may need to
flush more often following your procedure.
Your doctor will give you specific
instructions on how to flush your tubing.
The general procedure is as follows:
1. Wash your hands thoroughly. Put
on gloves.
2. Turn off the stopcock to the
drainage bag. This is a plastic valve
that controls fluid flow through your
nephrostomy tube. It has three
openings. One opening is attached to
 the tubes attached to the dressing.
Another is attached to the drainage
bag, and the third is attached to an
irrigation port.
3. Remove the cap from the irrigation
port and swab thoroughly with alcohol.
4. Using a syringe, push saline
solution into the irrigation port. Do not
pull the syringe plunger back or inject
more than 5 milliliters of saline
solution.
5. Turn the stopcock back to the
drainage position.
6. Remove the syringe from the
irrigation port and recover the port with
a clean cap.

Additional things to remember

 Be sure to keep your drainage bag
below the level of your kidneys. This
prevents urine backup. Often, the
drainage bag is strapped to your leg.
 Whenever you handle your dressing,
tubing, or drainage bag, be sure
you’ve cleaned your hands with soap
and warm water or with an alcohol-
based sanitizer.
 You shouldn’t bathe or swim while you
have a nephrostomy tube in place.
You may shower again 48 hours after
your procedure. It’s helpful to use a
handheld showerhead, if possible, in
order to avoid getting your dressing
wet.
 Try to limit yourself to light activity
following your procedure and only
increase your activity level if you
tolerate it well. Avoid any movements
that could put strain on the dressings
or tubing.
 You’ll need to change your dressing at
least once a week.
 Be sure to drink a lot of fluids.
Complications of a nephrostomy tube
Placing a nephrostomy tube is generally a
safe procedure. The most common
complication that you’re likely to
encounter is infection. You should contact
your doctor immediately if you experience
the following symptoms, as they may
indicate an infection:

 a fever over 101°F (38.3°C)

 pain in your side or lower back
 swelling, redness, or tenderness at the
site of your dressing
 chills
 urine that is very dark or cloudy, or
smells bad
 urine that is pink or red
You should also contact your doctor
should any of the following occur, as it
may be a sign of a blockage:
  Urine drainage is poor or no urine has
collected for over two hours.
 Urine leaks from the dressing site or
from your tubing.
 You can’t flush your tubing.
 Your nephrostomy tube falls out.

Removing the tube

Your nephrostomy tube is temporary and
will eventually need to be removed.
During removal, your doctor will inject an
anesthetic at the site where the
nephrostomy tube was inserted. They’ll
then gently remove the nephrostomy tube
and apply a dressing to the site where it
used to be.
During your recovery period, you’ll be
instructed to drink plenty of fluids, avoid
strenuous activity, and avoid bathing or
swimming.

The takeaway
Placement of a nephrostomy tube is
temporary and allows urine to drain
outside of your body when it can’t flow
through your urinary system as normal.
You should contact your doctor
immediately if you have any concerns
about your nephrostomy tube or suspect
an infection or a block in your tubing.