Nephrostomy
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- updated 4 Sep 2022:
Nothing to disclose
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Nephrostomy is a common urologic or interventional radiology procedure in which a tube/catheter is introduced into the renal collecting system (usually the renal pelvis).
Nephrostomies can either be
- "open" nephrostomy: after a urological surgical procedure, such as a UPJ stone removal
- these tend to be larger calibre catheters and the open approach is less common now for initial access to the collecting system
- percutaneous nephrostomy: performed with a needle-over-wire (Seldinger technique) using ultrasound or fluoroscopic guidance
A nephrostomy can be used to relieve pressure in a hydronephrotic kidney, drain purulent material in pyonephrosis, or obtain access/reaccess for upper tract stone removal.
Radiographic features
The upper collecting system can be fluoroscopically-evaluated by introducing water soluble contrast through the nephrostomy catheter (nephrostogram / antegrade pyelogram). This can be useful to determine tube position or assess for residual stones in the upper collecting system.
Complications
- catheter dislodgement or kinking
- catheter obstruction (clot, purulent material, stone)
History and etymology
"Nephrostomy" is derived from a combination of the classical Greek terms "nephros" (kidney) and "stoma" (mouth), i.e. an opening into the kidney.
-<p><strong>Nephrostomy </strong>is a common urologic or interventional radiology procedure in which a tube/catheter is introduced into the renal collecting system (usually the <a href="/articles/renal-pelvis">renal pelvis</a>).</p><p>Nephrostomies can either be</p><ul>-<li>"open" nephrostomy: after a urological surgical procedure, such as a UPJ stone removal<ul><li>these tend to be larger calibre catheters and the open approach is less common now for initial access to the collecting system</li></ul>-</li>-<li>-<a href="/articles/percutaneous-nephrostomy">percutaneous nephrostomy</a>: performed with a needle-over-wire (<a href="/articles/seldinger-technique">Seldinger technique</a>) using ultrasound or fluoroscopic guidance</li>-</ul><p>A nephrostomy can be used to relieve pressure in a <a title="Hydronephrosis" href="/articles/hydronephrosis">hydronephrotic kidney</a>, drain purulent material in <a title="Pyonephrosis" href="/articles/pyonephrosis">pyonephrosis</a>, or obtain access/reaccess for upper tract stone removal.</p><h4>Radiographic features</h4><p>The upper collecting system can be fluoroscopically-evaluated by introducing water soluble contrast through the nephrostomy catheter (<a href="/articles/nephrostogram">nephrostogram</a> / <a href="/articles/antegrade-pyelogram">antegrade pyelogram</a>). This can be useful to determine tube position or assess for residual stones in the upper collecting system.</p><h4>Complications</h4><ul>-<li>catheter dislodgement or kinking</li>-<li>catheter obstruction (clot, purulent material, stone)</li>- +<p><strong>Nephrostomy </strong>is a common urologic or interventional radiology procedure in which a tube/catheter is introduced into the renal collecting system (usually the <a href="/articles/renal-pelvis">renal pelvis</a>).</p><p>Nephrostomies can either be</p><ul>
- +<li>"open" nephrostomy: after a urological surgical procedure, such as a UPJ stone removal<ul><li>these tend to be larger calibre catheters and the open approach is less common now for initial access to the collecting system</li></ul>
- +</li>
- +<li>
- +<a href="/articles/percutaneous-nephrostomy">percutaneous nephrostomy</a>: performed with a needle-over-wire (<a href="/articles/seldinger-technique">Seldinger technique</a>) using ultrasound or fluoroscopic guidance</li>
- +</ul><p>A nephrostomy can be used to relieve pressure in a <a title="Hydronephrosis" href="/articles/hydronephrosis">hydronephrotic kidney</a>, drain purulent material in <a title="Pyonephrosis" href="/articles/pyonephrosis">pyonephrosis</a>, or obtain access/reaccess for upper tract stone removal.</p><h4>Radiographic features</h4><p>The upper collecting system can be fluoroscopically-evaluated by introducing water soluble contrast through the nephrostomy catheter (<a href="/articles/nephrostogram">nephrostogram</a> / <a href="/articles/antegrade-pyelogram">antegrade pyelogram</a>). This can be useful to determine tube position or assess for residual stones in the upper collecting system.</p><h4>Complications</h4><ul>
- +<li>catheter dislodgement or kinking</li>
- +<li>catheter obstruction (clot, purulent material, stone)</li>
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