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 caliber 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.
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.
- catheter dislodgement or kinking
- catheter obstruction (clot, purulent material, stone)
History and etymology
"Nephrostomy" is a combination of "nephros" (kidney) and "stoma" (mouth), i.e. an opening into the kidney.
- urinary diversions
- treatment for urinary calculi
- prostate interventions