Last revised by Andrew Murphy on 23 Mar 2023

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)

"Nephrostomy" is derived from a combination of the classical Greek terms "nephros" (kidney) and "stoma" (mouth), i.e. an opening into the kidney.

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Cases and figures

  • Case 1: bilateral nephrostomy tubes
    Drag here to reorder.
  • Case 2: bilateral nephrostomies and ureteric stents
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