Introduction
A nephrostomy tube is a hollow tube which goes through your back and into the kidney. The tube is usually held in place using a stitch and is attached to a drainage bag. Why do I need a nephrostomy tube? The tube is necessary to drain urine from the kidney when there is an obstruction that prevents free drainage of urine into the bladder.
You may have a blockage of the ureter (the structure that normally carries urine from the kidney to the bladder). You may also need it if there is a hole in the ureter or bladder, causing urine to leak. A nephrostomy may also be needed to prepare for surgery or other procedures on the kidney and ureter, such as removal of a large kidney stone.
Drainage bags
You will wear a bag which will be strapped to your leg or attached to a waist strap. The leg bag holds 500—750mls (approx. 1 pint) of urine and needs to be emptied every 3 - 4 hours. You will be taught how to attach and detach the bag and how to empty it, before you leave hospital. The bag will need to be changed weekly by the District Nurse.
Care of the nephrostomy tube
The tube is a fine/narrow one it must be kept neatly coiled and unkinked to allow drainage. It will either be covered with a gauze dressing or secured well with tape or a specialised secure tube-lock device. The dressing will require changing if it becomes wet, soiled or begins to loosen. Before you leave the hospital the nursing staff will make arrangements for the dressing to be changed by the District Nurse. You will also be given a small supply of dressings and tape to take home.
It is advisable to drink 2 - 3 litres (4 - 6 pints) of fluid each day to help prevent any urine infection.
Your urine may continue to be bloodstained from time to time as long as the tube is present. There is no cause for alarm unless blood loss is persistent and heavy - in which case you should contact your hospital team or go to the nearest A & E.
Signs of infection are:
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The urine in the bag becomes cloudy and bloodstained.
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The urine smells offensive.
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You develop a fever.
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If you develop any of the above you should contact you G.P. who may need to take a specimen of your urine to confirm that you have an infection and commence treatment if necessary.
If the bag fails to drain any urine for more than one hour you should:
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Check the tubing for any kinks.
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If a urine drainage bag is attached then ensure the tap at the connection with it is switched on.
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Drink a litre of water if your fluid intake has been insufficient or the urine looks
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yellow/ concentrated.
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If the tube still fails to drain after a further hour and you develop pain you should contact your District Nurse, hospital team or go to your nearest A & E Department for advice.
The Nephrostomy drain can stay insitu for up to 3months. If it needs to remain in place for longer than this it will need to be changed 3 months after insertion. Your Consultant will make arrangements for the change of drain if it is required. If you require any further advice regarding this, please contact us on one of the numbers on the following page.
Nephrostomy insertion information
Patients Name…………………………………………………………………………………………….
Hospital Number………………………………………………………………………………………….
Date of Birth………………………………………………………………………………………………..
Date Nephrostomy drain inserted………………………………………………………………………
Type of Nephrostomy drain inserted……………………………………………………………………
Long term/ Short term drain……………………………………………………………………………..
Follow up appointment………………………………………………………………………………….
Management plan……………………………………………………………………………………….
……………………………………………………………………………………………………………
……………………………………………………………………………………………………………
Further dressings and bags can be obtained from your GP on prescription using the following details:- Nephrostomy dressing used: Unomedical Drain-Fix 680M
Drainage bag:- Manfred Sauer Nephsys NS721.3720S PIP CODE—399-1585
Belt: NSBelt.02 PIP CODE—305-1513
Night Bag: Manfred Sauer NB2 PIP CODE—320-3569
Contact details:-
Carlisle
Urology Nurse Specialists: 01228 814187 Ansa phone
Urology Outpatient Department, Cumberland Infirmary
Mon-Fri 9am-5pm
West Cumbria
Urology Nurse Specialist: 01946 523706 Ansa phone
Urology Outpatients, West Cumberland Hospital
Mon-Fri 9am-5pm
Out of hours contact details: Please contact Cumbria Health on Call (CHOC) on 111.
Where can I get more information?
NHS Direct
http://www.nhsdirect.nhs.uk/
Confidentiality
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For further information on confidentiality contact the Information Governance Team:
Information.Governance@ncic.nhs.uk | 01228 603961
Feedback
We appreciate and encourage feedback, which helps us to improve our services. If you have any comments, compliments or concerns to make about your care, please contact the Patient, Advice & Liaison Service:
pals@ncic.nhs.uk | 01228 814008 or 01946 523818
If you would like to raise a complaint regarding your care, please contact the Complaints Department:
complaints@ncic.nhs.uk | 01228 936302