Treatments

Nephrostomy tube and nephroureteral stent placement are minimally invasive procedures used to relieve obstruction in the urinary tract, usually caused by kidney stones, tumors, or strictures. A nephrostomy tube is inserted percutaneously into the renal pelvis to allow direct drainage of urine externally when the normal flow to the bladder is blocked. A nephroureteral stent is a catheter that traverses from the kidney, through the ureter, and into the bladder, allowing internal urine drainage. These procedures are typically performed under fluoroscopic or ultrasound guidance and can provide immediate relief from pain, infection, or renal dysfunction. They serve as temporary measures until definitive treatment, such as stone removal, tumor surgery, or ureteral repair, is possible.

Indications

• Urinary obstruction from stones, tumors, or strictures
• Hydronephrosis (swelling of kidney due to urine build-up)
• Urinary tract infection with obstruction
• Post-surgical urinary leaks

Procedure Steps (Nephrostomy example)

• Patient positioned and local anesthesia administered
• Imaging (ultrasound/fluoroscopy) guides puncture into renal pelvis
• Guidewire inserted, tract dilated, and nephrostomy tube placed
• External urine drainage established and secured

Procedure Steps (Nephroureteral Stent example)

• Catheter inserted percutaneously into kidney
• Guidewire advanced through ureter into bladder
• Stent deployed to allow internal drainage from kidney to bladder

Benefits

• Immediate relief of obstruction and pain
• Prevents kidney damage
• Reduces risk of urinary tract infection
• Minimally invasive alternative to open surgery

Risks / Complications

• Bleeding at puncture site
• Infection
• Dislodgement or blockage of tube/stent
• Rare injury to adjacent organs