Nephrostomy tube exchange

Your doctor has requested that you have a nephrostomy tube exchange. We hope the following information will answer some of the questions you may have about this procedure.

Why do I need to have my nephrostomy tube exchanged?

Your nephrostomy tube will require changing at regular intervals which can vary from every few weeks to every few months. This is because the urine often contains a gritty sediment which can block the tube.  This will slow down or even stop the urine from draining out. If this happens then the kidney will become infected and possibly damaged and this will lead to you becoming unwell.

The nephrostomy tube is also a foreign body. Your body’s natural response is to coat the tube with a protective layer which itself can become the source of infection. The longer the tube stays in the more this layer builds up. Frequent changes of the tube will reduce the chances of infections happening.

What are the risks involved?

Changing the nephrostomy tube is a much simpler and quicker procedure than having the nephrostomy tube inserted for the first time. It is very safe but as with any medical procedure there are some risks and complications that can arise:

  • Bleeding from the kidney – it is common for the urine to be bloody (pink or red) immediately after the procedure.  This usually clears over the next 24-48 hours.
  • Infection – Urine in the kidney may become infected.  This can generally be treated with antibiotics.
  • Sometimes the tube which is to be changed may be blocked inside and it can take a few minutes of manipulation by the operator to unblock the tube.
  • Very occasionally the tube has come out of the system completely so a new nephrostomy tube will need to be inserted.
  • The procedure uses x-rays and the amount of radiation used is small, however if you think you may be pregnant please inform the Imaging department before attending the appointment.

It is important to notify your consultant if your tube stops draining so that a change of tube can be arranged for you.

What happens before the procedure?

You can continue taking your normal medication and you may eat and drink as normal.

You will arrive at the Imaging Department (Gate 19) and a member of the Imaging team will accompany you into the angiography suite (x-ray room).

A member of the team will check your details and go through a checklist with you.  Please inform us if you have any allergies.

What happens during the procedure?

A radiologist (x-ray doctor) or specialist radiographer will perform the procedure for you. They will explain the procedure to you and if you have any questions you can ask then.  

You will be asked to lie on the x-ray table, in a position where it is possible for us to access the tube – usually on your front.

The skin around the nephrostomy tube will be cleaned with an antiseptic solution and covered with a drape.

A soft guidewire will be passed into the existing nephrostomy tube, using x-rays to guide the passage of the wire. This then allows the radiologist/radiographer to remove the old nephrostomy tube and a new tube is passed over the guidewire. The new nephrostomy tube is secured in position and a dressing applied.  

To confirm the nephrostomy tube is in the correct position, the radiologist/radiographer will inject a small amount of x-ray dye through the tube.

The nephrostomy tube is then connected to the drainage bag.

What happens after the procedure?

Once you are feeling well you are free to go home.

Is there anything I should look out for after the tube exchange?

Call your GP for any of the following reasons:

  • If you have a temperature.
  • If you develop back or side pain.
  • If your urine output stops, becomes dark or foul-smelling
  • If the tube falls out or becomes dislodged - don’t attempt to re-insert it yourself. This needs to be done at the hospital.

Finally we hope this information is helpful. If you have any questions either before or after the procedure the staff in the Imaging department will be happy to answer them. The telephone number for the Imaging department can be found on your appointment letter.

How to contact us:

Gate 19 - Brunel building
Southmead Hospital
Westbury-on-Trym
Bristol
BS10 5NB

Please see the number on your appointment letter

www.nbt.nhs.uk/

If you or the individual you are caring for need support reading this leaflet please ask a member of staff for advice.

© North Bristol NHS Trust. This edition published January 2020. Review due January 2022. NBT003248

Nephrostomy tube exchange