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Nephrostomy tube placement
A nephrostomy tube is a thin catheter placed through the skin directly into the kidney to drain urine when it can't flow normally down the ureter, protecting the kidney while the underlying blockage is diagnosed and treated.
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Briefly about this treatment
Indications
Kidney blocked by a stone, tumour, scar tissue or injury causing pain, swelling of the kidney or a rising creatinine; an infected, blocked kidney needing urgent drainage; a ureteric leak or fistula after surgery; or temporary access needed before related stone treatment.
Risks
Bleeding, infection, and injury to a nearby organ or blood vessel. Risks are minimised by careful patient selection and experienced interventional radiology teams.
Pre-procedure
Standard blood work and imaging to confirm the blockage, a review of blood-thinning medicines and contrast-dye allergies, and fasting per protocol before sedation.
Follow-up
Scheduled tube checks and exchanges roughly every 1–3 months, with ongoing monitoring of kidney function and drainage until the underlying blockage is resolved.
What is Nephrostomy tube placement? An expert explains
Your kidneys filter waste from your blood and turn it into urine, which normally travels down a narrow tube called the ureter into your bladder. If the ureter becomes blocked — by a kidney stone, a tumour pressing on it, scar tissue, or an injury — urine backs up into the kidney instead. Left untreated, this build-up (called hydronephrosis) can cause pain, infection, and lasting kidney damage.
A percutaneous nephrostomy uses radiological guidance, usually ultrasound together with X-ray, to place a catheter through the skin and into the kidney’s collecting system so urine has somewhere to go while the underlying blockage is treated or monitored. It’s performed by an interventional radiologist — a doctor trained to guide needles and tubes into the body using imaging — sometimes with a urologist involved in your wider care. The procedure is most often used for temporary urinary diversion when a stone is blocking the ureter, but it’s also used to divert urine away from leaks or fistulas, to relieve non-dilated obstruction, and to create access for later stone treatment.
A nephrostomy is a bridge, not a cure — it protects your kidney while the cause of the blockage (a stone, a tumour, a stricture) is diagnosed and treated. Depending on that cause, the tube may stay in for days, weeks, or occasionally longer.
Signs it may be time for Nephrostomy tube placement
You don’t choose this treatment the way you’d choose a diet plan — your care team recommends it based on what your symptoms, exam and test results show. Symptoms people often notice beforehand include:
- Flank or back pain on one side, sometimes with a feeling of swelling or pressure over the kidney.
- Fever, chills, or feeling generally unwell together with back pain — this combination can point to an infected, blocked kidney and needs same-day attention.
- Passing little or no urine despite drinking normally.
- Blood in the urine with pain, especially if you have a known kidney stone or have recently had pelvic or urological surgery.
- Fluid leaking from a surgical wound, or new swelling in the flank, after ureter or kidney surgery.
These are the conditions linked to nephrostomy tube placement in the directory. Your clinician decides whether treatment is appropriate using your symptoms, examination and test results.
- Renal Trauma — Physical injury to kidneys due to accidents or surgery.
- Ureterocele — Ballooning of distal ureter into bladder.
- Ureteropelvic Junction Obstruction — Blockage between kidney pelvis and ureter.
- Duplex Kidney — Double collecting system or ureter duplication.
- Multicystic Dysplastic Kidney (MCDK) — Malformed nonfunctioning kidney with cysts.
Remember: These entries are not a diagnosis or a treatment recommendation. Discuss your symptoms and test results with a qualified clinician.
When to consult a specialist
Back pain, a fever, or passing noticeably less urine than usual can feel alarming, but they’re also straightforward to check. A simple blood test, urine test and scan will usually tell your care team quickly whether a kidney is blocked and how urgently it needs attention — and most blockages, once found, are very manageable with the right care. You don’t need to self-diagnose or wait to see if it passes. If any of this sounds familiar, find a specialist on KidneyGlobal to talk through your symptoms and get the right tests ordered.
How a session works
- Check-in and monitoring. You’ll sign a consent form if you haven’t already, and a small IV line (cannula) is placed in your hand or arm so the team can give pain relief or sedation if needed. Monitors track your heart rate, blood pressure and oxygen level throughout.
- Positioning. You’ll lie on the X-ray table, usually flat on your stomach or turned slightly to one side.
- Sterile preparation. The radiologist cleans your skin with antiseptic and numbs the area with local anaesthetic, working under sterile conditions with gowns and drapes.
- Imaging-guided needle placement. An ultrasound machine is used to see the kidney and guide a fine needle through the skin into it; a guidewire then passes through the needle, and X-ray confirms the wire is correctly positioned before the tube itself is inserted.
- Securing the tube. The catheter’s inner end coils inside the kidney (sometimes called a „pigtail” shape) to help hold it in place, and the outer end is secured to your skin with a stitch and/or an adhesive dressing.
- Connecting the bag. The tube is then attached to a drainage bag outside the body, which collects the urine. The whole procedure typically takes around 20–30 minutes, though it can run longer for a more complex blockage.
Session duration
20–30 minutes
recorded for this treatment
Cost verify
$2500–$6997
indicative range
Anesthesia
Local
recorded for this treatment
Remember: The exact steps, duration and preparation can vary with your indication, health and care setting. Confirm the current plan with your treating team.
Benefits
A nephrostomy tube works quickly to take pressure off a blocked kidney and buys time to deal with the real problem underneath. Benefits include:
- Relieves painful, potentially damaging pressure on a blocked kidney quickly.
- Can be placed under local anaesthetic, avoiding a larger operation.
- Helps clear infection when blocked, infected urine is present, which can otherwise become serious.
- Buys time to diagnose and treat the underlying cause — a stone, tumour or stricture — without risking kidney function in the meantime.
- Reversible: the tube can be removed once it’s no longer needed.
Risks & side effects
The treatment has risks and trade-offs to discuss with your care team. The information below comes from this treatment’s data: bleeding, infection, and injury to a nearby organ or blood vessel are the main risks of a nephrostomy tube, and they’re minimised by careful patient selection and an experienced interventional radiology team.
- Short-lived discomfort at the kidney or insertion site — reported by almost all patients, usually settling within a day or two.
- Minor bleeding from the kidney — affects roughly 1 in 2 to 1 in 10 people, usually seen as some blood in the urine that clears on its own.
- Leakage of urine around the tube — also affects roughly 1 in 2 to 1 in 10 people.
- Blockage of the drainage tube — affects roughly 1 in 2 to 1 in 10 people and needs prompt attention if drainage stops.
- Generalised infection (sepsis) after the tube is placed — affects roughly 1 in 2 to 1 in 10 people, which is why antibiotics and monitoring are routine.
- Failure to place the tube, or injury to a nearby organ (bowel, liver, spleen, lung) — both uncommon, affecting roughly 1 in 50 to 1 in 250 people.
Who it may not suit: these are general cautions, not a personal verdict. People with an uncorrectable bleeding disorder, a severe contrast-dye allergy, or very limited life expectancy from an unrelated illness may need a different approach, weighed case by case. A qualified clinician must assess your full medical picture before recommending or delaying treatment.
What happens during & after
During the procedure you’ll be awake but comfortable; you may feel pressure but shouldn’t feel sharp pain. Afterwards you’ll return to the ward, where nurses monitor your temperature, blood pressure and how much urine is draining from the tube, and you’ll usually be asked to rest in bed for a few hours. Most people go home the same day or after one night, with clear written instructions on caring for the tube and bag, and a follow-up plan agreed with your urologist or radiologist before discharge.
Possible complications
Most problems are minor and manageable, but contact your care team promptly if you notice:
- Blocked or dislodged tube — obstruction of the tube is a recognised complication that needs prompt attention.
- Infection at the skin site or in the kidney — local pain and redness at the insertion site can result from infection, in addition to non-infectious causes like adhesive irritation; fever or chills need urgent review.
- Bleeding — some blood-stained urine in the first day or two is common and usually settles on its own, but heavier or persistent bleeding needs medical attention.
- Injury to a nearby organ — rare, but possible given the tube’s path through the back.
- Allergic reaction to contrast dye, if dye is used to check the tube’s position.
- Tube falling out — this needs same-day medical attention, since the tract can close within hours.
Remember:
New or severe symptoms require prompt medical advice. Do not wait for a routine appointment if you feel seriously unwell.
Recovery
The end of the tube inside the kidney has a small coil, sometimes described as a „pig’s tail,” that helps hold it in place, while the outer end is secured with a special dressing and often a clear cover on top. Keep the drainage bag strapped to your thigh, attached to a belt, or pinned to your clothing rather than left hanging — pulling or tugging can dislodge the tube. Empty the bag regularly and change it on the schedule your nurse recommends, often weekly.
Keep the skin around the tube clean and dry, and don’t remove or change the dressing yourself unless a nurse has specifically trained you to. A community or district nurse can usually be arranged to help with tube and dressing care once you’re home. Drink plenty of fluids to help keep the tube flushed and reduce the risk of blockage or infection, unless your doctor has told you to limit fluids for another reason.
Contact your care team straight away if you develop a high temperature, back pain, redness or swelling around the tube, urine leaking from the drainage site, poor or absent drainage, or if the tube falls out.
Nephrostomy tubes aren’t left in indefinitely without maintenance. As a general rule, tubes are exchanged roughly every three months, or sooner if a problem arises — your own interval will be set by your team. Removal of the tube, once it’s no longer needed, is done by your care team in a clinical setting — never at home on your own.
Clinics offering Nephrostomy tube placement
Verified kidney centres linked to this treatment in the KidneyGlobal directory.
University Hospital
Urologic Oncology & Robotic Surgery
ISO 9001European Urology Boardda Vinci Robotic Center
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Academic Medical Center
Minimally Invasive Urologic Surgery
Joint CommissionNCI Cancer CenterRobotic Surgery Excellence
✓ 24/7 ER✓ ICU✓ Insurance
Academic Medical Center
Kidney Transplantation
Joint CommissionUNOS CertifiedLiving Donor Excellence
✓ 24/7 ER✓ ICU✓ Insurance
Good questions
Most Common Questions
Will I be asleep for the procedure?
Usually not fully asleep. Most people have local anaesthetic to numb the skin, often with light sedation to help you relax. You may or may not be fully asleep, and some people need a short hospital stay.
How long does a nephrostomy tube stay in?
It varies from person to person — your surgeon or radiologist will tell you the expected timeline for your situation. Tubes placed for a temporary blockage may come out once the cause is fixed; tubes used long-term are typically exchanged on a routine schedule (commonly around every 2–3 months) to keep them working well and reduce infection risk.
Will I still urinate normally?
If only one kidney has a tube, the other kidney keeps working as before and you'll continue to pass some urine the usual way. If both kidneys need tubes, most of your urine will drain through the tubes instead.
Is this the same as a ureteral (JJ/double-J) stent?
No. A stent sits inside the ureter itself and is placed via the bladder; a nephrostomy tube goes through the skin directly into the kidney. Your team will explain which is right for your situation, and sometimes both are used together.
Do I need a referral to see a specialist for this?
In many healthcare systems, yes — your GP, nephrologist, or emergency team typically refers you. You can use KidneyGlobal's doctor directory to find specialists and check each profile for how to arrange a consultation.
Is this done as an outpatient or inpatient procedure?
Both happen — many people have it done as outpatients and go home the same day, while others need a short inpatient stay, especially if the tube was placed urgently for infection.
Sources
- Percutaneous Insertion of a Nephrostomy Tube (patient information leaflet)British Association of Urological Surgeons (BAUS)
- Percutaneous NephrostomyBritish Society of Interventional Radiology (BSIR) / Royal College of Radiologists
- Practice Parameter for Percutaneous NephrostomyAmerican College of Radiology / Society of Interventional Radiology / Society for Pediatric Radiology
- Nephrostomy TubeCleveland Clinic
- Percutaneous NephrostomyRadiopaedia
- Percutaneous Insertion of a Nephrostomy Tube (patient leaflet)Cambridge University Hospitals NHS Foundation Trust