Percutaneous Nephrostomy-Pediatric

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Percutaneous nephrostomy is a therapy performed when there is an obstruction in the urinary tract between the kidneys and bladder, blocking the drainage of urine. It involves introducing a catheter through the kidney into the renal collecting system under image guidance.

What is it? 

Ureteral obstructions arise from injury or ureteral calculi or chronic conditions like cancer, and when they occur, the drainage of urine is blocked, and infections are likely. For this reason, percutaneous nephrostomies are performed to provide a means to drain and decompress the system. A rubber catheter tube is placed directly through the skin and into the kidney. As a result, the urine can flow through the catheter with ease.

What should I do to prepare?

Fasting before the procedure (usually beginning the night before) is crucial. However, the patient is unlikely to be placed under general anesthesia. If so, a doctor may only require a six hour fast. If general anesthesia is required, patients cannot eat or drink the evening before the surgery to avoid complications with anesthesia such as aspiration. When a patient is put under anesthesia, it is possible for food in the stomach to be expelled into the lungs. Additionally, the patient should refrain from taking blood thinners a week before the surgery since these drugs increase the risk of bleeding during the procedure. The patient should consult with his or her doctor regarding the use of blood thinners based on his or her personal health needs since some may require them for stroke prevention. To prevent complications, it is best to report all relevant medical history, medication allergies, CT and MRI scans to one’s doctor to develop an appropriate treatment plan.

What happens during the process? 

During a percutaneous nephrostomy, the patient receives a local anesthetic like lidocaine to the area in the back/flank where the procedure takes place. The patient will be put on his or her stomach, face down and the doctor will insert the catheter via a needle through the skin and into the kidney. The procedure is not painful with only slight pressure felt throughout. An x-ray is used to confirm the catheter is in the correct place and that the procedure is successful.

What are the risks and potential complications?

A percutaneous nephrostomy has risks, which include, but are not limited to, infection, excessive bleeding, decreased kidney function, and complications with kidney stones.


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