Introduction

Percutaneous nephrostomy ( PCN ) is an interventional procedure used mainly in the decompression of the renal collecting system by insertion of a percutaneous nephrostomy catheter. A percutaneous nephrostomy catheter is a small flexible, rubber tube that is placed through your skin into the kidney to drain your urine.

Indications

1. treatment of nephrolithiasis (renal or ureteral stone) or complex urinary tract infections
2. urinary diversion ( such as urine leakage, pregnancy or tumor compression )
3. access for other procedures ( e.g., surgery, ureteral stent placement, stone retrieval (percutaneous nephrolithotomy (PCNL)…etc)

Relative contraindication

Bleeding tendency or clotting deficiency

Preprocdure preparation

1. Admission and sign the consent form
2. Do not eat any solid foods within 6 hours or drink any clear liquids within 2 hours of your scheduled appointment
3. Let us know if you have an allergy to x-ray ( contrast ) dye so that we can take the necessary precautions
4. Blood transfusion maybe needed if you have coagulopathy prior to the procedure

Procedure

1. The procedure is performed in the interventional radiology suite. The patient will be placed on the X-ray table, lying on the stomach. The radiologist will sterilize the area where the tube will be inserted. Then local anesthetic agents will be injected to numb your skin.
2. The interventional radiologist will use x-rays and/or ultrasound to locate your kidney and a needle will be inserted through your skin into the kidneys. Contrast ( x-ray ) dye will be injected through the needle and the nephrostomy catheter will be inserted into the kidney.
3. You may feel some pressure and discomfort when the tube is inserted.
4. The nephrostomy catheter site will be covered with a dressing. The catheter itself will be connected to a drainage bag. The urine will flow from your kidney through the catheter into the bag. The fluid may contain some blood at first.  However, the blood usually clears over time.

Post procedure care

1. Bed rest for 6-8 hours
2. Keep the dressing dry and change dressing daily
3. Fix the bag properly to avoid pulling out or kinking of the catheter
4. Several problems you may experience

• Decreased catheter output ( due to catheter dislodged, blocked or kinked)
• Leakage around the catheter site

5. Please come back to hospital as soon as possible or call our ( radiology ) department to check you tube.