Nephrostomy
Encyclopedia
A nephrostomy is an artificial opening created between the kidney
and the skin
which allows for the urinary diversion
directly from the upper part of the urinary system (renal pelvis
).
An urostomy
is a related procedure performed more distally along the urinary system to provide urinary diversion.
and into the urinary bladder
. Without another way for urine to drain, pressure would rise within the urinary system and the kidneys would be damaged.
The most common cause of blockage necessitating a nephrostomy is cancer
, especially ovarian cancer
and colon cancer. Nephrostomies may also be required to treat pyonephrosis
and kidney stones.
s or interventional radiologist
s and typically consist of a catheter
which pierces the skin and rests in the urinary tract. It is performed under ultrasound guidance, CT fluoroscopy or under image intensifier. Local anesthetic infiltration is used to numb the area where the needle would pass through to make the puncture on the kidney.
Newer technologies such as 3D fluoroscopy are being developed to aid in placement of these types of drainage tubes.
Urine is collected in an external bag which can be emptied as often as necessary.
Kidney
The kidneys, organs with several functions, serve essential regulatory roles in most animals, including vertebrates and some invertebrates. They are essential in the urinary system and also serve homeostatic functions such as the regulation of electrolytes, maintenance of acid–base balance, and...
and the skin
Skin
-Dermis:The dermis is the layer of skin beneath the epidermis that consists of connective tissue and cushions the body from stress and strain. The dermis is tightly connected to the epidermis by a basement membrane. It also harbors many Mechanoreceptors that provide the sense of touch and heat...
which allows for the urinary diversion
Urinary diversion
Urinary diversion is any one of several surgical procedures to reroute urine flow from its normal pathway. It may be necessary for diseased or defective ureters, bladder or urethra, either temporarily or permanently...
directly from the upper part of the urinary system (renal pelvis
Renal pelvis
The renal pelvis or pyelum is the funnel-like dilated proximal part of the ureter in the kidney.In humans, the renal pelvis is the point of convergence of two or three major calyces...
).
An urostomy
Urostomy
A urostomy is a stoma for the urinary system. A urostomy is made to avail for urinary diversion in cases where drainage of urine through the bladder and urethra is not possible, e.g...
is a related procedure performed more distally along the urinary system to provide urinary diversion.
Uses
A nephrostomy is performed whenever a blockage keeps urine from passing from the kidneys, through the ureterUreter
In human anatomy, the ureters are muscular tubes that propel urine from the kidneys to the urinary bladder. In the adult, the ureters are usually long and ~3-4 mm in diameter....
and into the urinary bladder
Urinary bladder
The urinary bladder is the organ that collects urine excreted by the kidneys before disposal by urination. A hollow muscular, and distensible organ, the bladder sits on the pelvic floor...
. Without another way for urine to drain, pressure would rise within the urinary system and the kidneys would be damaged.
The most common cause of blockage necessitating a nephrostomy is cancer
Cancer
Cancer , known medically as a malignant neoplasm, is a large group of different diseases, all involving unregulated cell growth. In cancer, cells divide and grow uncontrollably, forming malignant tumors, and invade nearby parts of the body. The cancer may also spread to more distant parts of the...
, especially ovarian cancer
Ovarian cancer
Ovarian cancer is a cancerous growth arising from the ovary. Symptoms are frequently very subtle early on and may include: bloating, pelvic pain, difficulty eating and frequent urination, and are easily confused with other illnesses....
and colon cancer. Nephrostomies may also be required to treat pyonephrosis
Pyonephrosis
Pyonephrosis is an infection of the renal collecting system. Pus collects in the renal pelvis and causes distension of the kidney.It can cause kidney failure.-Causes:...
and kidney stones.
Process
Nephrostomies are created by surgeonSurgeon
In medicine, a surgeon is a specialist in surgery. Surgery is a broad category of invasive medical treatment that involves the cutting of a body, whether human or animal, for a specific reason such as the removal of diseased tissue or to repair a tear or breakage...
s or interventional radiologist
Interventional radiology
Interventional radiology is a specialty of radiology, in which image-guided procedures are used to diagnose and treat a multitude of diseases across all body systems...
s and typically consist of a catheter
Catheter
In medicine, a catheter is a tube that can be inserted into a body cavity, duct, or vessel. Catheters thereby allow drainage, administration of fluids or gases, or access by surgical instruments. The process of inserting a catheter is catheterization...
which pierces the skin and rests in the urinary tract. It is performed under ultrasound guidance, CT fluoroscopy or under image intensifier. Local anesthetic infiltration is used to numb the area where the needle would pass through to make the puncture on the kidney.
Newer technologies such as 3D fluoroscopy are being developed to aid in placement of these types of drainage tubes.
Urine is collected in an external bag which can be emptied as often as necessary.