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What is a nephrostomy catheter?

A nephrostomy catheter goes through your skin into your kidney to drain your urine. In some cases, the urine drains out of your body into a drainage bag. In other cases, the catheter drains the urine into the bladder and there is no bag on the outside. Reasons to need a nephrostomy catheter include: blockage of the ureter (the structure that normally carries urine from the kidney to the bladder), presence of a hole in the ureter, and preparation for surgery or other procedures on the kidney and ureter.

What problems can occur with a nephrostomy catheter?

The main problem that can occur is infection. Your nephrostomy catheter can cause two types of infection: a skin infection and a kidney infection. A skin infection can be prevented by taking good care of the skin around the catheter. If a skin infection occurs in spite of good skin care, it is usually simple to treat.
A kidney infection occurs if the catheter gets blocked. A kidney infection is more serious than a skin infection, but it can be avoided. The best way to avoid a kidney infection is to have your catheter changed for a new one regularly. If your catheter gets blocked and your kidney gets infected in spite of good care, your doctors can treat the problem by changing the catheter and giving you antibiotics.

How do I take care of the skin around my nephrostomy catheter?

Because the catheter is on your back, you will need help. Follow these instructions unless your doctor specifies otherwise:
  • Keep the skin around your nephrostomy catheter dry. You can take showers, but cover the area with plastic wrap. Tape the edges of the plastic wrap to your skin so that water cannot get under it. If the area does get wet, dry the skin completely after your shower.
  • Keep the skin around your nephrostomy catheter clean. Clean the area every day or every other day with a cotton swab that has been moistened with peroxide. Always wash your hands before you clean the catheter site.
  • Keep the skin around your nephrostomy catheter covered. After cleaning the skin of the catheter insertion site, cover the area with a clean bandage or dressing. Change the dressing if it gets wet.

What are signs of a skin infection? What should I do for a skin infection?

Signs of a skin infection are redness, soreness, and swelling of the skin around the catheter. If you notice any of these signs, even if they are very mild, you should follow these instructions unless your doctor specifies otherwise:
  • Clean the skin site more often. If you usually clean the skin and change the dressing every other day, start doing this every day. If you usually clean the skin and change the dressing once a day, do this twice a day.
  • Apply antibiotic ointment to the skin around the catheter after each time you clean it.
  • If your symptoms of skin infection do not improve within 48 hours, or if they worsen despite the extra care, call your doctor.
  • If your symptoms of skin infection do improve promptly, keep up the extra care for a total of one week, and then go back to your usual skin care routine.

How do I keep my nephrostomy catheter from getting blocked so that I won’t get a kidney infection?

You cannot completely avoid the possibility that your nephrostomy catheter will get blocked. However, the instructions listed below can minimize the risk:
  • If your nephrostomy catheter drains urine into an external drainage bag, rinse the bag out with water every day. It is best to have two bags so that you can wear one while you are rinsing the other one.
  • Apply antibiotic ointment to the skin around the catheter after each time you clean it.
  • Keep your appointments to have your nephrostomy catheter changed. In most cases, the catheter is changed every two to three months. Changing the catheter helps to prevent catheter blockage. The longer the catheter is in, the more likely it is to get blocked. It is much easier to change the catheter than it is to place the original catheter. This change can usually be done as an outpatient.

What are signs that my nephrostomy catheter is blocked? What are signs of kidney infection?

These two problems frequently go together. Your nephrostomy catheter may get blocked and cause kidney infection in spite of good care. Signs that your catheter is blocked are back pain and leakage of urine around the catheter onto your skin and catheter dressing. Signs that you have a kidney infection are pain, fever, and chills.

What should I do if I think my catheter is blocked and/or I think I have a kidney infection?

Call your interventional radiologist and/or primary doctor immediately. These doctors will arrange for prompt treatment of your problem. In most cases, you will need to have your catheter changed and you will need antibiotic medicine. You may need to be admitted to the hospital. If your tube is capped off, uncap it and connect it to a drainage bag.

What supplies will I need to take care of my nephrostomy catheter?

You will need to buy:
  • cotton swabs or cotton balls
  • hydrogen peroxide
  • gauze pads
  • surgical tape
  • antibiotic ointment
  • drainage bags
These things are available at drug stores and hospital supply stores. Your doctor will let you know if there are supplies you need that are not on this list.

Do I have to limit my activity?

You will be sore for one to two weeks after the catheter is first inserted. This will limit your activity. After that, you should continue to avoid any activity that causes a pulling sensation or pain around the catheter or kinking of the catheter.

I know I need to call my doctor if: I have a skin infection that does not go away with care at home, I think my catheter is blocked, or I suspect I have a kidney infection. Are there other times I should call my doctor about the catheter?

Yes. Call your doctor immediately if:
  • your catheter becomes dislodged or broken.
  • you have stitches and they become loose.
  • your catheter begins to leak.
  • there is blood in or around your catheter.

Which doctor do I call about my nephrostomy catheter?

Most people who need a nephrostomy catheter have more than one doctor, and it can be difficult to know which doctor to call when you have questions about or a problem with your catheter. Your catheter was placed by a specially trained doctor called an interventional radiologist. This specialist works with your other doctors (such as your surgeon, internist, or family doctor) to take care of you once you have a nephrostomy catheter. Your team of doctors may prefer that you contact your interventional radiologist directly if you have a question or problem relating to your catheter. Or, your medical team may prefer that you contact your surgeon, internist, or family doctor first. Ask your doctors whom you should call when you need advice or help with catheter care.