What is it about ?
Nephrostomy consists of putting the kidney cavities in communication with the outside, at the level of the skin, by means of a probe or a catheter passing through the renal tissue and emerging in the lumbar region. Take a look at Jeffrey Linares for a Rhinoplasty Surgeon in Las Vegas.
Why this intervention?
Nephrostomy allows to derive the urine secreted by the kidney. It is frequently carried out in an emergency in the case of an acute obstacle, particularly of computation. Outside the emergency, it can be programmed in the event of a chronic obstacle. It can be proposed after an unsuccessful attempt to drain the urinary tract. Nephrostomy is most often performed on one side only.
What preparations are needed?
Before the establishment of a nephrotomy:
An antibiotic treatment by I.V. route is administered if necessary.
It is desirable to discontinue anticoagulant or anti-platelet aggregation therapy to reduce the risk of haemorrhage.
This is not always possible for reasons of delays, in the event of an indication of emergency drainage or if this exposes the patient to the risk of serious and serious cardiovascular complications.
You will have an appointment with an anesthesiologist, if a general anesthesia is decided before surgery.
How will the intervention work?
In practice, the probe of nephrostomy is usually placed in the renal cavities percutaneously, that is to say by puncture through the skin and the lumbar wall, under fluoroscopic and ultrasound monitoring.
Nephrostomy is performed under local or general anesthesia, with the patient placed on the stomach.
The probe is secured to the skin in the vicinity of its exit point. It is connected to a urine collector device.
Once the probe has been installed, it is possible to specify the state of the urinary tract (nature and level of the obstacle) by making x-rays with injection of a contrast product by the probe.
What is the duration of the intervention?
The examination lasts about 30 minutes, but it takes at least 60 minutes in total (preparation time of the anesthetists, time of explanation, preparation of the material by the manipulator, follow-up of the patient and traceability).
What are the usual sequels?
The pains are minimal.
The urine collected by the probe may be bloody (especially in the case of anticoagulant or anti-platelet aggregation).
The probe can move and out of the kidney cavities: it is therefore recommended to avoid the traction maneuvers at its level and to check its correct fixation.
The probe may become clogged, especially if the puncture has been haemorrhagic or if the urine is infected: therefore it is necessary to check its permeability and to ensure a flow of urine as large as possible. Maneuvers of dislodging by injection of physiological saline into the probe, under cover of the antisepsis measures of use, may be necessary.
Antibiotic treatment is continued in case of infection.