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Q. Which doctor do I call about mynephrostomy catheter?
A. Most people who need a nephrostomycatheter have more than one doctor, and itcan be difficult to know which doctor to callwhen you have questions about or a problemwith your catheter. Your catheter was placedby a specially trained doctor called an inter-ventional radiologist. This specialist works withyour other doctors (such as your surgeon,internist, or family doctor) to take care of youonce you have a nephrostomy catheter. Yourteam of doctors may prefer that you contactyour interventional radiologist directly if youhave a question or problem relating to yourcatheter. Or, your medical team may preferthat you contact your surgeon, internist, orfamily doctor first. Ask your doctors whomyou should call when you need advice or helpwith catheter care.
Q. What is an interventional radiologist?
A. Interventional radiologists are doctors whospecialize in minimally invasive, targetedtreatments performed using imaging forguidance. They use their expertise in readingX-rays, ultrasound, MRI and other diagnos-tic imaging equipment to guide tiny instru-ments, such as catheters, through blood ves-sels or through the skin to treat diseaseswithout surgery. Interventional radiologistsare board-certified and fellowship trained inminimally invasive interventions using imag-ing guidance. Their specialized training iscertified by The American Board of MedicalSpecialties. Your interventional radiologistwill work closely with your primary care orother physician to be sure you receive thebest possible care.
You or a member of your
family has been referred to
an interventional radiologist for
treatment. This brochure will
answer some of the questions
about the medical specialty and
how an interventional radiologist
can help you.
Questions and Answers aboutNephrostomy Catheter Care
Q. What is a nephrostomy catheter?
A. A nephrostomy catheter goes through yourskin into your kidney to drain your urine. Insome cases, the urine drains out of your bodyinto a drainage bag. In other cases, thecatheter drains the urine into the bladder andthere is no bag on the outside. Reasons toneed a nephrostomy catheter include: blockageof the ureter (the structure that normallycarries urine from the kidney to the bladder),presence of a hole in the ureter, and preparationfor surgery or other procedures on the kidneyand ureter.
Q. What problems can occur with anephrostomy catheter?
A. The main problem that can occur is infection.Your nephrostomy catheter can cause twotypes of infection: a skin infection and a kidneyinfection. A skin infection can be preventedby taking good care of the skin around thecatheter. If a skin infection occurs in spite ofgood skin care, it is usually simple to treat.
A kidney infection occurs if the catheter getsblocked. A kidney infection is more serious thana skin infection, but it can be avoided. The bestway to avoid a kidney infection is to have yourcatheter changed for a new one regularly. Ifyour catheter gets blocked and your kidneygets infected in spite of good care, your doctors can treat the problem by changing thecatheter and giving you antibiotics.
Q. How do I take care of the skin aroundmy nephrostomy catheter?
A. Because the catheter is on your back, you willneed help. Follow these instructions unlessyour doctor specifies otherwise:
• Keep the skin around your nephrostomycatheter dry. You can take showers, but coverthe area with plastic wrap. Tape the edges ofthe plastic wrap to your skin so that watercannot get under it. If the area does get wet,dry the skin completely after your shower.
• Keep the skin around your nephrostomycatheter clean. Clean the area every day orevery other day with a cotton swab that hasbeen moistened with peroxide. Always washyour hands before you clean the catheter site.
• Keep the skin around your nephrostomycatheter covered. After cleaning the skin ofthe catheter insertion site, cover the area witha clean bandage or dressing. Change thedressing if it gets wet.
Q. What are signs of a skin infection?What should I do for a skin infection?
A. 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 arevery mild, you should follow these instructionsunless your doctor specifies otherwise:
• Clean the skin site more often. If you usuallyclean the skin and change the dressing everyother day, start doing this every day. If youusually clean the skin and change the dressingonce a day, do this twice a day.
• Apply antibiotic ointment to the skin aroundthe catheter after each time you clean it.
• If your symptoms of skin infection do notimprove within 48 hours, or if they worsendespite the extra care, call your doctor.
• If your symptoms of skin infection doimprove promptly, keep up the extra care for atotal of one week, and then go back to yourusual skin care routine.
Q. How do I keep my nephrostomycatheter from getting blocked so that I won’t get a kidney infection?
A. You cannot completely avoid the possibilitythat your nephrostomy catheter will getblocked. However, the instructions listedbelow can minimize the risk:
• If your nephrostomy catheter drains urine intoan external drainage bag, rinse the bag outwith water every day. It is best to have twobags so that you can wear one while you arerinsing the other one.
• Keep your appointments to have yournephrostomy catheter changed. In most cases,the catheter is changed every two to threemonths. Changing the catheter helps to preventcatheter blockage. The longer the catheter isin, the more likely it is to get blocked. It ismuch easier to change the catheter than it isto place the original catheter. This change canusually be done as an outpatient.
Q. What are signs that my nephrostomycatheter is blocked? What are signs ofkidney infection?
A. These two problems frequently go together.Your nephrostomy catheter may get blockedand cause kidney infection in spite of goodcare. Signs that your catheter is blocked areback pain and leakage of urine around thecatheter onto your skin and catheter dressing.Signs that you have a kidney infection arepain, fever and chills.
Q. What should I do if I think my catheteris blocked and/or I think I have a kid-ney infection?
A. Call your interventional radiologist and/orprimary doctor immediately. These doctorswill arrange for prompt treatment of yourproblem. In most cases, you will need to
have your catheter changed and you willneed antibiotic medicine. You may need tobe admitted to the hospital. If your tube iscapped off, uncap it and connect it to adrainage bag.
Q. What supplies will I need to take careof my nephrostomy catheter?
A. 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 andhospital supply stores. Your doctor will let youknow if there are supplies you need that arenot on this list.
Q. Do I have to limit my activity?
A. You will be sore for one to two weeks afterthe catheter is first inserted. This will limityour activity. After that, you should continueto avoid any activity that causes a pullingsensation or pain around the catheter orkinking of the catheter.
Q. I know I need to call my doctor if: Ihave a skin infection that does not goaway with care at home, I think mycatheter is blocked, or I suspect I havea kidney infection. Are there othertimes I should call my doctor aboutthe catheter?
A. 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.
