You had a procedure to drain urine from your kidney or to get rid of kidney stones. This article gives you advice on what to expect after the procedure and steps you should take to care for yourself.
Percutaneous nephrostomy - discharge; Percutaneous nephrostolithotomy - discharge; PCNL - discharge; Nephrolithotomy - discharge; Percutaneous lithotripsy - discharge; Endoscopic lithotripsy - discharge; Kidney stent - discharge; Uteric stent - discharge; Renal calculi - nephrostomy; Nephrolithiasis - nephrostomy; Stones and kidney - self-care; Calcium stones - nephrostomy; Oxalate stones - nephrostomy; Uric acid stones - nephrostomy
You had percutaneous (through the skin) urinary procedures to help drain urine from your kidney and get rid of kidney stones.
If you had a percutaneous nephrostomy, the health care provider inserted a small, flexible catheter (tube) through your skin into your kidney to drain your urine.
If you also had percutaneous nephrostolithotomy (or nephrolithotomy), the provider passed a small medical instrument through your skin into your kidney. This was done to break up or remove kidney stones.
You may have some pain in your back for the first week after the catheter was inserted into the kidney. Over-the-counter pain medicine such as Tylenol may help with the pain. Other pain medicines, such as aspirin or ibuprofen (Advil) can also help, but your provider may not recommend that you take these medicines because they can increase your risk of bleeding.
You may have some clear-to-light yellow drainage around the catheter insertion site for the first 1 to 3 days. This is normal.
A tube that comes from your kidney will pass through the skin on your back. This helps the urine flow from your kidney into a bag that is attached to your leg. You may see some blood in the bag at first. This is normal and should clear over time.
Proper care of your nephrostomy catheter is important so you do not get an infection.
Drink plenty of liquids (2 to 3 liters) every day, unless your provider tells you not to do so.
Avoid any activity that causes a pulling sensation, pain around the catheter, or kinking in the catheter. DO NOT swim when you have this catheter.
Your provider will recommend that you take sponge baths so that your dressing stays dry. You may take a shower if you wrap the dressing with plastic wrap and replace the dressing if it gets damp. DO NOT soak in a bathtub or hot tub.
Your provider will show you how to place a new dressing.
Change your dressing every 2 to 3 days for the first week. Change it more often if it gets dirty, wet, or becomes loose. After the first week, change your dressing once a week, or more often as needed.
You will need some supplies when you change your dressing. These include: Telfa (the dressing material), Tegaderm (the clear plastic tape that holds the plastic ring in place), scissors, split gauze sponges, 4-inch x 4-inch (10 cm x 10 cm) gauze sponges, tape, connecting tube, hydrogen peroxide, and warm water (plus a clean container to mix them in), and a drainage bag (if needed).
Always wash your hands well with soap and water before you remove the old dressing. Wash them again before you put on the new dressing.
Be careful when you take off the old dressing:
When the old dressing is off, gently clean the skin around your catheter. Use a cotton swab soaked with a solution of half hydrogen peroxide and half warm water. Pat it dry with a clean cloth.
Look at the skin around your catheter for any increase in redness, tenderness, or drainage. Call your provider if you notice these changes.
Place a clean dressing the way your provider showed you.
If possible, have family or a friend change the dressing for you. This makes the process easier.
Call your provider if you have any of these symptoms:
Also call if:
Bushinsky DA. Nephrolithiasis. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine. 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 126.
Wolf JS. Percutaneous approaches to the upper urinary tract collecting system. In: Wein AJ, Kavoussi LR, Partin AW, Peters CA, eds. Campbell-Walsh Urology. 11th ed. Philadelphia, PA: Elsevier; 2016:chap 8.