Fasting: Do not eat or drink 4 hours prior to your procedure time

Allergies: Please tell Intra staff at the time of booking if you have any food or medication allergies, or previous reactions to X-ray contrast (dye).

Diabetes: If you are a diabetic, please tell Intra staff at the time of booking. You may need to discuss your insulin/diabetes medication doses with your radiologist.

Anticoagulants (blood thinner): If you are taking any blood thinners (e.g. Warfarin, Clexane, Pradaxa, Rivaroxban), please make this known to Intra staff at the time of booking. You will need to stop this medication temporarily 2-5 days before the procedure, but this will be advised via your interventional radiologist, Intra nurse, or the admin team.

Other regular medications: Continue taking these, unless otherwise discussed with your interventional radiologist.

A nephrostomy is performed by an interventional radiologist. During the procedure you will be sedated but awake. Local anaesthetic will also be injected around the access site.

It is easier to access your kidney via your back, therefore you will be positioned on your stomach. Your back will be painted with an antiseptic solution, and a sterile drape will then be placed over your body, to ensure sterility is maintained. Local anaesthetic will be injected around the access point in your back, and deeper into your tissue. This will sting for approximately 30 seconds, but after this, you should not feel any pain. If at any time you feel pain, or discomfort, please inform the doctor immediately, and more pain relief can be given via your IV line, as well as more local anaesthetic.

Using ultrasound guidance, the kidney will be accessed. Contrast dye and fluoroscopy will then be used to take some angiograms.

A wire will be inserted into the kidney and used to insert a drainage catheter, so that the urine can drain directly outside the body, into a drainage bag.

If the radiologist deems a ureteric stent is required, this may be inserted prior to inserting the drainage catheter (above). Wires and catheters will be used to gain further access down the ureter, and into the bladder. This may cause some amount of pressure, but is momentary, and will subside once these are removed. Please inform the doctor if you have pain and it is not going away. More pain relief can be given.

A long, thin plastic tubing (ureteric stent) will be inserted over the wire. One end will be positioned in your bladder, and the other end will sit in the kidney. You will not feel the stent once the wire is removed.

If a ureteric stent is inserted, you will have a drainage catheter left insitu for a day or two, and this will be capped off (will not be attached to a drainage bag). This is to ensure that we have access to the kidney, if the stent is not working efficiently, and needs revising.

A dressing will be placed over the nephrostomy drain to keep it secure, and ensure it is safe from being accidentally pulled.

The interventional radiologist will discuss the outcome of the procedure with you.

You will be required to stay overnight if a drain or stent is inserted for the first time, just to ensure there are not issues with blockage.

You will be able to eat and drink, once the sedation has worn off.

Before you leave, a nurse will give you discharge instructions to follow at home.

• Someone must drive you home or accompany you in a taxi. Please arrange for accompanied transport in advance.
• Due to the sedation or effects of the general anaesthetic, you may feel lethargic afterwards with reduced concentration. For this reason, for 24 hours after your procedure please:
  • Do not drive.
  • Do not drink alcohol.
  • Do not make any legal decisions or sign legal documents.
• Do not do activity requiring strength, concentration, or full alertness for the rest of the day.

As with any procedure, there are potential risks involved. Your interventional radiologist will explain the procedure, discuss possible risks and answer any questions you may have. You will then be asked to sign the consent form. This will occur on the day of your procedure.