From the Guidelines
No, aspiration from a nephrostomy tube is not used to relieve obstruction. A percutaneous nephrostomy tube is actually inserted to bypass an obstruction in the urinary system, not to aspirate it. The tube is placed directly into the kidney through the skin to drain urine when there is a blockage in the normal urinary pathway (such as the ureter) 1. The tube allows urine to flow out of the kidney into an external collection bag, relieving pressure in the kidney and preventing complications like infection or kidney damage.
The obstruction itself—which may be caused by kidney stones, tumors, blood clots, or strictures—remains in place and requires separate treatment such as surgery, stent placement, or other interventions to resolve 1. Attempting to aspirate or suction an obstruction through a nephrostomy tube would be ineffective and potentially harmful, as most obstructions are solid or involve structural issues that cannot be removed by simple aspiration.
Key points to consider:
- The nephrostomy tube is a temporary drainage solution while the underlying cause of obstruction is addressed through appropriate medical or surgical management 1.
- Percutaneous nephrostomy (PCN) catheter placement provides access into the renal collecting system for urinary decompression and facilitates endourologic surgery 1.
- The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel 1.
In clinical practice, the focus should be on relieving the obstruction through appropriate medical or surgical interventions, rather than attempting to aspirate the obstruction through the nephrostomy tube. The primary goal is to prevent further deterioration of the patient’s clinical status by addressing the underlying obstructive process.
From the Research
Aspiration from Nephrostomy Tube to Relieve Obstruction
- Aspiration from a nephrostomy tube can be used to relieve obstruction, but there is limited direct evidence to support this specific use 2, 3.
- Nephrostomy tubes are commonly placed for urinary obstruction, urinary diversion, or future endourologic procedures, and aspiration may be a part of the management of these tubes 3.
- However, the primary function of a nephrostomy tube is to provide drainage, and aspiration is not typically the primary method of relieving obstruction 2, 3.
- In some cases, aspiration may be used to remove debris or stones that are causing obstruction, but this is typically done in conjunction with other procedures such as percutaneous nephrolithotomy 4, 5.
- The use of aspiration to relieve obstruction should be done under the guidance of a qualified healthcare professional, as there are potential risks and complications associated with the procedure 2, 3.
Potential Risks and Complications
- Potential risks and complications of aspiration from a nephrostomy tube include infection, bleeding, and damage to surrounding tissues 2, 3.
- Patients with nephrostomy tubes should be monitored closely for signs of infection, such as fever, chills, and cloudy or foul-smelling urine 3, 4.
- Aspiration should be done using sterile technique to minimize the risk of infection, and patients should be treated with antibiotics if infection is suspected 2, 3.
Management of Nephrostomy Tubes
- Nephrostomy tubes require regular maintenance and care to prevent complications and ensure proper function 3.
- Patients with nephrostomy tubes should be instructed on how to care for their tube, including how to irrigate and flush the tube, and how to monitor for signs of infection or other complications 3.
- Regular follow-up appointments with a healthcare professional are necessary to monitor the tube and ensure that it is functioning properly 2, 3.