Urinary Leakage After Nephrostomy Tube Removal
Yes, it is normal to have some urinary leakage from the back (nephrostomy site) after nephrostomy tube removal, which typically resolves within 1-2 weeks as the tract heals. 1
Normal Post-Nephrostomy Expectations
- Urinary leakage from the nephrostomy site after tube removal is a common and expected occurrence as the tract begins to close 1
- Complete healing of the nephrostomy tract typically occurs within 1-2 weeks, during which some leakage is normal 1
- Mild hematuria (blood in urine) is common in approximately 50% of patients after nephrostomy procedures and can persist briefly after tube removal 1
- The urinary system needs time to adjust to the change in drainage patterns after nephrostomy tube removal, which can initially cause increased urinary frequency 1
Factors That Influence Duration of Urinary Leakage
Several factors can affect how long urine leakage persists after nephrostomy tube removal:
- Parenchymal thickness: Thinner renal parenchyma at the access site is strongly associated with prolonged urinary leakage (correlation coefficient -0.716) 2
- Degree of hydronephrosis: More severe hydronephrosis correlates with longer duration of urinary leakage (correlation coefficient 0.526) 2
- Presence of residual stones: Patients with residual stones experience significantly longer urinary leakage compared to those without residual stones 2, 3
- Multiple punctures: Patients who required multiple renal punctures during the procedure are more likely to experience prolonged leakage 3
- Size of nephrostomy tube: Larger nephrostomy tubes (e.g., 28F) are associated with longer duration of urinary leakage compared to smaller tubes (e.g., 9F pigtail catheters) 4
When to Seek Medical Attention
While some leakage is normal, certain symptoms warrant immediate medical evaluation:
- Fever, flank pain, or purulent (pus-like) drainage from the nephrostomy site may indicate infection 1
- Severe or persistent hematuria beyond the expected timeframe requires evaluation 1
- Prolonged urinary leakage (>48 hours) after nephrostomy tube removal may require placement of a ureteral stent 3
- Complete absence of urination, which could indicate obstruction, is a concern that warrants medical evaluation 1
Management of Nephrostomy Site
- Keep the nephrostomy site clean and covered with a sterile dressing until fully closed 1
- Avoid strenuous activities until cleared by your healthcare provider, typically 1-2 weeks after tube removal 1
- Follow up with your healthcare provider as scheduled to ensure proper healing 1
- For prolonged leakage (>48 hours), placement of a double-J ureteral stent may be necessary to facilitate proper drainage and healing 3
Risk Factors for Complications
- Premature removal of nephrostomy tubes can lead to complications including prolonged hospitalization and patient discomfort 5
- In patients with high-risk factors (thin parenchyma, significant hydronephrosis, residual stones), preventive placement of a double-J stent at the end of the procedure may be beneficial 3
- A parenchymal thickness less than 17.2 mm at the access site is associated with prolonged hospitalization due to urinary leakage 2