Nephrostomy (kidney drainage) (Percutaneous nephrostomy)

What is a nephrostomy?

A nephrostomy is a thin, flexible tube placed through the skin of your back directly into a kidney to drain urine. It is used when the normal route, down the tube to the bladder (the ureter), is blocked, so urine cannot escape and backs up into the kidney. An interventional radiologist places the tube using ultrasound and X-ray pictures to guide a needle in safely.

It is often done urgently, and sometimes as an emergency, because a blocked kidney can quickly become damaged, and a blocked kidney that is also infected can make you seriously unwell with sepsis. Draining the kidney relieves the pressure, protects it and lets infection be treated. Common causes of the blockage include kidney stones and tumours pressing on the ureter.

There is no large surgical cut, only a small puncture in the skin of the back, numbed with local anaesthetic and usually with sedation and strong pain relief. A nephrostomy treats the blockage's effects by draining the urine; it does not cure whatever is causing the blockage, which still needs its own treatment. Sometimes, at the same time or later, a stent can be threaded down the ureter so urine drains internally again.

Types, options & approaches

There may be different ways to do this. The right approach depends on the clinical question and your circumstances.

Options at a glance

These are the main approaches described in this guide. The right option depends on the diagnosis, your goals and what your clinician thinks is safe.

Preparing for your procedure

• In an emergency there may be little time; the team will explain what they can and may take consent quickly while treating you.
• Tell the team about allergies, especially to contrast dye, and about asthma.
• Blood tests check your clotting and kidney function before the procedure.
• List all your medicines, especially blood thinners, as these usually need pausing for a kidney puncture.
• You may be asked not to eat for a few hours, particularly if sedation is planned; you can usually drink clear fluids.
• A drip is placed for fluids, antibiotics and pain relief, and antibiotics are often given beforehand.
• Tell the team if you are or might be pregnant, as the procedure uses X-rays.

What happens

You usually lie on your front on the X-ray table. The skin over the kidney, in your back or side, is cleaned and numbed with local anaesthetic, and you are often given sedation and strong pain relief through a vein. The radiologist uses ultrasound to find the kidney and guides a needle through the skin into the part of the kidney where urine collects.

A fine guidewire is passed through the needle and its position is checked with X-rays and a little dye. The drainage tube is then passed over the wire and curled inside the kidney to hold it in place. Urine usually starts to drain straight away into a bag.

The tube is stitched or fixed to the skin and connected to the drainage bag, which you wear on your leg or by the bed. You then rest and are monitored. Most people stay in hospital at least overnight, and longer if they are unwell from infection or need treatment for the underlying cause.

Is this procedure right for me?

A good consultation should explore whether it's the right choice for you now — including reasons to wait or consider something else.

Before you decide

Use this as a shared-decision checklist. The aim is not just “can this be done?”, but whether it is right for you, now, with the risks and alternatives clearly understood.

Comfort, sedation or contrast choices

If local anaesthetic, sedation, contrast or pain relief is used, ask what is planned, why, and what it means afterwards.

Some blood in the urine for a day or two is normal; heavy or persistent bleeding is uncommon but, rarely, needs a transfusion or a further procedure to stop it. The other main concern is infection, especially if the blocked kidney was already infected. Ask your team how long they expect you to need the tube, when it will be changed, and what the plan is to treat the cause of the blockage.

Published figures to discuss

Risk varies with how unwell you are, whether the kidney is infected, your clotting and the anatomy, so single percentages are hard to apply to everyone. UK patient information generally describes serious complications as uncommon. The figures below are cautious and drawn from UK patient information; your own risk may differ.

These are literature figures, not a personalised prediction. Your own risks and likely benefits depend on your circumstances, your health, and how your care is carried out and followed up.

What happens afterwards

There is no large wound, only a small puncture in the back, but you will have a tube and bag to get used to, and recovery is shaped mainly by the underlying cause and how unwell you were. Most people stay in hospital at least overnight.

• Bloodstained urine in the bag for the first day or two that gradually clears
• Soreness or aching at the tube site in the back
• A small amount of urine leaking around the tube at first
• Getting used to emptying and caring for the drainage bag

Aftercare

• Keep the tube site clean and dry and follow the advice you are given on dressings.
• Empty the drainage bag regularly and keep it below the level of the kidney so urine drains.
• Make sure the tube is not kinked, pulled or lying under you, which can stop it draining.
• Drink plenty of fluids, unless told otherwise, to help keep the tube clear.
• Watch for the tube blocking (less urine draining), leaking or coming out, and report it.
• Watch for fever or feeling unwell, as this can signal infection, and seek help promptly.
• Attend appointments for tube changes and to treat the underlying cause.

• Clear instructions and a demonstration on caring for the tube and bag
• Spare drainage bags and dressings, and how to get more
• The ward, urology or radiology contact number for blockage, leaking or fever
• A note of which medicines, especially blood thinners, to stop and restart and when
• The date for the next tube change if the tube is staying in
• Support at home if you find managing the tube difficult

⚠ Get urgent help if…

• A high fever, shivering or feeling very unwell (possible serious infection or sepsis)
• Heavy or bright red bleeding in the urine, or the urine in the bag turning deep red
• The tube stops draining or much less urine appears in the bag
• The tube falls out or is pulled out (cover the site and contact the team urgently)
• Increasing pain, redness, swelling or discharge at the tube site
• A lot of urine leaking around the tube or soaking the dressing
• Feeling faint, a racing heart or worsening tummy or back pain

Who to contact: your clinician, clinic or test provider first (keep their number to hand). For urgent advice when you can't reach them, call NHS 111. In an emergency, call 999.

General guidance — it doesn't replace the specific advice your radiologist gives you.

Results & realistic expectations

A working nephrostomy drains the blocked kidney, relieves the pressure and protects the kidney, and lets an infected kidney be treated. You should see urine draining into the bag, and if you were unwell with infection you should begin to improve as it is treated.

A nephrostomy treats the effect of the blockage, not its cause. Whatever is blocking the kidney, such as a stone or a tumour, still needs its own treatment, and your team will plan this. In time, some people can have a stent placed so urine drains internally and the external tube can be removed.

A nephrostomy can be short-term, until the cause is treated, or longer-term if the blockage cannot be relieved. Long-term tubes need changing at intervals (often around every three months) to stop them blocking. Whether the tube can eventually be removed, or replaced by an internal stent, depends on treating the underlying cause.

Related tests, treatments or support

A nephrostomy is often part of wider treatment. It may be combined with antibiotics for infection, with treatment of the underlying cause (such as removing a stone or treating a tumour), and with placing a ureteric stent so urine can later drain internally. The urology and radiology teams plan these together.

Follow-up & long-term care

You stay under the urology and radiology teams, who treat the cause of the blockage, arrange tube changes if the tube is staying in, and decide whether a stent can replace the external tube. The tube site, drainage and signs of infection are checked. Report any blockage, leaking, bleeding, fever or the tube coming out straight away.

• Tube changes at intervals (often around every three months) if needed long term
• Keeping the site clean and the bag draining freely day to day
• Treatment of the underlying cause, such as a stone or tumour
• Possible later placement of a ureteric stent to drain urine internally
• Regular review of kidney function

Repeat, follow-on and what comes next

• The tube needs changing at intervals (often around every three months) if it stays in long term.
• A blocked or displaced tube may need adjusting or replacing.
• A ureteric stent may later replace the external tube so urine drains internally.
• The underlying cause still needs its own treatment.

Ask what happens if the result is unclear or needs repeating, and what is included if further tests or follow-up are needed.

What good aftercare looks like

• Clear teaching on caring for the tube and bag before you go home, with spares and a contact number.
• Written warning signs for bleeding, infection, blockage and the tube coming out.
• A clear plan for tube changes and for treating the underlying cause.
• Review to decide whether a stent can replace the external tube.

What affects the cost

Costs vary a great deal between people and providers, and we don't publish prices. What matters is understanding what drives the cost and making sure your quote is complete. The main things that affect it:

• Whether it is an emergency or planned procedure
• Whether a ureteric stent is placed at the same time
• Sedation and the level of monitoring needed
• The length of hospital stay, especially if you are unwell with infection
• Tube changes over time if the tube is needed long term
• The interventional radiologist's fee, the facility fee and treatment of the underlying cause

• The interventional radiologist's fee and the facility fee
• Contrast dye, sedation and the drainage tube and bags
• The likely length of hospital stay
• The cost and frequency of tube changes if needed long term
• Whether treatment of the underlying cause is included or separate
• What is covered if a complication, such as bleeding or infection, needs further care

On the NHS? A nephrostomy is a core NHS service, frequently delivered urgently or as an emergency; it is rarely arranged privately because it usually forms part of urgent hospital treatment.

You're entitled to your total cost in writing — including reports, follow-up and what happens if the result is inconclusive — before you decide.

Consent traps and marketing red flags

These are not small details. They are often where patients lose choice, time to reflect, or realistic expectations.

Choosing a specialist safely

• Check the radiologist is on the GMC Specialist Register for this area.
• Make sure they work at a CQC-registered service, and look for membership of the relevant Royal College or professional body.
• You're entitled to time to consider and to have your questions answered before you agree — the radiologist who looks after you should explain it, not a salesperson.
• Be wary of pressure: time-limited offers or deposits taken before you've had time to think are red flags, not bargains.
• You're entitled to your total cost in writing — including any follow-up — before you decide.

How Vuemedics verifies every consultant →

Take this to your consultation. A good radiologist will welcome every one of these.

• What is blocking my kidney, and how will that cause be treated?
• Is this being done urgently because of infection, and how unwell am I?
• How long am I likely to need the tube, and how often will it be changed?
• Could I have a stent so urine drains internally instead of into a bag?
• What is my risk of bleeding or infection from the procedure?
• What should I watch for at home, and who do I call if the tube blocks or falls out?
• Are you on the GMC Specialist Register for this area, and which Royal College or professional body are you a member of?
• Will you be the radiologist who carries out my procedure, and who looks after me afterwards?
• What are the risks for someone like me, and how often do your own patients have a problem or need it repeated or redone?
• What does a realistic result look like — and what can this procedure not achieve?
• What are my options, including waiting, doing nothing for now, or choosing a different approach?
• Can I have written information, results and aftercare instructions in a format I can use, including any accessibility or communication support I need?
• What is the total cost in writing, including any follow-ups, and how much time do I have to decide?

Find a verified radiologist for nephrostomy (kidney drainage)

Every consultant is GMC-checked and independently reviewed. Search by postcode and distance, or switch to a map. Ordered by rating, relevance and recency — never by who pays.

How we made this page

Medically reviewed by a GMC-registered consultant. Written in plain English, checked against NHS, NICE, GMC and relevant Royal College / specialist-society guidance, and kept under review. No clinic paid to appear on this page, and we publish no pricing. This is general information to help you prepare — it is not a substitute for advice from your own clinician. How we review our guides →

Source hierarchy: UK regulator and NHS/NICE guidance first, then relevant Royal College or specialist-society guidance, then peer-reviewed evidence for procedure-specific figures where available.

Sources & standards: BSIR - Percutaneous nephrostomy (patient leaflet) North Bristol NHS Trust - Nephrostomy and ureteric stent insertion Royal Marsden NHS - Insertion of a percutaneous nephrostomy BSIR - What is interventional radiology?

Reviews reflect patients' experience of care, not clinical outcomes. For procedure volumes and outcome data see PHIN.

Last medically reviewed 2026-09-21. Spotted something wrong or out of date? Report an error in this guide.