What is a Nephrostomy Tube?
A Percutaneous Nephrostomy (PCN) tube is a small, flexible, plastic tube (catheter) that is inserted through the skin on your back or side, directly into the collecting system of your kidney. The tube allows urine to drain directly from the kidney into a small external bag.
Why do I need a Nephrostomy Tube?
The most common reason for this procedure is a blockage in the urinary system that is preventing urine from draining normally from the kidney into the bladder. This blockage causes pressure to build up, which can damage the kidney and may lead to a serious infection.
The procedure is typically performed for:
- Relief of Obstruction: To drain urine that is backed up due to kidney stones, tumors, scarring (strictures), or other causes.
- Treating Infection (Pyonephrosis): To drain infected urine from the kidney, which is a life-threatening condition (sepsis) if left untreated.
- Access for Other Procedures: To provide a pathway into the kidney for stone removal or the insertion of an internal stent (a tube placed inside the ureter).
Benefits of the Procedure
| Benefit | Description | Estimated Success Rate |
| High Technical Success | The placement of the catheter is highly successful in the vast majority of cases. | Generally 96% to 100% (4, 6) |
| Preservation of Kidney Function | Relieving the blockage stops the damaging back-pressure and helps the kidney recover function. | N/A |
| Infection Control | Drains infected urine quickly, which is critical for treating or preventing life-threatening blood infections (sepsis). | N/A |
| Minimally Invasive | Performed through a small puncture under X-ray and ultrasound guidance, which is less extensive than major surgery. | N/A |
Risks and Potential Complications
While generally safe and effective, as with any invasive procedure, there are potential risks. The benefits of relieving the obstruction usually outweigh these risks. Major complications are rare, but can be serious.
| Complication | Description | Estimated Percentage Range |
| Bleeding/Hemorrhage | Urine may be blood-tinged for a day or two (common and expected). Significant bleeding that may require a blood transfusion or further intervention. | 1% to 4.3% (2, 5, 7) |
| Infection/Sepsis | Infection of the kidney or bloodstream, especially if the urine was already infected prior to the procedure. | 1% to 14% (2, 3, 5) |
| Catheter Dislodgement | The tube may slip out of the kidney entirely or shift out of its correct position. | 1% to 5% (2, 7) |
| Catheter Blockage/Kinking | The tube can become blocked with blood clots or sediment, or kink, preventing proper drainage. | Common (often treated by flushing/replacement) |
| Injury to Adjacent Organs | Rare injury to nearby structures like the lung (pneumothorax), colon, liver, or spleen during tube placement. | <1% (Pneumothorax around 0.3%) (3) |
| Urinary Leakage | Urine may leak around the tube at the skin site or internally, causing an internal fluid collection (urinoma). | 0.5% to 9% (1, 3) |
| Major Complications (Overall) | Complications requiring major therapy, prolonged hospitalization, or permanent adverse outcome. | 1.4% to 7.7% (2, 6) |
Note: Percentage ranges are based on published clinical studies and can vary depending on the patient’s underlying condition, health status, and the complexity of the procedure.
What to Expect After the Procedure
- Recovery: You will be monitored closely in the recovery area and may be required to stay in the hospital overnight.
- Pain: Discomfort at the insertion site is common and manageable with pain medication.
- Catheter Care: You will receive detailed instructions on caring for the tube and drainage bag, including keeping the area clean and secure. It is crucial to prevent the tube from being pulled or kinked.
- Follow-up: The tube will need to be changed regularly (usually every 2-3 months). Your doctor will discuss the next steps for treating the cause of the blockage.
When to Call Your Doctor Immediately
Contact your healthcare provider or seek immediate medical care if you experience any of the following:
- Fever above 100.4∘F or chills.
- Severe pain in your back or abdomen that is not relieved by medication.
- Significant bleeding from the tube site or if your urine remains bright red (like tomato juice) and heavy for more than 48 hours.
- The tube falls out or is completely blocked (no urine is draining into the bag for several hours).
- Severe swelling, redness, or pus around the tube insertion site.
Bibliography/Citations
- British Association of Urological Surgeons (BAUS). Percutaneous Nephrostomy (PCN) – Patient Information Leaflet. 2023. Accessed October 1, 2025.
- Biyik, M., et al. “The results of ultrasound-guided percutaneous nephrostomy tube placement for obstructive uropathy: A single-centre 10-year experience.” Nigerian Journal of Clinical Practice, vol. 21, no. 1, 2018, pp. 69-74. (Source for overall technical success 96.1%, minor 11.1% and major 7.7% complication rates).
- Chalmers, N. I., et al. “Complications of Percutaneous Nephrostomy Tubes: ED Presentations, Evaluation, and Management.” Emergency Medicine Clinics of North America, vol. 37, no. 4, 2019, pp. 627–643. (Source for infection rate up to 14% and significant bleeding 1% to 4.3%).
- Imperial College Healthcare NHS Trust. Having a percutaneous nephrostomy. 2022. Accessed October 1, 2025.
- Society of Interventional Radiology (SIR). Quality Improvement Guidelines for Percutaneous Nephrostomy. Journal of Vascular and Interventional Radiology, vol. 20, no. 11, 2009, pp. 1381–1387. (Source for general success rate of 96% to 100% for obstructed dilated system).
- Tal, S., et al. “Obstructive Uropathy Treatment Complication Rate After Percutaneous Nephrostomy Versus Double J Catheter Insertion.” Journal of the Royal Medical Services, vol. 25, no. 3, 2018, pp. 43–48. (Source for septicemia 5% and bleeding 11% rates for PCN).
- Uhlman, T., et al. “Percutaneous Nephrostomy Tube: Insertion and Management.” Seminars in Interventional Radiology, vol. 38, no. 1, 2021, pp. 60–67. (Source for dislodgement 5%).