Care nephrostomy - Causes, Symptoms and Treatment .MF .

August 12, 2017 17:52 | Other Manipulations

nephrostomy - a special tube that is installed in the cavity of the renal pelvis to the outflow of urine after the operation performed on the kidney or ureter.The objective is to effectively nephrostomy evacuation of urine from the kidney cavity, at a time when the ureter and bladder are not yet ready to to actively withdraw urine.

There are two methods of setting nephrostomy.The first time this occurs during surgery, and in the second - using percutaneous puncture of the renal pelvis.In principle, the statement of nephrostomy - it's only medical manipulation, and the patient it takes only passive participation.As a rule, nephrostomy set at such pathological conditions like kidney stones, tumors or ureteral obstruction.In this case, it can have a therapeutic or diagnostic purpose.For example, in purulent diseases of the kidneys is often performed nephrostomy to take the analysis of the contents of her pelvis.

Appearance nephrostomy

Timing setting nephrostomy

As a rule, the period when the neph

rostomy tube is large enough.For example, if a patient operate about urolithiasis, his life wearing nephrostomy can reach six months, during which it is necessary to carefully monitor and take care of the tube.In other pathologies, such as partial obstruction of ureteral calculi nephrostomy wearing period and can not exceed one month.However, in such situations, urologists try not to burden patients staging catheter and do not fulfill the said procedure, replacing it with other, more sparing therapies.

Percutaneous nephrostomy statement

Care nephrostomy

Care nephrostomy tube, regardless of the setting of terms of the latter, should always be the most thorough.On this depends not only the condition of the patient during treatment, but also the timing of its final rehabilitation.There are some simple rules for the care nephrostomy:

1. Perfect cleanliness around puncture wounds.In any case, the wound, whatever it may be, is a source of infection in the human body.Puncture wound with nephrostomy is no exception.And in order to prevent penetration of infection along this path, and the need to carefully handle the daily puncture wound antiseptic solutions and sterile perform ligation.As antiseptic agents may be used such as chlorhexidine or furatsillina solution.A bandage at home you need to purchase a sterile bandage or gauze cutting position.

2. Regular evacuation urinal .At its core, nephrostomy is a tube through which urine gets into a special tank, called the urinal.In fact, he is an ordinary plastic bag, which has a hermetic clasp.On each of urinals there is a special mark, which indicates the level of urine, requiring replacement of the urinal.Late replacement tank threatens patient reflux reflux of urine into the cavity of the renal pelvis.This may have a double negative effect.Firstly, increased pressure in the renal pelvis may affect the tightness operating seams and secondly, inverse casting urine is always dangerous kidney infection.

3. Constant washing kidneys.Generally, for the passive outflow nephrostomy not always enough to ensure good circulation in the pelvis.Therefore, in respect of nephrostomy periodically necessary to use an active drainage.Especially for this purpose, in the cavity of the renal pelvis at the time of puncture is not established one, but two tubes.By actively feeding an antiseptic into one of the tubes can be obtained from the second washing liquid containing stagnant urine with sand residues.Urologists recommend to carry out such a procedure about once a week over the life of wearing nephrostomy.

Possible complications of nephrostomy

first group of complications caused by nephrostomy, refers to the procedure itself staging of the catheter.For example, if used for the production nephrostomy percutaneous access, during the last needle can damage the artery located near the kidneys.This will lead to severe hemorrhage, and retroperitoneal fat obrzovanie retroperitoneal hematoma.This clinical situation is dangerous because the hematoma can not dissolve and become infected, leading to an inevitable surgery in the retroperitoneal space.In addition, if, despite hematoma still be made to access the renal pelvis, it may result in that the blood appears in the urine, which can result in misdiagnosis and incorrect treatment intended.

second group of complications that can accompany nephrostomy is a kidney infection.Secondary postoperative pyelonephritis, which is at the same time developing a very aggressive course and responds poorly to standard antibiotic treatment.To correct arisen pathology is necessary to use powerful modern antibacterial agents, which are not very cheap.That is why the named pathology is better to prevent than to treat.

Ed.urologist, sexologist-andrologist Plotnikov AN