"The patient presents with either the tube completely out or with a history of poor or no urine output. In those who have had the tube in place for sometime (> 4 weeks) a tract may remain open for a period of time (typically up to 24 hours), through which a new tube may be placed."
"If the nephrostomy is completely dislodged, a plastic dilator may be placed in the track and a tractogram performed to illustrate if the track remains patent into the renal collecting system. A hydrophilic wire may then be used to enter the collecting system. A plastic dilator may then be passed over the wire, enabling exchange with a stiff wire. A new catheter can then be placed over the wire, avoiding a new procedure and new renal puncture."
Expected headings
"Nephrostomy salvage"
"Technique"
"Nephrostomy tube exchange"
"Technique"
"Complications"
"There are reports of up to 17% of patients acquiring a bacteraemia after routine tube exchange, but it is considered low risk, and many centres do not give prophylactic antibiotics prior to the procedure 1."