Our kidneys perform the most important for the body functions - form and remove urine, while cleaning the blood from various bad impurities. If there are any pathological processes in the organ, the outflow of urine is disturbed. In such situations, it becomes necessary to install a nephrostomy.
Kidney nephrostoma
Renal nephrostomy is a drainage tube that is placed under the ultrasound or radiographic control in the kidney to divert the urine from the diseased organ. The nephrostome passes through the skin and the muscle layer in the lumbar region, and is injected into the pelvic apparatus. On the drainage tube, urine is freely excreted into the container, which functions as a urine receiver.
Nephrostomy surgery is necessary mainly for oncopacilli to restore full-fledged urinary flow, which is disturbed by the influence of low-dose tumor processes, urolithiasis and cancer pathology, ureteral strictures or metastatic lesions of the abdominal organs, as well as compression of the ureters by tumors.
Setting nephrostomy in the kidney is necessary not only for tumor lesions in the kidney structures, it is indicated with:
- Acute hydronephrosis;
- Tumor lesions of the vagina, prostate, bladder;
- Removal of coral-like calculi;
- Anuria excretory;
- Traumatic injury of the kidney or ureter.
If in time to not take appropriate measures, the kidneys begin irreversible damage, destroying the organ. Sometimes drainage is established for a short time to prevent the development of inflammation and kidney failure, before some procedures like chemotherapeutic treatment, stent placement, etc. But if the kidney is seriously damaged, the drainage system can be left for good.
Care
After the surgical installation of the drainage tube the patient is sent home, the patient is thoroughly instructed how to properly care for the established drainage system in order to avoid inflammatory complications. While the patient is carrying a nephrostome, any physical strain is prohibited to him, otherwise the drainage tube may fall out. A salt-free diet is also needed, and in order to prevent the development of infection, the patient needs to wash the drainage and wound with saline solution.
Nephrostomy care involves the following:
- Rinsing of drainage with saline solution;
- Treatment of the wound with an antiseptic preparation such as Chlorhexidine or Furacilin. Then a dry sterile bandage is applied to the wound. Mind dressings must be changed daily, and the sterile transparent patch changes every three days;
- When the urine level in the urine receiver reaches a certain risk, if the drive is not changed in time, it may happen that urine is cast back into the renal cavity. As a result, pressure inside the kidney rises, suture tissues divergent and drainage falls out. Also, as a result of getting urine back into the kidney, infection can occur;
- If the kidney is infected, it is recommended to rinse it, for which the patient is administered two nephrostomes. A wash solution is supplied to one tube, and at that time, stagnant urines and small concretions leave the other;
- Nephrostome needs to be protected if it is used for chemotherapeutic procedures. To do this, all activities with drainage equipment are carried out strictly with gloves;
- Ensuring Dryness. Swimming, prolonged baths under prohibition, a shower is possible, but the place around the wound should be kept in dry condition for at least 2 weeks;
- Such patients need the help of outsiders, because. It takes at least two households to empty the urine collection container and change the bandage.
Pregnant women often have kidney problems, against which there is a violation of urination. And also the enlarged uterus sometimes just covers any ureter, which makes urine waste impossible. In such cases, there is a real threat of kidney failure, so the installation of drainage or nephrostomy is indicated. If there is evidence, a kidney nephrostomy is necessary.
The video shows drainage care:
Rehabilitation period
After a nephrostomy surgery, the patient is transferred to outpatient therapy, prescriptions are prescribed such as excluding loads and salt from the diet, ensuring proper care and keeping the wound in absolute purity. Initially, the care of the equipment is carried out with the help of medical workers, but then the patient will be able to take care of the home after the wound independently with the help of the household.
Pregnant women with a nephrostomy say that in such a situation it is very difficult for a woman to walk with drainage, but it helps to save the kidney and the baby, so after the delivery, in most cases they thank doctors for the opportunity of happy motherhood.
Quite popular is the question of how many live after the operation. The patient can safely live with a nephrostomy for many years. It will be changed periodically, as necessary. The main thing is to take care of it properly, daily rinse and process the wound. Also, with a nephrostome, a salt-free diet is needed. Treatment table № 7 provides favorable conditions for renal activity and facilitates the work of the body. Exchange processes in the kidney structures are restored. In addition, the salt-free diet significantly improves the processes of urination.
In the video about kidney nephrostomy in the kidney:
Replacement of the nephrostoma
If the nephrostomy is set for life, for example, patients with advanced oncology or contraindications to the operation, you will periodically need to change it. Also, the rennefrostomy is carried out with the tube falling out or its displacement. The replacement procedure should be performed only by a specialist using special tools and equipment, then the probability of complications will be minimal.
Regardless of how long a nephromot is established, its replacement is necessary when there is a blockage of salts that are produced in excess quantities. If the nephrostomy was only set for a while, then, when the urine flow is fully restored, it is possible to remove it, since the need for it already disappears. But before the drainage equipment is removed, a mandatory check of ureteral patency is necessary. Children are more mobile, so they may experience loss or slight displacement of the nephrostomy. If the tube fell out, then it is also necessary to do a rennefrostomy.
Complications of
Complications may be primary or secondary. Primary ones are usually associated with the operation itself. When an incision is made, damage to the perineal arterial structures is possible. This causes severe bleeding and the formation of a hematoma that can inflame or become infected.
Complications of a secondary nature are usually caused by infection of the kidney, for example, postoperative pyelonephritis, which is characterized by aggressive development and the complexity of therapy. If, after the cavity installation method, the temperature has suddenly risen to 38 ° C and even higher, then it is necessary to call an ambulance. To correct the kidney infection, antibiotic therapy is necessary, which is not very desirable for pregnant women, therefore, the rules of nephrostomy care must be strictly observed in order to avoid such consequences.