Neph tube - stent. What's happening?

After being hospitalized twice for kidney infections my husband is having a neph tube installed (is that even the right word?) on Friday. He had a loopogram that showed they could not reflux any fluid through the left ureter. The doctor thinks it may be scar tissue occluding the ureter. The plan is he will have the tube installed for several days until the doc is satisfied the infection is clearing up. Then he will have a stent put in via the neph tube. The stent will lay in the conduit for a while with the hope the ureter will remain open. Uro says they may have to try to enlarge the opening if this does not work.

Questions: Does this sound familiar?
How much pain will he be in during the procedure?

It is outpatient. I have read he may have to stay in the hospital up to 8 hours to make sure the tube is draining? Does this sound right?

Tips? Advice?

He's not reading anything. I am driving myself crazy reading everything. What's the real deal here? He says the kidney infections were so painful he'll undergo anything to keep them from coming back.

PS - should you find yourself on vacation in LA and need to go to the hospital...stay out of Valley Presbyterian. And just say "NO!" to a certain Dr. Patel. ugh.

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I have a nephrostomy tube in place. The tube goes from my kidney, out my back and is attached to extra tubing and a leg bag. Pat said she used a "belly bag" which I think would be easier to deal with. I was 'out" when the tube was placed, it is done by radiology. I had no pain from it really. I did have to be careful after initial placement as even reaching down to pick up a tissue from the floor caused irritation to my kidney and I would have bleeding, as noted by the blood tinged urine. This is my third nephrostomy tube. They need to be replaced periodically. I have a stent in place also and don't even know I have it. They check the patency of the nephrostomy tube in radiology when it is put in, so they know if it is draining right away. He shouldn't be in recovery too long, a few hours at the most. Mostly just some minor discomfort initially. I never took anything for pain from it, so he should do fine with it.

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My John had a Nephrostomy Tube installed a week ago Tuesday. All went well with the procedure.
We were, however, not told that an after-effect would be the unexpected (but short-lived) high fevers - for about three days; a slight sore throat; some bronchial congestion; and, a crummy-sounding cough.
Going back to our Primary/Referring Physician - she said this was not entirely unusual. She even sent a prescription for a broad antibiotic. But, he didn't need to take it. And, these symptoms are almost gone tonight.
Do try to wrap plastic wrap around (and around) his middle during showers. And, we have found a lovely-soft pillow helps to offset John's left side at night.
He immediately mastered the pelvic-level bag. Our "Wonderful Guys" do so much better with these contraptions than we think possible.
Take good care of yourself - also. Best Wishes to you both.

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Karen, I forgot to say that you should put "Stent" in the FIND IT box above. There is a lot of first-hand experience archived regarding the subject of "Stents".

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My husband had a neph tube/stent put in about 3 weeks ago as a result of a blockage where the ureter is attached to his ileal conduit. He had recurrent painful UTIs all winter, apparently caused by this. Unlike many others here, his is due to a recurrence of his bladder cancer not scar tissue so we are in the process of tests etc to see what his Sloan doctors want to do about all this. Tuesday he will have an endoscopy w/biopsy and possible lasering of the area ( he already had a brush biopsy when the neph tube was put in) to see where, how much and what stage of cancer is there. The best case scenario is to save his kidney/ureter possibly by removing the affected area of his ureter and reattaching it after BCG treatments in his ureter, but we won't know what can be done until the results of next weeks procedure.
The actual neph tube insertion procedure was apparently very unpleasant for him-afterwards he said he could feel way more of the procedure than he expected and could only communicate by moaning.. It was "twilight sleep" not full general anastetia because they seemed to want him somewhat responsive. He mentioned this to a doctor after and they told him to tell the anestisiologist next time so they are aware he might need extra. The procedure took 90 minutes and he was in recovery another 60-90 minutes.
He doesn't like the neph tube, has found it uncomfortable with position changes, and we've read here that a few people have internalized tubes (see Cageygal's posts) which sounds better if long term. By the way, he got some Aqua guard waterproof shields at Sloan ( check online-they have a website) that make showering easy-they are large squares of plastic with adhesive all around that you use to cover the neph tube area when showering, though you still need to aim water away and be careful. Save the old leg straps from each vag he discards so you'll always have a dry set to change into after a shower! We've had a visiting nurse ( covered by our insurance) come to help with the 1-2x/week dressing/ tube changes which is helpful but I think I can do it now myself. ( he can't due to location almost on back around his side). He uses the leg bag so gets up 1-2 times at night to empty it.
Hope your husband does well with it and that it's temporary and fixes his problem. There have been a lot of responses on Bcan from people who have had neph bags that you can search for; my husband never reads or researches anything, either!

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Thank you all so much for the information and for sharing your experiences. I am going to hope his procedure goes well, with little to no pain. If he really needs it in for only a few days, I think we can deal with that. He's been through a lot, so a little more discomfort ought to be manageable.

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I have had neph tubes placed and to me it sounds as everything is going to protocol. Intervention radiology does the procedure under light sedation, mine took about an hour, sent to recovery, scheduled to stay overnight with the first one. I do not remember having much pain afterwards, my stomach can not handle pain meds so I would remember having pain once I returned home. They will give him pain meds through the IV and a prescription for some for home if needed. You will need to help him with dressing changes as it can be hard to reach. Hope the procedure goes well and does the trick. If not they can go in and remove the scar tissure. Please let us know how things go. Your husband it fortunate to have you as his caregiver!!! Hugs,

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Usually a stent/neph tube placement is a very quick and easy procedure. Tony has had both the "outside neph tube" (through the back) for both kidneys, but now has an internalized tube for each kidney, which come through his stoma. His tubes are considered permanent, as he has both scar tissue and tumor which blocks the kidneys. The internalized tubes give you less of a chance of infection if you are undergoing chemo. And Tony says he can't even tell the internalized tubes are there, whereas he didn't care for the tubes/dressing coming out of his back.

The internalized tubes also have to be replaced, but with Tony they do a kub x-ray every 3 months to see if placement is still good, and to make sure there is no calcification. So he actually can go 6 months, even 9, as long as things look good.

He had both tubes changed in March. The actually procedure took maybe an hour (this was for both tubes), and he was in recovery another hour. Then back home.

You WILL need to change his dressing every 2 or 3 days, though - so make sure that the nurse shows you how to do it. There's really nothing to it, and doesn't take long at all.

I see no reason why everything shouldn't go smoothly, so try not to worry needlessly. You certainly don't want to lose kidney function, and a neph tube is the best way to prevent that. Hopefully it was be very temporary, and the kidney will recover nicely.

My thoughts and prayers are with you.


Gayle

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Thanks Tamlin and Gayle. Your posts are very reassuring. By this time tomorrow it will be all over with. i will let you know how he does. Karen

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My husband had his procedure this morning. It was really okay. He said it was virtually painless. We are both nervous about the tubing, but it should be okay. We see the urologist on Monday morning. Thanks again for the encouragement. We were scared. Karen

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Glad to hear the procedure went well. It is so nice to have the support system from this site. So many new things we have to learn. It sure makes things easier to have others walk with us. Hugs,

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