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Percutaneous Nephrostomy — Urinary Drainage

Interventional Radiology · Cochin Hospital AP-HP · Paris

️ ri.cch@aphp.fr +33 1 58 41 46 12
IR Home›Percutaneous Nephrostomy — Urinary Drainage
🩺 Urology · Urinary drainage

Percutaneous Nephrostomy — Urinary Drainage, Paris

CT/ultrasound-guided · Ureteric obstruction · Oncology · Stone disease · Local anaesthesia · Cochin AP-HP

What is nephrostomy?

A percutaneous nephrostomy (PCN) is a drainage catheter inserted through the skin directly into the kidney collecting system under imaging guidance (ultrasound ± CT). It relieves urinary obstruction when urine cannot drain normally through the ureter into the bladder — due to a tumour, stone, stricture, or external compression.

PCN is performed under local anaesthesia, usually as an urgent or semi-urgent procedure. It is the first step in relieving obstructive nephropathy and may be followed by anterograde ureteric stent placement.

Nephrostomy at a glance — At a glance

A percutaneous nephrostomy drains urine from an obstructed kidney through a fine tube placed under imaging guidance, often as an emergency.

Criterion Data
UrgencyOften performed urgently, especially if the kidney is infected
AnaesthesiaLocal, day case or short stay
DurationTemporary or longer-term with regular tube changes, depending on the cause
CostCovered by French national health insurance at Cochin AP-HP — no out-of-pocket fees

Data validated by the team of Prof. Anthony Dohan, Department of Interventional Radiology, Cochin Hospital AP-HP, Université Paris Cité.

Indications

  • Ureteric obstruction by pelvic or retroperitoneal tumour (cervical, bladder, prostate, colorectal cancer)
  • Obstructive ureteric stone not amenable to ureteroscopy
  • Ureteric stricture (post-radiation, post-surgical, inflammatory)
  • Infected obstructed kidney (pyonephrosis) — emergency drainage
  • Bridge to definitive treatment (ureteric stent, surgery)

Procedure

1
Imaging assessment

CT urogram or ultrasound to assess degree of hydronephrosis and plan optimal access route.

2
Local anaesthesia and positioning

Patient prone. Local anaesthesia at the posterior lumbar puncture site. Ultrasound guidance for initial calyceal puncture.

3
Guidewire and catheter placement

Seldinger technique: needle → guidewire → serial dilation → nephrostomy catheter (8–10 Fr). CT fluoroscopy for complex or ectopic kidneys.

4
External drainage or anterograde stenting

PCN drain left to external drainage bag. If ureteric passage possible: anterograde ureteric stent insertion over the guidewire to re-establish internal drainage.

5
Post-procedure care

Catheter secured. Output monitored. Creatinine check at 24 and 48 hours. Tube change every 2–3 months.

FAQs

This depends on the underlying cause. For obstructing tumours managed with palliative intent, the tube may be long-term (replaced every 2–3 months). For a stone awaiting ureteroscopy, it is typically temporary (days to weeks). For strictures, anterograde stenting may allow removal of the external tube.
Yes. Most patients adapt well. The external bag is changed regularly. Swimming is not recommended (shower with waterproof cover is fine). Your nursing team will provide full care instructions.
Performed under local anaesthesia with conscious sedation if required. Most patients report a pressure sensation rather than pain during insertion. Post-procedure discomfort is mild and managed with oral analgesia.

Frequently asked questions

A nephrostomy is a fine drainage tube placed through the skin into the kidney under imaging guidance, to drain urine when the ureter is blocked by a stone, a tumour or scarring.
It is often performed urgently, particularly if the blocked kidney is infected or if kidney function is deteriorating, as relieving the obstruction quickly protects the kidney.
It depends on the cause of the blockage. It may be temporary, until the obstruction is treated, or longer-term with regular tube changes.
Yes. At Cochin AP-HP (a French public hospital), this procedure is covered by national health insurance with no out-of-pocket fees. Contact ri.cch@aphp.fr or +33 1 58 41 46 12.

Related pages

Why this page is trustworthy

Written by the Interventional Radiology team at Cochin Hospital AP-HP, Université Paris Cité. Medically reviewed by an interventional radiologist of the department. Last updated: August 2026.

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