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Nephrostomy or Stent

VickyM21
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Hello Everyone!

 

My husband had a phone consultation with the urologist today and he has told him his kidneys have swollen slightly which suggests a blockage. The oncologist at our appointment last week sent my husband home with a course of water tablets (diuretics) to take for 7 days. His CAPOX treatment got stopped as well because he had some fluid retention in his legs and feet and this may be involving the kidneys. So the urologist said he may need a nephrostomy which would mean him having to wear another bag because he already has a stoma. He's a bit reluctant to go for this because of the practicalities involved sleeping for one. He sleeps on the side opposite of his stoma bag and so if they put this bag in it would mean him having to lie on that which would be awkward. The other thing too is that he has already been through 2 operations one for his stoma and the other to successfully remove his tumour in January and then it unfortunately came back. The other alternative if he doesn't get done is well- nothing. His kidneys are in danger of shutting down if nothing gets done and I said to him do you just want to die and he said I am going to eventually but I am hoping thats not for a good few years yet. I want him here, and I want him alive and I want his to see his wee grandaughter go to school. Can someone tell me what is the difference between a stent or nephrostomy and would it be possible on this occasion to get either for this. Thanks. 

 

Vicky 

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    Hello again,

                        your latest post continues along a very troubled path, and l am very sorry tor your misfortune.

    Put simply a stent is a tube inserted into a collapsed or blocked passage to allow fluid to flow freely, in your case to allow the possibility of allowing the kidney to fully function. A neophrostomy is a small tube unserted into the kidney to the outside of the body allowing urine to be collected into a bag. l am sure that one of the Nurses will be along shortly with a much better detailed answer.

    Having had my brush with a sword wielded by Damocles l have some understanding of just what you are facing, so all l can offer is support if not comfort,,

                                                                                    David

  • Hello Vicky and thanks for posting, 

    Urine flows from a kidney to the bladder through a tube called a ureter.  A ureteric stent is a narrow flexible tube placed inside the ureter to keep it open if it is blocked. 

    A nephrostomy is a small opening into the middle of the kidney made through a small incision in the back.

    A narrow tube can be placed into the kidney via a nephrostomy so that urine can drain freely (through a nephrostomy tube) into a bag outside the body.  

    Ureteric stents can be put into place through the bladder using a telescopic tube or into the kidney via a nephrostomy opening.

    I think nephrostomy tubes are probably used more often when there is some urgency about sorting out a ureteric blockage whereas stenting seems to be more of a pre-planned procedure that I think can sometimes involve having a general anaesthetic, but this seems to vary. 

    Both procedures are possible options to maintain the flow of urine from a kidney. Unfortunately neither are always trouble free for example tubes can get blocked or become infected.

    I am not sure if there are specific clinical reasons why one would be preferred over another. I think if the kidney has an infection a nephrostomy tube might be preferred and depending on body anatomy and the site of the blockage, stenting might not be possible. 

    Your husband probably needs to ask the doctors about them and to explain his options.  

    Give us a ring if you want to talk anything over.  Our number is Freephone 0808 800 4040 and we are here weekdays from 9-5.

    Best wishes 

    Julia

  • Offline in reply to CRUK Nurse Julia

    Thank You Julia!

    That's answered my question. I'm not sure if it is urgent or not. The urologist said that his kidneys have swollen slightly don't know if this is only one or two but as cancer is present in his pelvis apparently they are concerned that this may block the kidneys and have a reluctance at this time to resume his chemotherapy and so assuming this procedure would need to be done beforehand? I think the aim would be to hopefully shrink the tumour wherever it is sitting in his pelvis and then maybe able to reverse the nephrostomy?? Thanks. 

     

    Vicky

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