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Nephrostomy when cancer blocks the kidneys | CION Cancer Clinics
A nephrostomy is a thin tube placed through the back into the kidney, so urine can drain into a bag when a cancer blocks its normal route to the bladder. It relieves the blockage, protects kidney function and can make further treatment possible. It does not treat the cancer. This page explains how it is done, how it compares with a stent, and what the team weighs before suggesting it. CION Cancer Clinics’ surgical oncologists in Hyderabad can talk this through with you.
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Medically reviewed by Dr. Muralidhar MuddusettyConsultant Surgical Oncologist · MBBS (AIIMS), MS (Surgery, AIIMS), DNB (Surgical Oncology), MRCS (Edinburgh) · last reviewed September 2026, next review due September 2027
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On this page
- What is a nephrostomy, and why is it done for a blocked kidney?
- How does a nephrostomy compare with a stent inside the body?
- What happens when a nephrostomy tube is put in?
- What does the team weigh before suggesting it?
- What do families often believe about a nephrostomy?
- What do the words on the scan and blood report mean?
- Who is a nephrostomy not suited to, and what can this page not tell you?
- Common questions about nephrostomy for a blocked kidney
The short answer
What is a nephrostomy, and why is it done for a blocked kidney?
A nephrostomy is a thin tube passed through the skin of the back straight into the kidney, so urine can drain into a bag outside the body. It is done when a cancer blocks the tube that carries urine down to the bladder.
Why a blocked kidney matters
When urine cannot drain, it backs up and the kidney swells. If both kidneys are blocked, or the only working kidney is, the body cannot clear waste. You may feel sick, very tired, confused or pass little urine. A blood test showing a rising creatinine, a waste product, is often the first sign.
Which cancers cause it
Cancers in the pelvis are the usual cause: cervix, bladder, prostate, bowel and ovary. Enlarged lymph nodes, the small glands along the back of the tummy, can also press on the tubes. Scar tissue after radiotherapy sometimes does the same.
What it can and cannot do
A nephrostomy relieves the blockage and protects kidney function. It can make someone well enough to have chemotherapy or radiotherapy. It does not treat the cancer causing the blockage.
Side by side
How does a nephrostomy compare with a stent inside the body?
Nephrostomy tube
Ureteric stent
Placed through the back into the kidney, guided by a scan
Passed up from the bladder through a telescope, usually under anaesthetic
Urine drains into a bag worn outside the body
Nothing outside the body; urine passes normally
Works even when the blockage is too tight to get past from below
May not pass a tight blockage, especially from a large pelvic tumour
Tube and dressing need daily care and can come loose
Can cause bladder irritation and may block without warning
Often used urgently when the patient is very unwell
Often preferred when it can be placed and the patient is stable
Not sure whether this applies to you?
Ask an oncologistThe procedure
What happens when a nephrostomy tube is put in?
Checks and preparation
Blood tests check kidney function and clotting. If you take blood thinners, the team will tell you what to do with them. You may be asked not to eat for a few hours.
Lying face down
You lie on your front. The skin on your back is numbed, and you are often given sedation to keep you relaxed. An ultrasound or X-ray picture shows exactly where the kidney is.
Placing the tube
A fine needle goes into the kidney, a guide wire follows, and a thin tube is passed over it. The tube is stitched or fixed to the skin and joined to a drainage bag.
Recovery
You rest while nurses watch your blood pressure and the urine in the bag. It is often pink at first. Most people stay at least overnight, and blood tests show whether the kidney is recovering.
Making the decision
What does the team weigh before suggesting it?
Unblocking a kidney is not automatically the right step for everyone. These are the questions your team works through with you.
Is further treatment planned?
If chemotherapy or radiotherapy could follow, protecting the kidneys often makes that treatment possible. Many anti-cancer drugs need working kidneys.
How unwell is the person now?
A very unwell patient may be helped quickly, but may also find the procedure and a tube a heavy burden. The team considers both sides.
One side or both?
If one kidney is blocked and the other works well, draining may not be needed straight away. When both are blocked, the question is more pressing.
What does the person want?
Near the end of life, some people decide not to have a tube. That is a valid choice, and comfort care continues either way.
Worth asking
- What happens if we do not drain it?
- Can we change our minds later?
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Commonly believed
What do families often believe about a nephrostomy?
"The tube means the kidney has failed for good."
A blocked kidney often recovers some or all of its work once urine drains again. Blood tests over the following days show how much. The tube is there to give the kidney that chance.
"He will have to wear a bag for the rest of his life."
Not always. If treatment shrinks the blockage, a stent inside the body may later replace the tube, or the tube may be removed. For some people it does stay long term. Ask your team what is likely for you.
"A nephrostomy is a major operation."
It is usually done by a radiologist through a small puncture in the back, with numbing and sedation rather than a large cut. It is still a procedure with real risks, which your team will explain.
"If we say no to the tube, the doctors will stop caring for her."
Declining a procedure does not end care. Symptoms such as sickness, pain and restlessness can still be eased, and the team will continue to support the patient and the family.
On your report
What do the words on the scan and blood report mean?
- Hydronephrosis
- A swollen kidney, because urine cannot drain out of it.
- Hydroureter
- A swollen ureter, the tube carrying urine from the kidney to the bladder, above a blockage.
- Obstructive uropathy
- Kidney trouble caused by a blockage to the flow of urine.
- Creatinine and urea
- Waste products measured in the blood. When they rise, the kidneys are not clearing waste well.
- Percutaneous nephrostomy
- "Percutaneous" simply means through the skin. It is the full name for the tube described on this page.
Being straight with you
Who is a nephrostomy not suited to, and what can this page not tell you?
A nephrostomy may not be advised when clotting cannot be made safe, when a stent from below is likely to work just as well, or when the person is in the last days of life and a tube would add burden without meaningful benefit. Your team should tell you plainly if they think it will not help.
It cannot tell you what lies ahead
A blocked kidney is often a sign that the cancer has grown in the pelvis. It does not, on its own, tell you how long anyone has or how further treatment will go. That is a conversation for your oncologist, when you are ready.
Questions worth taking to the appointment
Why is a tube suggested rather than a stent? Is one side blocked or both? Could the tube later be removed or replaced? Who will change it, and how often? Who do we call if it stops draining at night?
You can ask for time to talk it over as a family, unless the team says the situation is urgent.Questions we are asked
Common questions about nephrostomy for a blocked kidney
Does putting in a nephrostomy hurt?
The skin and deeper tissue are numbed, and most people are given sedation, so the procedure itself is usually bearable. Some people feel pressure or a brief sharp moment. The area can ache for a few days and is treated with pain relief. Tell the nurses if pain is not controlled.
How long does the procedure take?
The procedure itself is usually fairly short, but preparation, sedation and recovery mean you should expect most of a day. Most people stay in hospital at least overnight so the team can watch the tube, the urine and your blood tests.
Is blood in the bag normal?
Pink or lightly blood-stained urine is common for the first day or two. It should gradually clear. Thick red urine, clots, or bleeding that gets heavier rather than lighter should be reported to the team straight away.
What are the main risks?
The main risks are bleeding, infection, the tube blocking or slipping out, and urine leaking around it. Rarely, nearby organs can be injured. Your team will explain which risks matter most for you and which signs mean coming back the same day.
Can both kidneys have a tube?
Yes. If both kidneys are blocked, a tube may be placed on each side, sometimes at the same visit. Often the team drains one side first and checks how well the kidney recovers before deciding about the other.
Can chemotherapy go ahead with a tube in?
Often yes. Relieving the blockage is frequently what makes chemotherapy or radiotherapy possible, because the kidneys need to work well enough to clear the drugs. Your oncologist will look at your blood results before planning treatment.
How often is the tube changed?
Tubes left in long term are changed at regular intervals, usually as a short procedure in the radiology department. Your team will set the schedule. Keep a note of the date it was placed and bring it to every visit.
Is a nephrostomy covered by Aarogyasri or insurance?
It is often covered as part of cancer care, though tube changes and home supplies such as bags and dressings may be counted separately. Aarogyasri, CGHS, ECHS, EHS and cashless insurers differ. Call the helpline with your card details to check.
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Dr. C. Raghavendra Reddy
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MBBS, MD(General Medicine), DM(Medical Oncology)(Adyar,Chennai), ECMO, MRCP SCE(UK)
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Dr. Owais Mohammed
MBBS, MD (General Medicine), DrNB (Medical Oncology), ECMO, MRCP SCE (Medical Oncology) (UK)
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Dr. Muralidhar Muddusetty
MBBS (AIIMS), MS (Surgery) (AIIMS), DNB (Surgical Oncology), MRCS (Edinburgh)
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Dr. Vinay Mamidala
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MBBS, MS (General Surgery), DrNB (Surgical Oncology), FALS Oncology
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Sources
- NHS — Nephrostomy
- Macmillan Cancer Support — Cancer information and support
- National Cancer Institute — Advanced cancer
- Cancer.Net — Managing physical side effects
This page is general information, not a prescription. Do not change or stop any treatment based on what you read here. If anything is worrying you, contact your own treating team — or call our helpline and we will help you reach the right specialist.
Keep reading
Related pages
Living with a nephrostomy tubeDaily care, bags and warning signs at homeUrinary diversion for palliationWhen a longer-term route for urine is discussedDeciding whether to operate near the end of lifeHow families weigh a procedure late in illnessPalliative and symptom-control surgeryThe wider guide this page belongs to
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