What is Nephrostogram?
Nephrostogram is a special x-ray test in which contrast is instilled into the kidney through the Percutaneous nephrostomy tube (PCN).
Why it is done?
This test is done to evaluate the level of obstruction in the ureters and to see if contrast drains into the urinary bladder. This test will also confirm the position of the PCN if it is displaced outside the kidney.
Should I need to do any preparation for the test?
No. There is also no need to be on empty stomach. But if you have fever, then this test will be deferred. You will be told to empty the bladder at the start of the study.
How the procedure is done?
You will be asked to lie down on an x-ray table. After taking aseptic precautions, the urine bag will be disconnected from PCN tube. About 5-10ml diluted contrast will be instilled into the nephrostomy tube by the urologist/urology specialist nurse, so that contrast flows by gravity. Usually one immediate erect X-ray is taken. After this you may be asked to walk for with PCN tube blocked and fixed on your back. Another x-ray is taken at 20 minutes and during this interval you should not pass urine. This delayed film is to see whether contrast has drained into the bladder.
Is the test painful?
The test is not painful. However, there may be mild discomfort. If there is obstruction to the flow of contrast and you have severe pain, you can inform your doctor/nurse/radiographer who will unclamp the PCN immediately.
Is there any risk for the test?
Usually, this test is safe. There is a rare chance of infection, which will manifest as fever and vomiting. If this occurs you may require admission and treatment with antibiotics.
What happens after the test?
After the test, your urine bag will be reconnected to the PCN tube and secured. Then your doctor will explain you the result of the test during the consultation and plan further treatment.