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Indications for nephrostomy Urinary obstruction is the most common reason for a nephrostomy, and is indicated by any of the following symptoms: Imaging demonstrating obstruction nephropathy Rising creatinine Acute renal failure Loin pain Nausea and vomiting Fever Urosepsis Nephrostomy tubes are also inserted for urinary diversion, for example in the following situations: Following a ureteral injury Ureteral fissure/fistula Haemorrhagic cystitis Stenosis of urostomy Herniation of urostomy They can be used to provide access for therapeutic interventions, such as: Stone removal Antegrade stent insertion Removal of foreign body, such as a broken ureteric stent Delivery of medications Ureteral biopsy Nephrostomies are also used in some diagnostic testing, for example: Antegrade pyelography Ureteral perfusion tests (Dagli and Ramchandani 2011

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