Two urinary diversion techniques—nephrostomy and cystostomy—ensure temporary or permanent drainage from the kidneys or bladder and help prevent urinary tract infection or kidney failure. (See Urinary diversion techniques, page 512.)

A nephrostomy tube drains urine directly from a kidney when a disorder inhibits the normal flow of urine. The tube is usually placed percutaneously, although sometimes it’s surgically inserted through the renal cortex and medulla into the renal pelvis from a lateral flank incision. Tube placement is usually performed because of obstructive problems, such as ureteral or ureteropelvic junction calculi or tumors. Diverting urine with a nephrostomy tube also allows kidney tissue damaged from obstructive disease to heal.

A cystostomy tube drains urine from the bladder, diverting it from the urethra. This type of tube is used after certain gynecologic procedures, bladder surgery, prostatectomy, severe urethral strictures, or traumatic injury. The tube is inserted into the bladder approximately 2″ (5 cm) above the pubic symphysis and may be used alone or in addition to an indwelling urethral catheter.