Changes

==Procedure with established nephrostomy==

*Take an initial anteroposterior image including the presumed locations of the kidney, ureter and urinary bladder.

*Infuse iodinated contrast, usually at least a volume corresponding to about 15 ml of 240mg/ml iodine. Observe both the imaging and whether the patient develops flank pain. Optionally, note how much contrast has been infused at that point.

:*Location of the tip of the catheter in the kidney

:*Any visible hydronephrosis or hydroureter. If present, also note:

::*Any caliber change, or most distal part reached by contrast.

:*Any contrast outside the catheter or urinary tract, including leakage along the outside of the catheter

:*Flow into the urinary bladder (see below if none).

After the procedure, open up any closed bladder catheter.

===If contrast does not reach the urinary bladder===