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Great Ormond Street Hospital for Children NHS Trust UCL Institute of Child Health
 

Children and families

Nephrectomy

This leaflet explains a nephrectomy and what to expect when your child comes to Great Ormond Street Hospital for this operation.

Contents

What is a nephrectomy?

A nephrectomy is an operation to remove a kidney. Your child will have this operation under a general anaesthetic and will generally need to stay in hospital for three to four days.

Why does my child need to have this operation?

Your child will need this operation because a kidney is not working properly. This could cause infections which may damage the other kidney, and makes it more likely that your child will have high blood pressure at some point in their life. Being left with one kidney should not cause your child any problems.

What happens before the nephrectomy?

You will already have received information about how to prepare your child for the operation in the Parents' Handbook and your admission letter.
The surgeon will explain the operation in more detail, discuss any worries you may have and ask you to sign a consent form. An anaesthetist will also visit you to explain about the anaesthetic.

If your child has any medical problems, particularly allergies, please tell the doctors about these. Please also bring in any medicines your child is currently taking.

What does the operation involve?

The surgeon will remove your child's damaged kidney through a cut (incision) in his or her side. The operation takes between one-and-a-half and two hours.

What happens after the operation?

Your child will be brought back to the ward to recover. He or she will be able to eat and drink soon after the operation.

Your child may have a tube (catheter) coming out of the bladder to drain away urine. This is usually removed two days after the operation and then you will be able to go home. The surgeons use dissolvable stitches so you do not need to have them removed.

What are the risks of a nephrectomy?

All the surgeons who perform nephrectomies are specialists in the field, have had lots of experience and will minimise the chance of any risks.
All surgery carries a small risk of bleeding during or after the operation. Every anaesthetic carries a risk of complications, but this is very small. Your child's anaesthetist is an experienced doctor who is trained to deal with any complications. After an anaesthetic some children may feel sick and vomit. They may have a headache, sore throat or feel dizzy. These side effects are usually short-lived and not severe.

There is a risk that the bleeding can occur when the surgeon removes the kidney. Usually, there is only a small amount of bleeding, but occasionally a child may need to be given extra blood in the form of a transfusion.
The ureter (tube from the kidney to the bladder) is not always removed completely. Occasionally this can cause infections later. If this happens, the rest of the tube may need to be removed.

When you get home:

  • You should encourage, but not force, your child to drink.
  • Your child may need some pain relief when you get home. Please make sure you have some paracetamol ready at home for when you get back from hospital. Please remember that children under 12 years old should not take aspirin. If your child is likely to need stronger pain relief, this will be prescribed by your doctor and should be collected from Pharmacy.
  • Your child should not have a bath or shower until a scab has formed over the wound site. When a scab has formed, try to avoid long baths as this may cause the scab to soften and fall off too early.
  • The wound site will be closed with steri-strips. The steri-strips usually fall off of their own accord. If they have not fallen off within a week, you can soak them off using a wet flannel.
  • Your child's surgeon will want to see you around three months after the operation to check on your child's progress. This outpatients appointment will be sent to you at home.
  • Your child should return to school when he or she is feeling well again, but should avoid contact sports until after the outpatient appointment.

You should call the Hospital if:

  • your child is in a lot of pain and pain relief does not seem to help;
  • the wound site looks red, inflamed and feels hotter than the surrounding skin;
  • there is any oozing from the wound;
  • your child has a lot of blood in his or her urine.
Ref: F000270 © GOSH Trust 2000
This information does not constitute health or medical advice and will not necessarily reflect treatment at other hospitals. If you have any questions, please ask your doctor. No liability can be taken as a result of using this information.

This page was last updated on 12 August, 2008