We previously went over how to place a ureteral stent. In today’s post, we go over the steps of removing a stent. Ureteral stents are removed using two basic methods:
1) By pulling on a stent string, if the string was left in place.
2) Placing a camera into the bladder (cystoscopy) to directly see and grab the stent with a small grasping device.
Removing a stent with a string left in place:
In some cases, your urologist will leave a string attached to one end of a ureteral stent. The stent string is a long piece of thread that will start from the stent and drape out the urethra, where it is visible at the urethral meatus (where urine comes out). A diagram and photos of a stent with a string attached are shown below.
To remove the stent, the visible string is firmly held and steady continuous pulling is applied until the entire stent comes out. The curls at the end of ureteral stent are flexible, so the stent should uncurl and come out easily.
What’s the advantage of leaving a string?
- The stent can be removed without performing cystoscopy.
- Patients can remove their own stent without waiting for an appointment or having to come to the office.
- Stents can’t be “forgotten” when a string is attached. When no string is left attached, a patient may forget or not realize that a stent was left in place. Over time, these forgotten stents can form large stones on them, making removal very difficult.
What’s the disadvantage of a string?
- The string can get snagged on clothing or be pulled on accidentally, resulting in a ureteral stent being removed earlier than it was supposed to. This seems to more commonly occur with female patients.
- The string can be a minor annoyance.
- Some patients prefer not to have to remove their stents themselves at home using the string. They however can usually come to the office where the staff can perform this for them.
Removing a stent by performing cystoscopy (with video below):
When no string or only a portion of the string is left attached, your urologist will need to use a camera to enter your bladder through your urethra. He or she can then see the stent and use an instrument to securely grasp it and remove it. The process is usually quick and occurs in the clinic. It takes only a minute or so in most cases.
Steps in removing a ureteral stent with cystoscopy
- Use a cystoscope to enter the bladder. (A cystoscope is a camera that can be placed into the bladder).
- Identify the stent.
- Use a grasper to securely grab the stent.
- Remove the cystoscope, grasper, and the secured stent as one unit.
The video at the bottom of the page demonstrates all these steps.
How uncomfortable is stent removal using a cystoscope?
For the majority of patients, stent removal is not as uncomfortable as they expected. We often have patients react in surprise when they learn that the stent has been already been removed and the procedure is done.
Unfortunately, some patients do experience discomfort with stent removal, more commonly in men because of their longer urethra. This can be due to discomfort from the cystoscope itself or from the sensation of the stent being removed. While most patients do not feel the stent actually sliding when removed from the kidney, some do experience an uncomfortable sensation with this.
Is there anything that can be done to make it more comfortable?
- Lidocaine jelly placed into the urethra at the beginning of the procedure will help to numb the area but will not completely take away sensation.
- In men, and also occasionally in women, increased discomfort is related to tightening of the urethral sphincter as the scope is passed into the bladder. Trying to relax, take a deep breath, and not “clench” down during the cystoscopy process can sometimes make the process less uncomfortable.
- Anticipation and perception also seem to play a role: Researchers have found that patients who watch their own cystoscopy procedure on a video screen experienced less discomfort than those that did not.
Video of ureteral stent removal in a male patient.
Pain after stent removal:
In most patients, stent removal is a relief as their stent discomfort goes away. However, in some patients, severe pain may occur for several hours. This is thought to be due to spasms of the ureter or swelling and temporary blockage developing after the stent comes out.
Not enough is known about this phenomenon but one recent study suggests it may occur in as many as half of patients. In the study, patients given a single dose of rofecoxib did not experience this pain while those given placebo developed it in 55% of cases. Rofecoxib went by the brand name Vioxx and is no longer available in the U.S. as it was withdrawn by the manufacturer. The authors of the study report they now use naproxen as an alternative. You can read more about the study in our post “Severe pain after stent removal: How often does it occur and can anything prevent it?”
If you are thinking about trying naproxen, be sure to read the manufacturer’s warnings as some patients should not take the medication and check with your doctor first to make sure it’s okay in your situation.
Why am I wetting myself I have a kidney stent. Wetting is driving me nuts what can I do to stop this now.
I had a 4mm stone removed using a ureteroscope. A stent was left in place for about a week. I took meds for pain and to reduce swelling of the ureter. I had the stent removed on an outpatient basis. I was very nervous anticipating the removal. The Doc grabbed the end of the string and jerked like starting a lawnmower. I screamed like a girl for a couple of seconds at the pain, but after about a minute, the pain subsided and I felt better. After a few days of anti-inflammatory meds, I was back to normal. If there is a next time, I’ll certainly ask for something like a valium or local anesthetic before the stent is removed.
I had colon surgery and urethra surgery, back on June 5th. all is well but the urologists pue a stent in. I have to go back this coming monday, july 21st to get it taken out. How does he do that without another surgery? does he go up thru the penis? that would hurt. that is the only way to get to the ureter (Iam not spelling that right) but he says he can do that in his office, is it painful? or what. you cannot put something in the penis that is nt painful. when he does it, does he deaden the lower extremities?
I just had a very large stone, a month of A&E, wards, morphine and the dreaded stents (2). I really found this site a comfort, and wanted to share that today my stent was removed by the local procedure described above. Whilst I was super scared, it was not horrific and it is very tolerable. It is so fantastic to not feel the stent anymore (I had experienced trouble even just climbing the stairs had have been off work a month). The other one was removed during a general anaesthetic so I can’t comment on that one. Good luck for all you out there coping with stent issues. My sympathies are with you x
I went to the E.R. five days ago for horrible pain on my right side. I was also vomiting. CT revealed a kidney stone that was lodged and had formed an obstruction, I could not urinate at all though I had the urgency. I was admitted and given back to back doses of pain killers and anti-nausea medicine through the IV. They also gave me antibiotics administered through the IV as well, along with saline to keep me hydrated. The medicationb helped, but after my surgery in which the urologist removed the stone and placed the stent in so my urethra wall would not collapse, the pain got worse, especially when urinating. I was sent home with pain killers and antibiotics, along with another medication that allowed me to urinate. The pain was supposed to get better, but by day 3, it was horrific. The pain killer didn’t even take the edge off…not to mention the bleeding got worse. I went to the ER yesterday and they pumped me with pain killers again. Still felt the pain when I urinated. They performed another CT scan which showed that my kidney was dilated and the stent seemed to be defected, which caused a blood clot. The attending ER doctor called the on call doctor at my urologist’s office, and he advised for me to go in tomorrow morning (instead of my appointment in 5 days) to remove the stent. I can’t wait. The pain is horrid. I am also scared to feel pain during and after the removal. I had this done ten years ago, and there was only discomfort associated with the string removal at the office, however, I did not have the complications that I have now. My anxiety level as high. I’ve also been praying not to suffer an intestinal obstruction, which if you can believe, is worse pain than labor AND kidney stones/stent. Constipation can be a huge factor when taking narcotics which can cause the bowel obstruction. Worst pain ever. I really didn’t think I would make it through…that painful that it takes your breath away, and you can’t take pain meds because you’d make it worse. Wouldn’t wish it on anyone. I got really close to God, let me tell you…
I recently underwent Robotic Assisted Laparoscopic Pyeloplasty to correct a OPJ obstruction which is, in it’s simplest terms, chronic blockage of the kidney. It is sort of like having kidney stones once every two weeks with pain lasting about twenty-four hours.
Surgery was easy since I was unconcious but recovery has been something special. Since I am 28 years old and slender built with lots of muscle, moving my organs around to work on my kidney was not an easy chore and I was sore for the first two days. The referred pain from CO2 under my diaphragm really hurt in my shoulders. That went away after fourty-eight hours.
While they were in there they installed a stent which has been an odd experience. I can feel the top of the stent in my right kidney and bottom of stent in my badder. If I sit in the wrong position, it feels kinda like a warm sensation and at worse a slight burning. I have urinated what looks like red-wine until recently, which is nice to be rid of. There is some urgency but I am really familiar with the mechanics of the stent and I realize that I am not actually going to pee on myself. So, I don’t hurt myself trying to get to the bathroom and have been rewarded with more comfort.
After four weeks, the stent will be removed by scope at the Doc’s office which I am not looking forward to at all. The removal of my catheter was terrible. I’m pretty sure it was not properly deflated before it was pulled out. That was awkward and uncomfortable
I think the scope removal will go easily, more so than I anticipate. I would like to say, that though I do not have kidney stones, I know how you all feel and I hope that you can realize that a lot of this stuff is mental. You can truly stress yourself into a painful situation.
So, keep calm and confident. Also, use your brain, if somebody tells you something that doesn’t make sense, make them clarify it, or take a family member with you for support. Doctors will often tell you things and take for granted that you understand them completely.
Had a stent in from Februay until May of this year. During that time, four different cystoscope surgeries to remove stones. On May 3 they removed the stent. It was tremendously uncomfortable, but after it was out, improvement was immediate. (Really, I didn’t honestly expect a procedure that involved my privates, a hose clamp, a syringe, and a scope to be all that pleasant)
June 17, 2014.
Male Age 62…
Just had stents removed from both ureters without strings. Procedure was much more emotionally disturbing than painful. I was scared to death prior to having it done but honestly it was painless. I took a percocet about an hour before the scheduled procedure but that wasn’t really necessary since it was painless. (I did feel better after taking it however) When I got there they injected lidocaine (no needle) into my pee hole and after I was numb did the procedure. A weird feeling but no pain and it took no longer than 25 seconds to remove each stent. I do understand your concern which is why I’m writing today, I wish someone had written something prior to my procedure so I wouldn’t have been so concerned. Let me leave you with this, “piece of cake!”
Thank you for your post it is helping me calm down. I was nervous about the procedure; I am having it done at 1:30pm this afternoon. When you think about it why is it you have to be put to sleep for the placement but completely awake for the removal. i think that is what scared me the most. Thank you again for your awesome post.
I had 12.6 mm stone in my right upper ureter.I got it operated on 9 may 2014 by cystoscopic technique and stent was placed without string.Now after a week stent will be removed using cystoscope.I am really very scared about it.Does it pain? Anesthesia will be used or I will be kept awake while doing the procedure.Kindly share the truth if you can.
Thanks so much. I get my stent removed later this month.I feel a lot better!
Thank you! I get my stint out this Friday and am worried sick. I think I need to take something to make me relax before I go into the office! Your statement has made me feel alittle better.
This is what I needed to hear. I had kidney stone surgery and a cysto stent in right ureter. It is being taken out Jan 6, I am the most squimish and light stomached person ever, so the thought of them going up my penis absolutely terrifies me. I am scared to death. I do not have a string. They will be giving my numbing jelly and Valium, but I am still petrified. Any more words of encouragement or can you talk a little more about this? I can’t help but be scared, that’s just how I am wired. Thanks!
Just pulled stent out myself, no pain at all, few deep breaths than relaxed and slow and steady. Nothing to worry about. As far as prevention if prone to stones, chinese herb golden earring, boil it and drink the juice, flushes the kidneys, do this every 3-5 years and should help keep them suckers away. (Might not work for everyone)
I’ve had 4 stent removals, 2 via strings and 2 in the office with a scope. The string method is not too bad…the scope was the worst experience of my life.
Woke last week with horrific pain on right side. After intense day in er learned I had a 2mm stone involved in the urethra and would pass in 24-48 hours. Ct scan showed 11mm stone on left side in a not so great position. Appointment with md said that scope guided lithotripsy was need to break up stone soon. Never a mention about a stent. After waking from surgery friday and having strings taped to your leg…hello big surprise!! Wth!? Following days absolute misery. Pain, cramping, urgency, pressure and burning with every small movement. Pain meds barely took the edge off. Antibiotics for 3 days and no mention of anything other than to take Tylenol after the first 24 hours. Bull **ap.. I needed the pain meds every 6 hours. And if it couldn’t get better the dreaded yeast infection from the heavy antibiotics. Like there couldn’t be much more going on down there! 9:30 am appt with MD for (fingers crossed) stent removal. Cannot come soon enough!!! I only wish this pain for my worst enemies. Would have been nice for the MD to tell me what to expect at some point.
Hello. Have a stent in right now and will try taking it out tomorrow according to my doctors orders. Both scared and looking forward to getting it out. I feel like I know true pain after this and getting temporary trigeminal nueralgia from a botched root canal. As humans we need to end torture now!
I’m a Male, age 57… with a 5mm stone, which was lasered. I was left with a stent that had a string attached, which I’m told I can remove on my own after 7-10 days. YIKES!! My stent looked identical to the one in the picture above. To get ready for the big day, I did my research and called the nurse for suggestions. Her suggestion, was go slow, and don’t stop. It seemed logical to be either standing or laying down, so there’s no curves. My thought process was to have a straight line.
In hindsight this was nothing. The whole idea was more painful then the actual removal. I was in the shower and pulled the string down towards my feet, rather than out towards the wall, or up towards the ceiling. Easy as pie, took about 15-20 seconds, just a slow steady pull. No pain, felt like taking your finger and rubbing from your elbow to you wrist, except it was ‘down below’.
About having the stent: Didn’t have pain or spasms, but when I felt the urge to pee, I had about a minute to hold it. I ending up having two stents. One was placed into me at the ER to reduce the infection. About a week later, had surgery to laser the stone, and a second stent was left for 8 days, before I pulled the string.
Stay Thrifty My Friends!
Hello.. I had a 6mm stone removed from my left kidney and a stent was put in.. Tomorrow cannot come fast enough.. 1 week is enough.. Having to go to the bathroom constantly.. I dread it.. The pain every time i go.. And there is no warning or holding it.. It would wake me up out of a solid sleep..When its time.. Sudden pain on my left side.. Couldn’t really go to far from home, or if i did i would have to be close to a bathroom.. I took extra strength Tylenol which helped alittle with the pain and phenazopyridine which was for the burning.. And did make my urine orange… Hope never have to go through this ever again
Hi!!! I have a stent on me right now and this three months been very stressful to me this I had this stent placed on me I being suffering alot there not any single day without pain and worst when I go to the restroom that about every ten minutes I go I havent sleep well at all cuz everynight I wake up rushing to the restroom and peeing blood and with clot of blood I needed to have this stent remove since feb 5 but like my insurance had a waiting period the doctor didnt want to see me to have it remove.I think that doctor doesnt has feeling he just wrry about getting paid and still my insurance told him he was gng to get paid and still he refused to do the job so becuz of that I being suffering alot.well hopefully tomarrow or monday it will be remove anyways having a stent is being my worst thing in life I cant do anything no even wrkout and not even being sexually active so people think twice before having a stent placed. I still have more stones on my left kidney but this one is blocking my urine its a size 6.hopefully the otherone I prefer surgery on my back so they can remove them but a stent again on is a nononono.gd luck to all of u and lets drink more water so we dnt need to suffer anymore.
Stent was removed yesterday.. Would want to go through that ever again..
I am sorry.. I WOULD’NT want to go through the stent removel ever again..
After spending the day in the ER two days ago they found my first stone (23 years old) that was 6mm. The next day I went into “surgery” for them to push it back up into my kidney to try and break it up, luckily someone having a similar procedure that day was using a laser so they ended up using that for me as well instead of ultrasound to break it up. I had a stent put in, which is currently in right now. I’ve seen a lot of people complaining about the urge to urinate frequently, and anyone in this situation knows how this can be an ordeal, especially with a stent in. What I have found that helps with the burning sensations, urges to go and etc is AZO (an over the counter drug used to treat urinary tract infections.) Although you can only use it for two to three days, the relief it provides is much better than trying to bite the bullet, especially after the surgery and even more if a stent is put in place. Also I noticed that two aleves can help some of the pain that some of the narcotic meds can’t knock out. So if you are having trouble try AZO to help with the urination issues (it will likely turn your urine an orangish tint) and aleve for some of the pain that may be associated with soreness. Sometimes simple is better. I hope this bit of information helps those looking for relief because it has helped me tremendously battle the pain. Best of luck to anyone going through the struggle right now and remember, like the stone, the pain will soon pass as well. Cheers, and remember water, water, water!
Hi All,
I am suresh this is the second time got a stones in both kidney, first time doctor did lithotripsy now they kept stent in kidney on right and removed the stone with the size of 6mm …it was horrible to tolerate the pain of stent its my bad time … today doctor going to remove the stent now I am getting panic for that
I have passed almost a dozen stones. I have also just had my third surgery to remove a stone that was stuck. This time the doctor placed a stent and this is my fourth day on it. Monday can NOT come soon enough. I have been urinating blood, there has been pain with the whole thing…it’s just been a horrible situation all around. I spoke to my doctor about the blood and pain and was told it was normal. NOW they tell me it was normal. Before hand they said I would hardly notice. If I didn’t have an appointment to have it removed on Monday I would take it out now.
Hello, I have a stent in right now. Been placed in since March 27, 2014. It will be removed by doc on April 14. Two days before my birthday. Been suffering with kidney stones since 1986. 28 years. Each time a stent has been placed. This particular stone is 11mm. My stones are always huge & very painful. Doc used to put me to sleep to remove the stent. This was several years ago. Now he wants to perform it in his office. Lidocaine is used. I hate the stent bc it is soooooo painful for me. Have not returned back to work yet. I’m looking forward to having the stent removed, although I would rather be put to sleep to remove it. I just get nervous, but it does not hurt. Tired of stones & stents. ( I haven’t had a break or relief in years. Thank God for His strength that He has placed in me. I could not get through this without Him.)
this is the second time ive had stones removed the first time I didn’t get a stint this time I had four stones removed from the right kidney all 6mm+ I will remove the stint my self so I don’t need to loose time from work hope its no big deal feel better about it after reading these posts
took my stent out today was causing pain no big deal was a little nervous but did it any way was supprised how long it was if you are thinking of removing it yourself don’t stress it was easy and painless just go slow but steady
Omg yesterday I had the stint put in I had a stone of 2.5 cm and honestly I’ve been sick and in pain since they done it
I don’t know why docs can’t be honest. Had 2 ureteral stints placed in surgery. Doc says “you won’t even know they are there”. The spasm are horrid! Have to pee every 30 min which causes the spasms to start. I am supposed to pull the stents tomorrow but no one told me how. Do I pull both at same time? String is all knotted together. Have been taking pain meds, muscle relaxers, pyridium and of course antibiotic. If there are any docs ut there reading these posts, you need to be honest with your patients
I understand how horrible you feel, had a 3CM stone stuck in my ureter. Had surgery to have it removed. Had to have a nephostomy tube put in my back to drain the kidney for a few days, then they took it out before I left the hospital, sent me home, and stuff was still pouring out my back out of the wound…. it finally stopped after about a week, but now I still have the stent. It hurts quite often, especially at night. I hate the urge to urinate is so strong I barely make it to the bathroom. Supposed to have the stent removed this Friday, I wondered if the pain meant my ureter tube was not healed yet but as I read these I guess maybe not. I still have spots of blood when I urinate. The worst part honestly was waking up during the surgery, either that or I wasn’t out yet. It’s fuzzy, but I know they used lido first to put the laproscope into my side, then they were going to try to get it down where the stone was. The stone was 3 CM long and 1&1/2 CM wide so it was either when they put the scope down next to it, or during them trying to remove the stone it felt like someone had a wire brush inside me scrubbing back and forth. I Begged them to knock me out and they finally put a mask on me and that was it. I’m bout ready to always drink NOTHING BUT water for the rest of my life to never have to go through this experience AGAIN!!!
My husband had a stent put in 25 days ago to allow for infection drainage. His stone- like on the video- is in his left kidney and was pushed back up there by the stent insertion. His doctor said that was not a bad thing to have happen. His stone is 6.8mm according to xray view. He has been taking an herbal compound called Chanca Piedra – literally, ‘broken stone’ for 14 days. I know this may sound like a witch doctor remedy but it is the ‘go to’ remedy used by patients in Brazil and elsewhere with remarkable results. I went online and read many patient reviews on Amazon and the vast,vast majority experienced breakage of large stones which then passed successfully or dissolution of small stones which passed like sand grit. The minimum treatment time for results was about 2 wks, so my husband is not expecting his results that quickly due to the size of his stone. Thankfully for him his discomfort with the stent has been mostly minor with the intermittent but short lived baseball bat in the kidney sensation when peeing. He is going to delay his lithotripsy a week at a time to allow the herbal remedy to do its job. I know if you’re in too much pain you probably can’t wait for 2 or more wks to get results, but the compound is also taken as a preventative or in the early stages of stone formation so you don’t have to suffer.
immediately upon taking chanca piedra, my pain went away completely. after a couple of weeks, an xray revealed that my 9 mm stone had moved out of my kidney and close to my bladder. the stone had not shrunk, so it was lasered.
So I had my stent removed at my Dr.’s office via a cysto. I have to say that it was no more painful then my regular cysto checkup. Tools about 30 seconds or so and I had no spasms afterwards…. so for those that are getting them out I wouldn’t fret much about it.
I had my stent removed last night with the wife pulling the strings and me with a towel over my head and biting hard on it. Hurt slightly, mostly a very weird feeling with the stent moving. It was over in 20 seconds and the relief was AWESOME. I took 10 mg oxycodone and was happy I did because I had the ureter spasms for about an hour. Once I slept this off, I feel fantastic. Anxiety was much much worse than the procedure. I had panic attacks for 6 days with the stent in and am a total baby for pain. I NEVER want to get stones again.
Thank you all for being open about your experiences. I go to get my stint removed in about 7 hours and am a wreck. Very scared, but after reading these comments I really feel much better. I will comment after the procedure on how the pain was. Frankly, nothing could be worse than what I have gone through (5 times) with having a kidney stine. Fortunately, this is only the second stint. The first was removed while I was under anesthesia per my request. The doctor said it was a waste and not necessary. I am trusting him this time and doing it in his office. I hope it was the right decision!
Hi, wondering how you made out? My husband James is having his removed awake on Thurs. His last one was asleep by request. Would love to hear. Thank You
I faced a different problem, my ureter burst due to complications from laparoscopy surgery. The pain from that experience was the worst I’ve ever experienced, not to mention the infection it caused, as I did not know. The burst ureter was found on thanksgiving, I was hospitalized for just about two an a half days, the day prior to finding it burst for infection and pain, the day they found out and placed a stint in to see if the ureter will heal, and the following day for more antibiotics and pain. I am grateful they sent me home with a catheter (total of five days)it helped with the blood in my urine and I believe made the process less stressful on my body, lidocaine patches, and pain meds. I am to have the stint for eight weeks, removal on the 23 of this month. I do not have a string and am apprehensive about the removal of the stint and healing process of the ureter. I will say the lidocaine patches help greatly having the stint and I do feel a lot of pain if I skip a day of the patch. My back flank pain has been increasing lately which is a new symptom, the usual pain in the area of my ureter towards my bladder (I can draw a line it travels). My main concern is the removal and possible scar tissue build up where the ureter burst, not to mention how will they know it has fully healed, will I deal with issues from now on? The closer I get to removal the more apprehensive I become; I’ve read so much on the stints and removal for stones, but not much on if the ureter burst. If anyone has had or know of someone who has experienced something similar my mind would be put at ease with this whole process.
Mine did not burst that I know of, went through basicly the same procedure that you did tho, my stone was 3 CM long by 1&1/2 Cm wide so I’m sure it did quite a bit of damage. it looked like it was stretching out the ureter on my scans pics. (yes he showed me because he couldn’t believe a stone that size managed to work it’s way down into the tube! I worry about the removal of the stent also as I’m experiencing a lot of pain at night mostly, Still get spots of blood in my urine. I’m hoping they do a scan or something to ensure that it’s healed before I have it taken out.