Severe pain after stent removal: How often does it happen and can anything prevent it?

Can a single pill prevent post stent removal pain? (Image from Office.com)

Many patients complain of some pain after having a ureteral stent is removed. This pain is usually mild and self-limited. However, the pain can sometimes be severe. Because patients may not have been warned about the possibility of significant pain beforehand, it can come as an unwelcome surprise, and patients may be left wondering whether something is wrong. Patients who are affected by this pain may describe it as being worse than their original stone pain. In some cases the pain can be bad enough to bring them back to the emergency room.

Up to now, there hasn’t been much research on this topic and it was not clear how often this phenomenon occurs or what might be done to prevent it. A recent publication in the journal BJU International now suggests that severe pain after stent removal may occur in as many as half (55%) of patients. In the study, performed by researchers at Oregon Health & Science University and the Portland Veterans Administration Medical Center, patients having their indwelling ureteral stents removed were either given a placebo pill or a single 50mg dose of the non-steroidal anti-inflammatory drug (NSAID) rofecoxib fifteen minutes before their stent removal procedure. Patients were asked to report their pain just before and 24 hours after their stent removal on a scale ranging from 1 to 10, with 7 or above being considered severe pain. Six of the eleven patients (55%) given placebo developed severe pain after their stent removal while none of the ten patients given rofecoxib developed severe pain.

The authors speculated that the mechanism by which the NSAID medicine may have provided such a dramatic reduction in severe pain occurrence might have been through reducing ureteral spasms or by decreasing pressure within the kidney. While the results of the study are very encouraging, further research will be needed to confirm the findings. For now though, the study is currently the only evidence we have on how often post stent removal severe pain occurs and what we might do to prevent it – take a single dose of a NSAID pain medication fifteen minutes before removing a stent.

Of note, the medication used in the study, rofecoxib (brand name Vioxx), was withdrawn from the US market in 2004 due to concerns about cardiovascular side effects and it is no longer available. The authors report in their paper that they now use a single 220mg dose of the NSAID naproxen with their patients. Naproxen is available over the counter (as a generic or under brand names such as Aleve) but you should check with your doctor about whether you should take it and make sure to read the warnings from the manufacturer as some patients with certain medical conditions shouldn’t take it.

While you might think that a single pill of naproxen can’t be very strong, other research actually supports its use for acute pain. In 15 randomized studies involving 1509 participants, naproxen was found to be effective for relieving moderate to severe pain in patients after surgery. Half of patients who were given a single dose of naproxen experienced at least half pain relief and the effects of the medicine lasted on average for up to nine hours. You can read more about naproxen for postoperative pain at the Cochrane Collaboration website.

REFERENCE: Tadros NN, Bland L, Legg E, Olyaei A, Conlin MJ. “A single dose of a non-steroidal anti-inflammatory drug (NSAID) prevents severe pain after ureteric stent removal: a prospective, randomised, double-blind, placebo-controlled trial. BJU International, 2012.

 

About Dr. Mike Nguyen

Mike M Nguyen, MD, MPH, is a urologist and an Associate Professor of Clinical Urology at the Keck School of Medicine of USC in Los Angeles, CA. He specializes in the treatment of kidney stones with both surgery and dietary prevention and the in the treatment of kidney and prostate cancer using the latest robotic surgical approaches. He sees patients at clinics located in Los Angeles, Pasadena, and La Canada, CA. He is the founder of the www.KidneyStoners.org website.
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311 Responses to Severe pain after stent removal: How often does it happen and can anything prevent it?

  1. Wendy says:

    I took out my stent myself. After I got really nauseous And threw up. Now everytime I stand up I get light headed and nauseous. Is that normal?

  2. RAMESH says:

    Hi…

    This is Ra mesh. Last month 9th Jan, morning 6.30am i had severe back side pain. i think this is back pain. but the pain was becoming very severe. after one and half hour i went doctor. he suggested to take ultra sound scan… in that nothing was observed. Then doctor suggested to go kidney specialist. I went to that doctor.. he suggested Abdomen CT Scan.. in that it was observed 7 mm of stone in the ureter. Due to the obstructing the urine passage my left kidney was little swelling observed and that is the reason for the severe pain.

    In the next day morning doctor removed the stone and DJ stent placed in the left ureter. From that day i was happy… but after one month 13th Feb doctor removed the stent but the pain was very severe while taking out the stent. After one hour i went to my home. But up-to one day blood was observed in my urine and little bit pain also.
    As per doctor this is common…

    So friends please drink more water.. at least 3 to 4 liters of water to avoid this kind of pain…

  3. Doyle says:

    I had my Rt sided stent put in on Nov. 06, 2016 and it was just removed on Feb. 03, 2017, the removal itself was minimal in pain but within less than 2 hours I my right kidney was hurting me so badly I did not know if I should go back to the ER or not. It is not the morning of day 3 and I am still having pain but I am scared of having another stent put in so I have avoided returning to the ER for that reason. I am also having problems with constipation since the stent was removed not sure why what would happening but it is I am very confused as to what I should do

  4. killian says:

    Wow! Love that this site is here. Yes, us kidney stoners….we know what real pain is.

    I have a 7mm stone that I’ve had for 9 months. I passed a 2mm stone on my own. a couple months ago I went into septic shock and raced to the ER with a 105 fever. The doctors said I was hours away from death. That night I went into surgery and they drained my kidney and put a stent in my ureter.

    The healthcare system is so jacked. It took me another month to see a doctor to get pain medicine. Having the stent was literally hell. And the only relief that I found was oxycodone every 4-6 hours.

    Flash forward another month and I am back in the ER with sepsis again.
    Finally I get scheduled for lasertripsy….. but it wasn’t for another few weeks!

    Two and a half months of antibiotics, a lot of pain meds, two scares of septic shock, a stent, Not being able to walk, and so so so much pain….and here I am almost through it. In two days I get surgery and I supposedly get my stent removed.
    God, I am praying that they take this stent out.
    I will try to get back on here and update.

    What helped me was:
    Opiates + Advil every 6 hours. Heating pad or warm water bottle. Warm baths. Not walking. Azo and sometimes midol. Sitting on the toilet. Anti spasm medicine will help also although I didn’t get any.

    These stones are serious and I almost lost my life.
    Drink water and stay healthy and don’t take these things lightly.
    God bless. xoxo

  5. Janet says:

    Had a 15 mm kidney stoney stone , blocked out put, swollen kidney,etc. To make this short. 10 inch stent placed just above stone. Had stent 10 days. Stent caused more pain then the kidney stones. Even after removal, I am unable to sit or lay down with out pain level at around an 7. Also, only dust partials passed with stent. After removal, in 24 hours, have passed at least 75 or more the size of a period.. and some much larger. I hope I will not need another, as I will fight it.

  6. Valerie says:

    I had my kidney stent removed 3weeks ago as I could hardly walk with the stabbing pain in my bladder,it felt as if my insides were falling out and I got no relief from urinating,it was in for two months even though the surgeon wanted to leave it in for 6 months,the reason was not stones it was to try to stretch the outlet of the kidney which had blocked due to scar tissue from an old operation I had years ago.I was so delighted when he took it out and presumed all pain and discomfort would go,even though he had told me I would loose the kidney if the stent stretching did not work.But the pain since the removal (in the bladder) has got nearly intolerable,I feel as if I am permanently damaged and find it hard even to stand up straight.Has anyone else had symptoms like this with a removal? and it is not an infection as I have been given 6 lots of antibiotics in the time the stent was in and I refuse to have any more. I have to wait 6 weeks before I go back for another CT scan to see if the kidney has swollen up again.

    • Farrah Mcbroom says:

      I thought i was reading my 13 year old son story. He is in so much pain. He had his stent removed on the 8th and is hurting more now than ever. Is your doctor saying that normal?

  7. Gil says:

    Had my stent removed today, in the doctor’s office, after one week. I had the rezum procedure last Friday. The removal went well, very little pain. Urinated right after removal with no pain or complications. After 8 hrs, still no pain or problems. Saw everything being done on a screen next to me with the doctor using a camera on the scope.

  8. Amy says:

    I had PCNL surgery Nov 1st to remove a 3 cm staghorn calculus. I got my double J stent removed Nov 30th. I took 800 mg of Motrin 15-30 minutes before removal, I had no pain at all afterwards. I questioned my urologist about these pains, he said their very common and are bladder spasms, and taking the Motrin pre-removal was a good idea. The actual removal itself and the thought of being in pain afterwards had me quite anxious, but I took .25 of Xanax at the same time as the Motrin pre-removal and I was fine. The removal was a little pressure and then it was out very quickly. I had had a stent once before, for 10 days, in 2009 and I remember it being worse for removal. I had no pain after removal that time either. This time after removal I just had a little blood in my urine, which is common. It was all gone by the next morning. I was just relieved to have the stent out, I couldn’t take the frequency and urgency any longer! Anyways, the Motrin greatly helped me, so maybe it is what helps to avoid the pain after removal.

    • Vickie says:

      I just removed my stent after 5 days. First I took 1-1/2 Tylenol 3 & did not empty my bladder. After 20 min. I soaked in a warm tub for 10-12 min. to relax. then got up turned on the shower. Two min. later I pulled the string down and had to urinate at the same time, which I feel probably helped not to feel any pain or discomfort whatsoever. It was a breeze and total liberating! Reminded me of the first time I used a tampon so many years ago… Really the stent is not long at all – maybe 12″. The string is approx. 4″. I’m happy to have read everyone’s posts to know what to do, as the Doctors have no time to explain to their patients.

  9. VJ says:

    Had 10mm kidney stone sitting on right kidney. Told to big to pass on its own. First stent placed 3.5 weeks ago and removed 2 weeks later. Discomfort, blood in urine and pee pressure during entire 2 weeks but, pain manageable. Original stent and stone removed then new stent place for 3 days. Dr. said it helps to settle things down. 2nd stent removed in office with mild pain. Immediate relief from pee pressure. Before I got home in worse pain than with stone. Went to ER and stayed most of the night. Meds given. After that, continual pain, nausea/throwing up for next week. Had to take pain meds throughout day, every day. After week Dr. did another CT scan told me the ureter tube was swollen so given Flomax. I am female and this is generally given only to males but some medical info on using it to treat woman with kidney stones. In last 1.5 wks, have only had to take pain meds once. Still have discomfort and some pain but not as much as before. Not sure about taking this med much longer but it has helped. Based on what I have read, may try Aleve if this continues

  10. pain says:

    I had a stone of 10mm in my left ureter.Doctor suggested me for DJ stent.Stone passed with blood after putting DJ stent.Then DJ stent is removed after 4 weeks just after when the stone passed.The pain i had experienced during its removal was so bad that i even don’t want to remember it.But now also i am suffering from back pain just like when i had a stone.only one month ago my DJ stent was removed.Did I expect another stone?

  11. Kidney Stone says:

    Removed the stent last night after being inside of me for 10 days, this morning wake up with swollen penis and tip of hole…scary looking and painful. Swollen is really bad right under the head gulf ball size!!! I called the dr, he said just to give it couple of days!!! This isn’t right!!! Doesn’t feel normal!!!! I don’t know what to do :(

  12. Irene says:

    Today I had my stent removed after being in place for 7 weeks. The removal went quickly and fairly easy with some discomfort. However The pain I have experienced since was worse than anything I experienced with a 20 cm kidney stone. It seems to have passed but it started out being extremely cold, then very hot with sweat rolling down my face, stomach cramps and feeling of nausea. Standing and walking seemed to help. The Dr did not indicate this might happen, fortunately I still pain medication from the initial surgery

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