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Of note, the medication used in the study, rofecoxib (brand name Vioxx), was withdrawn from the US market in 2004 due to concerns about cardiovascular side effects and it is no longer available.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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203 Responses to Severe pain after stent removal: How often does it happen and can anything prevent it?

  1. Kevin Williams says:

    Everything is doing well. It is Sunday afternoon anxious am in very little pain. I am hoping this is over now. All of you that are going threw this now are in my prayers. For me it wasn’t that bad. Hang in there!

  2. Kevin Williams says:

    Just had my stent removed a couple of hours ago. So far, I have pain on my right side and abdomen. Not severe though, just annoying. I had three stones in my right kidney 2 of which were 10 mm, the other was 6 mm. All 3 were removed 3 weeks ago through lithotripsy surgery. I feel lucky I had a good surgeon.

  3. Joe says:

    Just had two stints removed they were in for two months . I took a strong pain
    Pill before the procedure . It took 5 minutes to remove the stints, minor discomfort
    Watched on a monitor while it was being done. Just went
    Pee two hours later and it was pain ful in the penus
    Area. I had read this should be expected . Not sure
    How long this will last . I had a lot of anxiety before
    The stint removal and it went smooth. The urinating
    After words sucks.

  4. Linda says:

    I had bilateral stents following laser lithotripsy. The doctor removed them last week and although it was an uncomfortable procedure to have them removed, it wasn’t painful. The pain started about an hour later on the way home. Make sure you have someone to drive you home! My doctor told me the pain would be mild but it was as bad as when I was in the emergency room with a blockage. I am still having waves of pain as the fragments pass- it has been a week. My advice though is to be aware of the post stent removal pain. It was so severe that my husband almost took me back to the emergency room. It did subside by morning – that would be about 8-10 hours after removal. Yes you will live :-) but you will not be happy?

  5. greg says:

    Well have read everyone’s stories and all seem to b in same boat after stent removal. Everyones recovery is different as we all r different in many ways. Yes making doctor listen is important, I recommend a young new doctor. Haven’t heard all our pain issues a billion times. So only thing I can add is watch amount of pain med taken, this has added more abdominal pain for me due to lack of #2 visits to r.r. aka full of sh.t. hang in there my fellow stone brothers and sisters.

  6. Tammy says:

    I sympathize with anyone who has ever had a kidney stone. I have had more then a dozen procedures, I just had one three weeks ago and had my stent removed yesterday. I have been in so much pain!!! I have never had pain after a stent removel before, and my stomach is so swollen don’t know what the heck Is going on I’m not getting much relief From the pain meds. so I might have to go to the emergency room , alway the last resort for me, has anyone else had pain and bloating after stent removel?

  7. Steve says:

    There is a number of posts on here that report pain that are never updated on when pain finally goes so I thought I would let you know my experience.
    Yesterday I had the stent removed, i had two stents the first stent was used to widen my tight ureter was in for 3 weeks. Had the 9mm stone laser blasted at week 3 and had new stent inserted for 2 weeks this was removed yesterday.
    The stent removal has its moments regarding being uncomfortable I.e takes a few minutes and in those few minute a few seconds of discomfort so not so bad.
    I was in very little pain for the first 30 to 60 minotes of removal. I started getting pain in the groin and kidneys approx 60 minutes after the procedure and pain was quite severe for a few hours I had a lay down in bed at home for a few hours. Pain eased by the evening and I was up watching TV with just a little pain in groin and kidneys and went to bed at my normal time. I awoke this morning and as we approach lunchtime I am in no pain whatsoever all seems really good.
    I hope my experience helps with people’s concerns
    Thanks

  8. lynda says:

    I’ve had two stents in since 17 Nov 2015 and tomorrow having one taken out of left kidney as stones are gone I’m on morphine for months now in so much pain try not to wee as it’s painfull so hold wee for ages worried about tomorrow having GA for removal but I’m in so much pain as it is would not have stones removed again rather die as stents are the worse pain ever 5 months of pain 12 tables a day and morphine all because of stents you couldn’t make it up

  9. John Groves says:

    Has anyone expierenced pain in bladder,griin and inginal area after stent removal? I had a stent placed they removed it and since then I developed a prostate infection and spasms and groin area pain. I went to another urologist and they mentioned that it was the stent that caused this. Anyone have any type of issue like this. Thanks

    • Steve says:

      Had stent removed this morning, pain in kidney and groin area. Was not expecting groin pain so not sure if this is normal.

  10. Harry Richards says:

    On 3/24/16 I had my kidney stone removed and a week later on 3/31/16 I had the stent removed. However, I am in more pain since the stent was removed. The pain is similar the pain prior to being disinoised in January for a kidney stone. Also, I am taking more pain meds than at any time.

  11. tina says:

    hello yes I had lots of kidney stones my dr told me . well they took the stent out in the office .I thought they gave you meds before hand well know I’m having pain up inside from the stent. I don’t know why I have tried creams to make pain go away the dr said it was normal to have pain. I said not like this nobody listens when you hurt inside from a stent

    • Karen Taucher says:

      Tina, were you ever able to get rid of the pain…I had my stent removed in November and still have the pain in my back…it is really annoying.

  12. Emily AndersonMaskell says:

    I’m scared!!! I get my stent and kidney stone (4mm) out in 2 days and I’m scared of the pain I’m going to be in afterwards. I mean I’ve only had it in for 6 days and everyday has been he’ll I’m earth. So painful with everu move I make. I thought something was wrong last Thursday so I went to my urologist they did an xray to check my stent and said everything looked good. Gave me a shot of toradol and a script for dilaudid and said some people’s body just doesn’t handle the stents like others do. Well, I couldn’t believe it would ever feel like this!! What’s been on my mind is if I’m in this much pain with it in, I’m scared to death after reading everyone’s response to having it removed. Oh, and I totally believe that it definitely has a lot to with being a fair skinned redhead, to which the amount of pain meds I need to take just to knock the edge off the severity of the pain. Does anyone else agree?? Or he’ll I might be just a whimp!!

    • tina says:

      hey I had my stent out in the office . it was not bad. its after you get pain back I have had pain inside from when the stent was taken out I told the dr and he said it was normal to have pain not I have tried creams and showers . they do not help call me its PATTY 252 259 6076 LETS CHAT

    • Wes says:

      No you are not a wimp I have had many very very painful surgeries and a few very very painful accidents and I just had my stent removed this morning and the pain is excruciating

  13. Deb Huskey says:

    I am 37 years old, and I have had kidney stones since I was 20 years old. I have had a total of 4 lithotripsys, 1 “bucket extraction”. In January of this year I started having back pain and bleeding with urination. It took two weeks to get in to see my doctor I was scheduled for a MAG test to check my kidney function. My left kidney was not functioning, I went straight into surgery to have a stent placed and to see what the problem was. Two weeks later stent was removed with no affect, I was back in the ER the next day. Another stent was placed, I have never been in so much pain in all my life…my doctor decided it was best to do an open procedure to see exactly what was going on, so I did it. I was suppose to have a three inch cut. I woke up to an eight inch cut in my lower abdomen, a drain line on my lower left side and a catheter. I stayed in the hospital three days. Oh yeah and before the last surgery my doctor decided that I liked pain medicine to much…really…anyway half of my ureter on the left side was dead, my doctor had to cut half of it out and reattach it to the bladder after he had to move the bladder up and back to get it to reach. I missed a month of work, still have severe pain in my abdomen and depression. I had my stent removed yesterday after six weeks and now I dribble when I go to the bathroom and have a constant cramp in my back. I am so frustrated with all of this, I’m sick and tired of being sick and tired I don’t know what to do anymore.

    • Valerie says:

      Oh my gosh, I cannot believe what you went through. I thought I had it bad. What did you mean by the doctor thinking you like the pain medicine too much? That’s insane! I absolutely loved mine and you know why? Because it took the edge off the pain! I don’t think doctors have any empathy unless they go through it themselves. So sorry for your pain.

  14. Janice says:

    I had an operation to have a 16 mm kidney stone removed on the 11/12/2015 by laser and a small cut into my back , it us now 3 months later and I still have very bad back pain , I have been back to Hospital Emergency and all they do is hive me Morphine , the pain goes I go home . I get liars more pain when I have to go to the toilet for either what. Could this be

  15. lori roscoe says:

    Any time I have had stents removed and had severe pain after, it was not due to spasms, it was because when they remove the stent, and some of the pieces of the stones had not passed while the stent was in, and are now trying to pass. Even a 2mm stone hurts like hell!! More than once I had to go back to the ER and they do another lithotripsy. Last time, I had 2 lithotripsies and then still passed a 5mm stone. I wanted to die!!

    • Lee green says:

      Hi Lori
      New to this site
      Have battled with kidney stones since my early 30’s … I’m 50 now… I’ve it all as it sounds like u have as well… Just had back to back surgeries right side & left… This is 1st time that I’ve had so much pain after stent removal … I read your post and I think your absolutely right… They didn’t get all the stones! But it moved it around enough that they are certainly passing and causing a hell of a lot of pain… Not sure what steps to take next

  16. lori roscoe says:

    I have had multiple kidney stones throughout the years. When I have a lithotripsy and stent they keep it in about a week. News FLASH! The lithotripsy doesn’t guarantee that the stones are small enough to pass. A 2mm hurts like hell! IF YOU HAVE LARGE STONES IT MAY TAKE 2 OR MORE LITHOTRIPSIES TO GET THEM SMALL ENOUGH. In October 2015, I have a stent put in due to kidney stones and UTI. Then after 2 days in the hospital, UTI was clear, so they did a double lithotripsy and put in stents in both kidneys. After a week they did another lithotripsy and thought everything was fine so they didn’t put in a stent. A day later, I was back in the ER in severe pain and they admitted me, and I passed a 5mm stone!!!!

  17. Brenda says:

    I went to the Emergency Room 3 weeks ago in severe pain..the resut was 2 kidney stones and a blood clot blocking at the ureter/bladder. The next day I had them removed and a stint placed. I had the stint removed 5 days later. The stint was uncomfortable while it was in place and only painful for about 30 seconds being removed. However my kidney continued to cause me great pain, which the Urologist was not interested in listening to. After 2 additional visits to the ER and another 3 days stay to get the pain under control, I now have frequency like 40 times a day. This has been an awful experience!!!!! Am returning to the Urologist tomorrow. And He is going to have to LISTEN to me. I also am now being treated for a UTI and a kidney infecton.. This has been my worst nighmare..3 weeks ago I felt perfectly fine.

    • Valerie says:

      What is with urologists? Mine was the most arrogant, inhumane doctor I have ever had! I wish they would all get really big stones so maybe they could conjure up some empathy.

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