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Of note, the medication used in the study, rofecoxib (brand name Vioxx), was withdrawn from the US market in 2004 due to concerns about cardiovascular side effects and it is no longer available.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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271 Responses to Severe pain after stent removal: How often does it happen and can anything prevent it?

  1. Zandria says:

    I had my stent put in almost 5 weeks ago. It will be removed next week along with my 12mm stone. I’m scared to death. I had extreme pain everyday and blood in my urine everyday for 5 weeks. Is the pain after the removal bad and how long will it last? I’m tired of being in constant pain and having to take pain meds every 4 hrs…

  2. Lydia says:

    Had my 1.5cm stone lasered on 9/12, stent removed 9/16, still with intermittent severe pain on 9/18. I’m not understanding how anyone can go right back to work after stent removal like my doctor says. I have to take Oxycodone for the pain and fall asleep after taking it. I still have at least 5 more stones in there to look forward to removing. Was anyone able to go right back to work? I feel like a wuss.

  3. ken says:

    I still have extreme pain at night in the ureter where the stone was lodged when trying to urinate 5 weeks after stone extraction and stent removal. If I walk around for some time it gets better. Dr. said it was from a full bladder but starting to think maybe still some debris or another stone in there. Trying to avoid pain meds except NSAIDS.

  4. cherie wiggins says:

    Is there always pain that won’t go away after stent removal? I am reading these people’s comments and its scaring me to death. I get my stent removed in two days. Please tell me this doesn’t always happen. I’ve been thru enough pain already.

    • lyzz says:

      I’m having more pain after the removal. the removal itself was yesterday and it was super easy. the cramping has been so painful. it still hurts today. I probably shouldn’t be at work. I don’t want to take the Percocet because I don’t feel like eating and if I don’t eat, the pain meds will make me sick. they don’t tell you about this.

  5. Jewell says:

    I had my stent removed today and the pain I get while urinating is excruciating. I have to mentally prepare myself before using the bathroom! I have norco, but there’s got to be something to ease this burning pain.

  6. Missy says:

    I had surgery to remove stones on 8.31, stint removed 9.6.16 and I feel I have stones, could these be flair ups? It really hurts.

  7. Ryan says:

    I was in very little pain due to the kidney stone (6mm) before surgery but it was discovered during a CT scan while investigating other health concerns. The stone had migrated from my kidney to my ureter before surgery but was still too high up to retrieve. The surgeon broke it up into smaller pieces with a laser. After surgery to break up the stones and have the stent put in I was in miserable pain. Moaning, sweating, vomiting…like one would expect from the kidney stone itself, not the surgery! The excruciating pain subsided after about 6 hours and I made it through a few more days on Norco, Advil, Flowmax, and Pyrridium. By the time of the stent removal (6 days after surgery) I was uncomfortable with pain after urination, but not unbearable. BTW an ice pack to the back help immensely.

    I took a pain pill prior to stent removal and the procedure itself was not very painful. I did not take any more pain meds the day of the procedure, which was in the morning. I woke up that night at 2am in immense pain and took about 2 hours to recover and go back to sleep. Then the next evening after dinner, and with pain pills in my system I was in all-4-on-the-floor weeping terrible pain. Again, Flowmax/Advil/Norco helped ease the pain. Some time in there I passed the stones (and blood clots or scabs from surgery). I think I am now on my way to recovery.

    Regarding the surgery and the stent removal I would do the following:
    1) Remember to take pain pills and Advil (if non-conflicting drugs) regularly after the procedures.
    2) Drink plenty of water to prevent any dehydration (seems to make kidney pain much much worse) – Even drink lots of water before bed. You would rather have to pee 2 times in the night than be in kidney pain.
    3) Have an ice pack ready and apply it to your back at the start of kidney pain in conjunction with taking any necessary medications.

  8. Dave Wilbers says:

    We are all in this together! Thanks for this website and the great information. It is evident that kidney stones are unpredictable, hard to understand and treat. After 9 surgeries including 5 lithotripsies and 3 stents seems like I have experienced all. Emergency room visits and a variety of pain medicines to help ease the pain. I have experienced pain and burning after the stent removals but have also experienced no pain after the removals . I have also felt flank pain after 2-3 days after removal of the stent which is a concern. Find a good doctor and surgeon but remember these stones are unpredictable. Love this site with all the stories and learning other methods that might work for all of us.

  9. Lisa says:

    I have just had one of the most miserable weeks of my life after kidney stone removal last Tuesday August 23 and JJ stent placement Had the stent removed yesterday and am still experiencing pain and back spasms I Can t wait until the pain and spasms go away Hopefully it will get better The only thing that I have experienced that was worse was when my Dad passed away last December from colon cancer Hopeful that the pain will go away

  10. syed says:

    My stent removed today after one week. As my stones passed by urine after lot of drinking water. Stent was removed in few seconds in doctors office as he pulls the strings.

    After 2 hours i start feeling really bad pain worst than the first starting pain. My doctor gave me Tamsulosin. After taking one capsule pain was totally gone within 15 minutes. But after 6 to 7 hours pain came back but this time it was worst than the previous one. I took again one capsul to relive the pain.

    I don’t know how long i have to take this medicine before it will be normal. Any idea?

  11. Jorge Pedraz says:

    I had 19 mm stone removed from my right kidney using Laser on August 11, now I have a stent will be removed this coming Wednesday the 24 , after read all this comments I scared to dead .

  12. Janet says:

    Finally relief after about 2 hours. Hot, pulsating shower on flank brought almost immediate rrlief. So I’d turn it off and stand there until I needed the water again. Took 2 oxycodon about 20 minutes ago. Also: per doc’s orders, drank water — about 20 -30 oz in 10 min. Now pain free, hallelujah. Starting to feel drugged…..

  13. Janet says:

    Ow. Stent was pulled out about 3 hours ago. Pain is about at 5. Standing in shower with very warm water falling against flank relieved it. But I couldn’t stand there forever. Doc gave me a sample of hydro-something ( like Urelle). Took at first onset of pain. Don’t think it’s working. Now lying on heating pad. I hate to experiment with all the different drugs I have on hand for fear of bad reactions. Maybe will try some pyrridium after a while. Ow…

  14. man in pain says:

    I have just had my jj stent taken out about an hour ago and the pain is unbearable.

    • Darlene says:

      Same thing is happening to me. worst pain ever. almost went back to ER. I have these surgery before. Always more pain when they put a stent in.this last one worst then ever. I will never let them put in another stent. I refused a stent the time before this. there was harley any pain, recovery was quick. No more stents

  15. Janet says:

    I’m getting my stent removed (the string kind) in a couple of hours. It’s only been in 3 days, following a surgical ureteroscopy ( no stone removal, little trauma to ureter). I had another stent in for three days prior to that because the doc couldn’t get the scope into my ureter during the first procedure. Has anyone tried pyrridium (sp?) it relieved my pain very well post op. Or do these spasms require a whole different arsenal if pain relief?

  16. Matthew says:

    Hello, I’m 7 days after removing my own stent. I am almost done my pain and anti inflamatory pills. Yesterday I had a mild flare up and didnt need to take any pills. This is really stressful just now after eating it flared up hard…. I just want someone to smash me over the head with a frying pan the pain is so bad… 25 min after taking my pills I’m feeling ok.

    Had the stent in for 5 days post op, blood in urine and burning was normal the string hanging out my penis was just annoying… pulling out the stent felt weird but thats all.. really sucks to know that once you get one chances are youll get another…

    Ill got for a followup sometime this week and figure out what the stone is composed of… Ill do anything not to have this again… the taxi was out front of my home but i said call an ambulance im not gonna make it ….

    Just thought id share… keep on trucking everyone

    • Mg says:

      I hear you and I am only a couple days without stent…Wow what an experience…the flare ups are no fun…they remind me too that I never want this pain again..mg

      • Derek T says:

        Me Too. I had my stint pulled out(yanked out) on Friday, its Tuesday and still feeling it. Thanks to the pain meds, todays flareup only lasted 20 minutes. I am a little confused on what is causing the pain. When the pain pills start to kick in it feels as if the ureter is having spasms that match my heartbeat. At the same time it feels like maybe the bowel moving through the intestine is pressing on the ureter? Regardless, most pain seems to be coming from where the ureter enters the bladder.
        Hope you all are doing better!

  17. maritza says:

    Atfer kidney stone removalHow long dose the spasm last after stent removal

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