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Of note, the medication used in the study, rofecoxib (brand name Vioxx), was withdrawn from the US market in 2004 due to concerns about cardiovascular side effects and it is no longer available.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 and laparoscopic surgical approaches. He sees patients patients at USC-Keck urology clinics located in Los Angeles, Pasadena, and La Canada, CA. He is the founder of the www.KidneyStoners.org website.
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64 Responses to Severe pain after stent removal: How often does it happen and can anything prevent it?

  1. Megan says:

    I started out with kidney stones my hospital told me i could pass it and sent me home that was on a tuesday, that friday i got really sick and had a high fever of 102.3 and had the chills. I couldnt even get out of the bed so my fiancee called the ambulance, they took me back to the same hospital. Once i was there the dr never even spoke to me a nurse hooked up fluids and sent me home. That sunday on mothers day i was really bad sick still, so we went to a hospital in a different town. They ran test and next thing i knew i had 6 different dr’s at my side, where my hospital didnt do anything for me or check how big the stone was i had the 9mm stone become lodged and caused infection and the infection got into my blood and i became septic. I was givin platelets and rushed to emergency surgery. I woke up the next morning in the CCU with a stent in my right kidney. I spent 3 days in CCU and 4 days on the regular floor, now i have had a cysto and replaced stent and got the last stent took out last week. I had alot of pain with the last stent and havin bad pain now that i am havin my monthly cycle. Has anyone else had bad pain after stent removal with ur monthly cycle?

  2. Sylvia Howard says:

    I had a terrible ordeal in November when Dr cut my urethra and I ended up with a urinoma had to have 2 stents 2 different times for eight weeks it was terribly painful and I am still experiencing pain to this day, doctors have no reason why. Pain seems to be centered around surgical site, I get colicky symptoms regularly. I keep thinking I am having another stone attack then the pain subsides. I just keep taking chanca piedra, naproxen and the occasional oxycodone and pry I can stay out of the hospital and NEVER get a stent again. There doesn’t really seem to be any answers. Everyone is different I suppose. I am beginning to believe this is the way it will be.. I am grateful that I didn’t lose a kidney. I keep reminding myself of that. I hope you all find relief and comfort and answers.

  3. Andrew Spencer says:

    Hi Guys. Im similar to you all, im Out in Austria, and had a 4mm stone in my left kidney. They tried to let it flush itself out for 4 days, during which time I was hospitalized and not allowed to eat due to the fact I could have been operated on at any time. Every night they’d relent and I’d get a small basic sandwich, and then the colic would burst in. One piece of advice I’d give to anyone going through that, is to learn really quickly the signs you’re having a colic attack – pain meds take about 15 minutes to kick in, so the sooner you realize your having an attack, the sooner it’ll be over! Don’t hesitate and think maybe it won’t be so bad this time, you’re fooling yourself and adding to the clock! Ok, so the stone was removed (laddered) after going through my urethane and into the kidney. They left a stent in fir whatever reason. You have to drink loads and this will make you ewe loads and seeing is agony, but you just tell yourself the kidney has to flush itself out. What they don’t tell you:
    The stent is uncomfortable. It makes seeing painful. No one told me to take anti cramp tablets. Thus is a god send and takes away 80% of the pain. I suffered cramps and the feeling of the urine pushing backwards into my kidney as it couldn’t go around or through the stent.
    Learn to control your wee. As long as the stent is in, it seems to reduce the amount of flow of the urine. You have to bite through the pain and learn to leave your wee hole open (in my case I had to learn to only allow a small trickle of urine go at one time through my penis. The wee takes longer but the pain is bearable).
    The blood is going to clear itself. The more you drink the quicker it’s going to get through. Expect blood clots to come out, this is normal. It took about three days for my urine to be a normalish colour.
    The stent removal is hideous. I’ve had a hip replacement, a hernia and nothing compares to this. It is painful and demeaning and frightening, and you’re better off asking if you can be asleep when it’s removed.
    It hurts after it’s removed. The first couple of ewes you will bleed again, but the stent is out and there isn’t and backwash feeling.
    However, I’ve also got colic again, at least every 5 hours..
    I’m hoping it goes away in the next two weeks – but I’m mentally preparing myself for longer. Like you all the doctor didn’t tell me anything about how much it would hurt. Or for how long. But there’s hope out there. Even hearing from you guys that have had unbelievable bad luck is inspiring me to get on with my life. If you can go through all that, my pain is a walk in the park. You’re the reason I’m writing this. I came here looking for hope, but you’ve given me something even more better – a spence if perspective and the courage and anger to get past this pain. This pain is not what defines us all, sure it’s a common thread, but it’s the fight in us all – I’m not going to be a victim here, I’m going to beat this thing. Thanks to you all for taking the time to post here. Good luck everyone.

  4. Sherri Walker says:

    I had surgery two weeks ago for a kidney stone that came out of now where. After surgery they put a stent in,… Three days later they took it out, my dr told me the pain would be minimal, but you know what? IT WASNT! It was horrible!!! I hurt soooo bad until I had to go back to the emergency room, it felt worse than the original stone. But now I’m faced with bladder fullness even when u don’t have to go, urethral pain and discomfort and it’s just horrible, I need to know how long is this gonna last! The only thing that helps me get through these pains is the medicine Pyridium or AZO. Without that I would not make it! How long does the uteral discomfort last after surgery and stent removal? Am I being impatient? Or do I have about 3 more weeks of pain? Some help!

  5. sherry says:

    I have had my stent removed 2 weeks ago .I was told I will be getting spazams for 2 to 3 days after removal but after 2 weeks I’m still getting pains in my back and side the feeling of the beggining of stones .any help would be good

    • Sherri Walker says:

      My Dr prescribed the medicine Indocin for me and it really works! I have the same problem but the meds are really a must! Hope this helps!

  6. Anddi says:

    I cannot believe all the people (everyone) posting here with the same complaints about their doctors…no warnings of the pain we’d endure with stents and the removal of them and also the fact that they not only didn’t tell us the pain would be outta control, they acted like we were over reacting to it. Tell me why are they treating us like this regarding the pain???…Makes no sense to me at all. Just help us with it so we can get through this horrible ordeal of kidney stones.

  7. Carol says:

    Today is Sunday 6/29/14, it has been a year of the most difficult time of my life physically. I have been the healthiest person ever, I turned 60 and for the first time experienced a kidney stone. The pain was extreme, along with the vomiting, and inability to concentrate, bleeding in the urine, and everyone around me seemed like I was exaggerating. I have a high tolerance for pain but this whole ordeal has stretched my ability to remain calm.

    After CScans, XRays, blood work and urine tests it was determined a large 5mm kidney stone lodged in the tube that goes from the kidney to the bladder. My first diagnosis was diverticulitis. The urologist said I had five stones and one was stuck so we start with the first surgery , come out after 3 hours to find it was lodged and he had to wiggle his way with a stent first as the kidney wasn’t working and caused my body to become toxic. Had to stay overnight and come back in two weeks to have the stones zapped and removed. Pain, pain and more pain between the stent, the kidney and experience of it all. Also I had awful side affects from antibiotics. Finally got back into surgery to remove the one large stone then had to go back in for the others. Over the past year I have had 7 or 8 surgeries, lost count, to insert a stent, a larger one than normal to try to get the tube to heal so that the kidney would start to function normally which never happened. It was established that since the blockage the kidney never bounced back. So now I have only one kidney working and has compensated for the one that doesn’t work.
    I am still in pain from the stent removal and pray I won’t have to have surgery to remove the non working kidney. I was told eventually it will just shrivel up, no diet restrictions other than drink a lot of water, which has become a regular part of my diet to drink, drink and drink some more.
    My advice to anyone feeling any abnormal pain not to wait for it to go away, a check up, XRay or CScan is far easier than to go through a year like I just had because I was afraid to find out what was really going on.

    • Anddi says:

      So sorry you went through what I am as well and no one can really know the pain unless they actually go through it themselves..it is torture to say the least.
      No one told me the stent would hurt or of any symptoms or side effects..I thought it was going to help me heal from the laser surgery and I’d get better and better..not the case. Then today they removed the stent and failed to tell me I could end up with excruciating pain after a few hours..no pain meds, not one mention of after pain, I am livid. Why couldn’t they at least tell me to prepare me? This article says half the patients hurt horribly afterwards and the nurse today said everyone has problems tolerating the stents..so why’d they make me feel I was over reacting to the pain of it? That’s why I am so upset..we are 60 year old adults that can handle the truth, why not give it to us? I for one am going to tell them a piece of my mind on my next visit…I have to go to ER again when this could’ve been avoided. I came in search of finding out how long the stent removal pain lasts and it doesn’t say but you wrote yours still hurts??..That totally scares me, if you get this please tell me what they told you about it and how long it’s been. Prayers for the medical field to be more compassionate and honest and for yours and every person suffering such horrid pain be healed and relieved of the pain…in Jesus name. Hope it’s a;right to pray..God bless all. Any answers appreciated since they sure aren’t telling me anything.

    • sherry says:

      What you are going through is very sad I myself worries of the what ifs I’m very afraid of losing a kidney due to all the surgeries iv had for stones its been 2 weeks now after my removal and I’m still having lots of pains and I’m getting worried after reading your story …

  8. Margaret Murphy says:

    My 40 year old daughter had a surgery for her ovaries in which something went horribly wrong.They had mistakenly cut her uretha and had to have an emergency Urologist come into the surgery to put a stent to save her.She ended up in intensive care for 3 days as her lungs collapsed!! A horrible 2 week hospital stay,a 7 week stent starting to leak,she was rushed to the ER and the stent came out ???? Now the urologist says see me in 2 weeks and you may need a stitch and a much more detailed test to see if a stent has to be reinsterted????? She has been in ongoing PAIN and on MEDICATIONS since April???? It seeme like no one has any answers!!!!!!!

    • Carol says:

      So sorry to hear about your daughter, you would think this day and age of medical technology this kind of thing would not happen. How difficult it must be to have to sit back an watch your loved one in such pain. My heart goes out to you and pray you hang in there as well as your daughter.
      Keep us updated as to how she is doing.

      Carol

  9. Jenny says:

    Just like to thank those who have posted on this site. I am still in hospital after having my stent removed about 15 minutes ago on the ward. I was terrified to not be asleep for the removal but I can say the thought of it was worse than the actual procedure. I am hoping the nightmare is over but am glad to know some people have ongoing pain. At least there will be no surprises thanks to your posts. My first wee was great. At least the nightmare is coming to an end. Good luck to all you fellow stone/stent suffers.

  10. Shannon says:

    Hey all. Here’s some good and bad for you. Stents suck! No one warned me that having the stent taken out would cause me pain. I am two days post op and have taken so much narco that nothing has gotten done in my house. For me heat works against my left side. (As the stent was in my left kidney)
    The stent actually made my life a living hell because unless I took ditropan I felt like I had to go pee every five to fifteen minutes. Ditropan made life a little easier. However I had my stent removed while they checked to make sure the kidney stone I had, had passed. They don’t tell you about the after pain. It’s been pretty horrible. I can’t even get out of bed most days because as soon as I move my back/side from my heating pad it sends pain shooting down toward my hip and across my back.
    Unfortunately I need to get things done, so for anyone who has had heat work for them… Do you think wearing an icyhot patch might work in lieu of the heating pad? Cause I need to go grocery shopping tomorrow and being a military spouse the commissary (military grocery store) is always packed on weekends. So i was thinking about putting an icyhot patch on to try and make things a bit more bearable tomorrow. Think that might help?
    Also. Water and rest is about the only thing we can do to make this more bearable. Wish I had better advice for everyone. Oh! Naproxen/Ibuprofen does help. Take 800 mg with your pain meds and it knocks the pain down further. I can thank this page for that advice.

    • Michel Merite says:

      Hi, unfortunately it seems that people on the site don’t come back after they feeling better to give hope to those suffering. I posted when I was in pain below u can see. N now I am much much better. I don’t get the severe pain anymore. Normally the pain u get it when u pass some dead blood. I got it for 4 days and still had to work. Good luck. Michel

  11. Loreen says:

    4 weeks ago I woke up to this massive pain on my right side, went to the Immediate care center and sure enough I had my first kidney stone. The Doctor at the Immediate care center gave me antibiotics and I even went to my family doctor who is kidney specialist and he made me get a X-ray. (saw no stone) there. I tried to wait to see if the stone passed it didn’t, then one morning the pain got worse and I drove myself to the ER. They gave me a CAT scan and found the stone 3 cm(right near my bladder) and an Ovarian cyst the size of an orange (never knew it was there). My Gyno said the cyst might be blocking the stone from passing so I went into surgery to take both out. In surgery they blasted the stone and put the stent in. I had the stent taken out 4 days later (uncomfortable but tolarable with no pain meds before/after), when the stent was in it only hurt when I urinated. But the massive pain I’m feeling now is even worse then when the stent was in. Doctor said the pain would be only for a few days. I really hope it stops soon. Does anyone see relief after a while?

    • Michel Merite says:

      Hi I have my stent removed 4 days ago and I am experiencing the same terrible pain like once a day for about 30 mins. The longest 30mins in my life. I was getting very worried . Yes let’s hope the pain go away quick. Thanks for the post it helps me a lot, even morally. Good luck. Regards Michel

      • Loreen says:

        Ok I’m back. Pain went away after about 2 weeks. What helped me with pain since they didn’t give me anthing (medicine) was a ice pack. Put Ice where the pain is, it helps!

  12. Kim says:

    Hi Everyone. I am a woman who just had a stent removed today. Actual stent removal was nothing compared to the hell I’ve gone through in the past 3 weeks. I was very worried about what pain I would feel when the stent was removed but thankfully it was over within seconds – I felt some burning and my face went very hot but other than that OK. I took pain meds about 30 min before the removal and would recommend that to everyone.

    Now it is approx 5 hrs after the stent removal and I am having some short sharp pains in my right side. Nothing like the kidney pain but certainly enough to take a pain pill. Doc warned me that the kidney stone fragments that they blasted need to be flushed out and that I have to drink about 3 litres of fluid today. 1 litre down – 2 more to go!

    Unless you’ve gone through this – it is so hard to explain to others how horrific it is – I had 4 emergency room visits, 3 ambulance rides, 2 surgeries and one bloody 4mm kidney stone. Have had to work somewhat during the last 3 weeks as I am an entrepreneur – no holiday or sick pay there!

    So my thoughts go out to all of you – the big thing is to make sure you get to the doctor when you first get hit with the kidney pain and if it doesn’t get better within a day (or less) get back to the hospital. I ended up having emergency surgery as the “little stone” they thought I had ended up plugging the ureter. Also – I found heat made things worse, use cold packs of ice front and back, and don’t drink caffeine.

    Good luck!!

    • Ann says:

      After having two operations for the removal of kidney stones within the past four weeks all i will say regarding stents is NEVER EVER AGAIN! I was in constant pain for three weeks and found out that the pain i was having what felt like in my womb was in fact kidney stones that had got stuck around the stent. i had blood in my urine for the first week and to pass urine was beyond anyone’s imagination regarding pain and doesn’t come any where close to natural childbirth.On Monday i told the surgeon that i would rather take my chances with passing a kidney stone without the stent as it wasn’t as painful. Did he listen to me? No! I awoke in pain but this time i had two nylon strings dangling from below. It is now Wednesday, i awoke in pain as usual and for about four hours i had to wear a pad as urine was dripping from me? When i went to the toilet yet again, i saw a light blue piece of plastic dangling from me? Not knowing what to do, i left it where it was with urine still slowing dripping from me. Realizing that if i did nothing, it would just continue i decided to pull out the stent myself. Big smile as i type this…i pulled it out slowly waiting for some sort of pain and…nothing! Today is the first day in a month that i am not urinating what looks like blood, i am not in pain and my my, the world seems like a wonderful world again. In addition to this, after 23 years, i am totally stone free and believe me, if i have to live on just water alone i will as i never ever want to go through this again. At the moment, i am very very tired and tearful and didn’t realize just how much stress i was under to cope with the constant pain and trying to ‘keep it all together’. My heart goes out to anyone who has a stent and is in pain. My opinion of a stent is that it is some sort of medieval gadget that the medical profession seriously need to re-evaluate and come up with something that does not inflict pain and misery onto anyone.

  13. brooke says:

    I just had my stent removed about a hour ago. I as well was not expecting the pain I’m currently in. I hurt in my lower back. I’m also having bladder spasms. I hurt worse since the stent was removed. I wish this pain upon no one. If anyone out there knows of anything to do to help with the pain im open for suggestions.

  14. Shaun says:

    I just had a stent put in about 4 weeks ago and was miserable the entire week it was in. Unfortunately, I didn’t know about this website then and wasn’t informed by my doctor that it could be uncomfortable (putting that mildly). It was so bad that I was in bed with excruciating pain, throwing up for the entire week.

    Now after 3 weeks of the stent removal, I am still in constant pain. I have missed several days of work (too much pain) and the doctor says everything looks fine (after X-rays and CT scans). They make me feel like I’m making it all up! Has a anyone else had this problem? It would be nice to know that I’m not the only one.

    • Jill says:

      I haven’t had my stents taken out yet but they’ve been in for 3 months now and I’m still in constant pain, and my urologist brushes it off like it’s nothing too :/ hope you feel better soon!

    • Kelly says:

      I have never experienced pain like this in my life. I was admitted to the ER 3 times since the stent was put in. I as well have missed several days of work. I am having my stent removed tomorrow and dreading the pain I will be in again. Wish me luck and I hope your feeling better soon.

  15. Ricardo says:

    I had a stent removed and it was the most uncomfortable & undescribable feeling i have ever felt. Five hours after I leave Dr’s office, I start getting pain in my back and soon the pain/iching/ burning feeling on my groin with the feeling of always having to pee. Lasts for about 1 hour then goes away. Now everyday i get the same pain once a day, usually in the afternoon. Just talked to my doctor and he told me it could just be debris or old blood passing through ( i did see some dry blood coming out). As long as I don’t have a fever and constant pain, he’s not worried, drink a lot of water, he said. I hope this pain goes away, because it is the longest hour i have ever been through. I can deal with the burning, but this pain is to much. Will keep updating…hope it helps someone, because the posts before me kept me from going to ER again, since my doc didn’t warn me about this….

    • Eneida says:

      Going thru the same, no warning after removing stent that I would still be experiencing any level of discomfort or pain. And now here I am, left to wonder if there is something else wrong? Is this normal or not? Pain in kidneys, lower back and bladder spasms. Plus the horrible burning when trying to urinate. I guess, I am to blame for assuming it would all be over after the stent came out. Not so!

    • Michel Merite says:

      Hi Thanks for your comment and does help Cause I was thinking that something was still wrong. I am having the same pain terrible pain once a day. I removed my stent 4 days ago and still having that pain that last around 30 mins. Please update whether you alright now without any more surgery or emergency . Thanks Michel

  16. Hannah says:

    I had a stent with string placed in my left kidney and bladder after laser removal of numerous small stones encapsulated in kidney. One small stone got stuck in my ureter and did not pass for another two weeks after surgery. My stent was removed after 4 days in doctor’s office. I had taken a pain med in anticipation of some modest cramping. Removal was quick and painless. But I felt “blocked” and unable to urinate after procedure. They sent me home without any further warning but severe pain began on my way home. I already had taken pain med so I could not take any more. I was scared about increased bloating and urge to pee without getting any release. Nurse had me return to office and I spent one night in hospital for observation + pain management. I felt very achy with burning and bleeding for 2 weeks until I felt normal again. Agreed: doctors must treat stent removal with adequate after care and pain management and should not send patient home without observation. Why do we have to suffer so unnecessarily?? I took a lot of bed rest and was lucky I had some holidays available for recovery.

    • Kerry sanford says:

      Hi Hanna, I seem to have the same symptoms as you did I had laser removal of stones 5 days ago , the doctor did not place a stent in ,as one of the stones was easy to remove but she had to wriggle the 4 mil out, the night of the surgery I felt fine and was discharged , but the next day severe pain attacks and the narco wasn’t working so I was back in the emergency rom and the admitted me overnight for observation and pain management, they have me stronger pain pills and I was at least then bake to sleep and try it eat, I have read that omen justice in water works so I am trying that now…how are you feeling and has you pain got under control and ad you back to normal activities

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