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Of note, the medication used in the study, rofecoxib (brand name Vioxx), was withdrawn from the US market in 2004 due to concerns about cardiovascular side effects and it is no longer available.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.
This entry was posted in Information. Bookmark the permalink.

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

  1. Pankaj Maurya says:

    I had gone under ureteroscopy on Nov 13, 2017. After the procedure, Doctor placed a stent in my right ureter, told to be removed after 21 days.
    On Dec 4, I went for stent removal. Before removing the stent, doctor told me that there will be only mild pain.
    He started the procedure, believe me that was the worst pain i had ever in my life….

    I was in alot of pain not able to stand, sit and walk well.
    very acute pain in my urethra and burning while urinating..
    My urine was about to come out itself…

    Till then, 4 days has spent i m still in alot of pain. no pain killer works.
    much pain in my kidney and bladder area..
    My kidney is just like cramping.

  2. Ani says:

    Hi I had 3 stones and had a laser lithotripsy done . I was in a lot of pain and discomfort . Panadeine forte didn’t help , the stinging and burning when I pee was helped by citravescent . The stent was uncomfortable and no tablet helped , then after a few days I tried the hot water bag and that was great and helped me a lot.
    After 4 weeks the stent came out and is very painful at the moment, I have to take tablets every day.

  3. Anna says:

    I have had multiple stents and have been forming stones for almost 15 years. I’ve had the stent removed three different ways. When they removed it under general anesthesia or outpatient with the scope o had minor discomfort with urinaring afterwards but overall felt huge relief and did not experience any residual pain. This past week I had a stent removed outpatient, but this time was different. The stent had a string attached and they didn’t give me any local anesthetic this time. The removal of the stent was very uncomfortable, but the pain I felt afterwards was excruciating. I came home in tears and was finally able to fall asleep after taking 2 hydrocodone (I’m usually very responsive to 1 but not this time). When I woke up the pain was gone and I haven’t had anymore pain. It seems like a roll of the dice in terms of whether pain will be present post stent removal and how long the pain will last although I do think removal method may have something to do with it (aka do they give you some variation of anesthetic or not).

  4. i have been putting up with pain from the stent in the last year and am on gravol and pain killers i cant find a decent pain killer tilli see my doctor and get antbiotics to stop the pain it feels infected i get sweating and am in pain for two days i cant take protein drink’s or my brain cancer powder becaude it starts all over again, sonya thomas the doctor who put it in wont let anyone else take it out but himself dr Granger at royal unversity hospital in newwest minister, sonya ann thomas

  5. Mohd nazri says:

    After dj stent removal,2day later my blood pressure increase..why it happen..I am very nervous..thank for answer..

  6. Saurabh says:

    I had my DJ stent removed on 01/11/2017. I was scared because I thought it will be very painful but its not painful at all however slight discomfort was there. It was removed in operation theatre .Diclofenac Injection half an hour prior to stent removal has definitely helped.

  7. sonya thomas says:

    im having mine removed in februray of this year 2018 and want to know how taking a bowel movement is possible or do i wear a bile bag again. sonyathomas234@gmail.com

  8. Mandy V says:

    I took my stent out myself past night and while the removal itself didn’t hurt, I woke up in the middle of the night with severe kidney discomfort. NSAIDS havent helped, only the strong pain medicine they prescribed. Still feel like i need to pee frequently and urethra is still irritated.

    • ashley Bonham says:

      I just took my stint out on 12/1/2017 it was not as bad as i thought it was going to be i just got in the shower and pulled. But i am having a lot of pain now they say its bladder spams they dr gave me so pain meds and a bladder relaxer the pain has been just as bad as having the the kidney stone in the first place they say it will get better. As anyone else had this how long dose it last.

  9. Joanne says:

    My hubby had his stent removed today got home and he is sweating and in so much pain he can’t even sit down, keeps being sick what do we do x

  10. Mohammed khaja pasha says:

    I removed my dj stent today from left kidney. I am now experiencing a burn pain at left kidney and pain while urination..
    I want to knew how much duration it take for being normal. And I got discharge summary same day

    • Cmb says:

      I got my stent taking out this past Friday. And I’m having the same symptoms as well. Hope you find some answers. They told me to take pain medicine they prescribed me after surgery to put stent in. If problem persists after the weekend to call your doctor on Monday.

  11. David W Carolla says:

    I went to ER at 11:00 PM 09/11/17 with the worst pain I have ever experienced and I’ve had 45 orthopedic surgeries. Turns out it was a 1.8 CM kidney stone. They called in a urologist and I had emergency surgery at 4:00 AM 09/12/17. The stone was so dense they were only able to get half of it broken up. They put in a stent and I have to have another surgery to finish the procedure. Still waiting for the call from the Dr for the follow up. Still peeing blood day two and still painful.

    • Angela Bauer says:

      I had my kidney stone broken up also, now I have a stent. It has been one week and I have had horrible pain, and still peeing blood after a week. I can’t wait to get this stent out, but now I’m wounding how much pain I will be in after the stent is taken out?

      • Stephanie says:

        Hia I had my stent removed Friday I was in same position as you I had it in 5weeks after my surgery I’m now in so much relief it didn’t hurt but was uncomfortable and I felt sick all day but I now feel apps fine with 0 pain, happy days xx

  12. Glenn and Beverly says:

    A month ago my wife had her gall bladder out and Xrays showed a larger than average kidney stone not yet dropped from the kidney into the urinary track so they scheduled to have her come in to receive a stent and blast the kidney stone 3 weeks later.

    The surgery went fine but the surgeon could not find any kidney stone. That was interesting to say the least! ( after all he said it was larger than the average stone)
    So they left the stent in for 3 days and had her come back into the Doctors office to remove the stent as it was somewhat painful and was on pain medication for it, however… about an hour after she came home she started crying in pain and bent over even on prescribed pain medication.

    Back to the emergency room we went where they prescribed oxi cotton.. (excuse spelling)
    That helped the pain but it is 3 days later and she is still has to take prescribed pain medication.
    Why in the _____ these Doctors don’t tell you that there is a good possibility of severe pain. I thought they screwed up the surgery or ripped or punctured something the pain and length of pain being so bad. I was ready to take her to another hospital but after reading all the reports from others experiencing very similar issues I settled down to the fact that it is what it is…

  13. Christina Graham says:

    Had a stent removed from left ureter on Monday, 7-31-17 out patient surgery ! Tried to do in office on 7-28-17 by Urologist who end up doing three cystos and could not do the procedure, I was crying and screaming in pain. Decided to take out on that following Monday 7-31-17. The burning is 10+ and I’m on Tylenol extra strength, as I am allergic to codeine ! Warm baths make it worse. what can I do to help stop the burning pain !! I have Multiple Sclerosis and stress can make a flare up happen. I am 65 yrs old .

Leave a Reply

Your email address will not be published. Required fields are marked *