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Of note, the medication used in the study, rofecoxib (brand name Vioxx), was withdrawn from the US market in 2004 due to concerns about cardiovascular side effects and it is no longer available.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 and La Canada, CA. He is the founder of the www.KidneyStoners.org website.

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Well this is depressing. I was hoping to read something positive and that this pain would go away soon. I currently have two stents. I am using voltaren 100 suppositories, targin, Ural, Valium and now something for urinary incontinence. 1st week left stent in, 2nd week left stones laser and right stent in, this week coming right stones lasered. I had no idea I would have such severe pain. Not all the time but it when it comes it is beyond excruciating either in my kidney or bladder. I can’t wait for this process to be over. Voltaren seems to be good but wears off quickly and then I need something stronger. My bladder area hurts constantly. I would not have two stents again at the same time.

jordan

i am 21 weeks pregnant i was having severe pain, went to ER and found out i had a kidney stone they put a stent in because they couldn’t break it up with a lazor due to the baby so they left the stent in for a week it was so painful i couldn’t stand it any longer i went back to the ER and told them i wanted it out they admitted me and the next morning they took the stent out and did a stone extraction to remove the stone which they did but as soon as i woke up from surgery my back was KILLING me i mean the absolute worst pain i have ever experienced similar to the kidney stone i literally was screaming and crying like a baby they finally gave me pain meds and a muscle relaxer which helped at the time but now i’m still having moderate to sever pains in my back it’s been 4 days i’m constantly having to take muscle relaxers and tylenol around the clock and i’m curious how long this is going to last it’s hard to even get a good nights rest because i always end up waking up from back pain. i pray this gets better, for i have had a terrible pregnancy.

Kris

I had a stone removed on the 8th. I woke up in horrible pain. They sent me home even though pain was not controlled AT ALL. Friday i took dialuded and slept all day about 3pm my pain was uncontrolled by the pain meds and i had so much pain and pressure in my kidney that i literally felt like my kidney was going fo explode. After 3 hours of misery my MIL took me to the Er. They gave me stronger pain meds and i was still miserable. Did i ct scan to find out my bladder was backing up into my kidney anf nothing was draining. Called Renal reflux i guess. As soon as they stuck the catheter up there and evetything drained i felt the biggest relief. Had pain all the way until the catheter was removed 4 days later. After catheter was out i was pretty much pain free for 2 days………then the stent was removed which again started the most painful, miserable pressure and pain. I have now been off of work since the 8th and i have only had 2 days pain free. Last night i was up for 3 hours in excruciating pain and pressure. Ive had to aleep in a recliner. It felt like my whole right side of my body had cramped into a ball and my kidney throbbed like it had its own heartbeat. Ive been having trouble catching my breath, fever, chills and body aches for 3 days as well. Urologist just called and said if pain gets any worse i need to get the hopsital for a CT scan. Tghs has been a nightmare 🙁

Lauri

I had my stent removed this morning and now that it’s bedtime I’m in more pain than when I had the stent or stone!!!

Waleska Mendez

Hello trying to see if anyone has gone through this I had stone removal/ stent placement surgery on March 8 2018 slept the first and most of the second day. On Saturday the 10th I was very week and really could not do anything and still in pain took a Percocet and went to sleep come sunday morning 1 am I was awaken by severe pain going up and down my back into my toes and up my neck into my pelvic region took some In profine and was trying to wait it out .My husband ended up taking me to the ER where they did an ultra sound and saw that i still had a stone left . The hospital admitted me because my urine was funky and started me on Antibiotics, naproxin and a pill for muscle spasms. I got discharged from the hospital on Monday 3/12 and was feeling ok just very tired. I took all of the pills that they gave me and tuesday and wed were pretty ok (we’d was the best day) now its thursday 3/15 one week after surgery and I woke up in pain. I can hardly walk /stand (if iam sitting or laying down I am fine)I have three kids so I have to be mobile. I have taken all of the meds again and nothing . Does orh as anyone had this before. This pain is insane !!! And i ve had this nausuase feeling all day long .pleas help if you can . P.S. i get the stent out on Monday 3/19

Kelly

Hello. I have been going through a very similar situation. I also had a stent placed on March 8th i ended up in the ER on th Sat and again on the Sunday then my gamily Dr on the minday. Tyesday was my best day then slowly got worse and today has been horrible. I am just counting down the days till this goes away. I am also havung mine removed on Monday the 19th. I havent been able to do much at all. This has been horrible. I dread everytime i have to pee. Its horrible. I feel when I am really bad I drink a ton of water i would say close to a litre. Then about half hour later sit on the toilet for a bit. It really does seem to help a bit i dont know if it is moving a stone thats lodged or what but its a little relief from severe pain. Oh and its important to dobthat while your pain meds and anti-inflammatories arenworking so everything os relaxed. Sounds crazy but it takes the edge off for a little bit

LORI CARDILLE

Just got back from the ER . I had my stent removed today, March 6, 2018 at 4:00. I started having cramps about an hour later. By 7:30, I was in the most severe pain I ever experienced. Much worse than the stones. It was a 9 out of 10 on the pain scale. My blood pressure was 185/90. I thought I would have a stroke. Happy to say after 8 mg of morphine, the pain went to a 3 thank God. I really thought something had to be seriously wrong. My blood work was good so Dr didn’t do another CT scan. I almost fainted with the pain and am so grateful to not be suffering like I was 5 hours ago. We shall see what the days ahead bring. I’m 64 years old and have had many operations, babies and chronic migraines for years. Don’t think you are crazy if you have this reaction. More study needs to be done.

Hello….
What was the outcome? Did you ever start feeling better and if so.. how long did it take? My husband had husband stent removed today
And he’s is a TON of pain.

Toni

On February 12 I removed my ureteral stent ( had 9 mm removed on February 8) . At first I had no pain at all but about 1 hour after stent was removed the burning pain was unbearable. I had pressure, incontinence, and urgency. I took a Percocet that helped and AZO. About 6 hours of being able to handle the pain and it was back again. Started trying Naprosyn and Tylenol because I took last of Percocet. I am drinking water, and supposed to return to work on Wednesday 14 but don’t know how to do this unless I wear a brief! Hope this is not uncommon and goes away soon!

Anonymous

I also had emergency stone surgery on Feb 9 2018. I had my stent removed by the doctor on the 13 at his office. I was good no pain until now and it hurts just as bad as the stone did. I have put a heating pad on it helps a little. I am back to eating Toradol and Percocet to tolerate the pain.

LAURA MOSLEY

How long did your pain last? I had mine removed on the 7th and still having severe pain…I’m hoping someone can shed some light on how long this may last.

Steve

I had my stent removed on Feb.13th 2018 and as of today, Mar. 23rd, I am still in pain in my lower back where my stone and double J was. Trying pain killers. I have seen my doctor and she says you had a foreign object in your body and will take time. I have a follow up in Aug. at the hospital. If the pain keeps up, will call to try to advance my app.

d.deven57@yahoo.ccom

Had giant stone broken and removed through ureter. My urologist said to expect pain for 4 to seven weeks, diminishing, as days go by. iimmediately, after the procedure– had Toridol IV. – this stopped all pain for the first 6 -7 hours. THE FIRST DAY POST-STONE REMOVAL WAS quite UNCOMFORTABLE, much urgency ( wore “over-nite Depends”- like, incontinency panties– VERY necessary . Don’ be on feet much, if possible. Drink lemonade. DISCOMFORT, BURNING URINATION, CRAMPING, BLADDER SPASMS– NOT AS BAD AS STONE COLIC, NEVERTHE LESS-MISERABLE…WHAT MADE IT TOLERABLE,…DIAZEPAM 2.5 MG TO 5 MG.– STOPS BLADDER SPASMS, Azo cuts burning urinnation, 2 extra Strength Tylenol last about 6 + hours, Was to leave stent in 3-5 days…Accidentally pulled it out on day 4 — thread got caught between toilet and leg as i sat down..Everthing felt great for a few hours then it was pain almost exactly like kidney stone, and huge urgency… right now i have about 5 mg Diazepam and 2 xtra strength Tylenol– it STOPPED spasms, an allowed normal urination, AN EXTENDED BLADDER IN SPASM…DOESNT RELEASE URINE— DIAZEPAM IS GREAT MUSCLE RELAXANT WITHOUT lots of scary paralysis…and it enhances the pain-relieving ability of the Tylenol. THIS IS A BETTER PAIN PROTOCOL. HOPE DOCTORS MAKE NOTE. If you cannot control pain…go to ER… ask for Toradol IV ( the tablets dont work. It may break the pain cycle…and it isnt narcotic ( not Opiod) . DRINK LEMONADE–SEVERAL GLASSES EACH DAY, ACIDIFYS URINE. I ALSO USE AN ANTIBIOTIC AFTER SURGERIES. I hope my experience helps you, i also hope This IS all …over in the 4-5 weeks, and pray for no more kidney stones.

d.deven57@yahoo.ccom

Had giant stone broken and removed through ureter. My urologist said to expect pain for 4 to seven weeks, diminishing, as days go by. iimmediately, after the procedure– had Toridol IV. – this stoppedd all pain for the first 6 -7 hours. THE FIRST DAY POST-STONE REMOVAL WAS quite UNCOMFORTABLE, much urgency ( wore “over-nite Depends”- like, incontinency panties– VERY necessary . Don’ be on feet much, if possible. DISCOMFORT, BURNING URINATION, CRAMPING, BLADDER SPASMS– NOT AS BAD AS STONE COLIC, NEVERTHE LESS-MISERABLE…WHAT MADE IT TOLERABLE,…DIAZEPAM 2.5 MG TO 5 MG.– STOPS BLADDER SPASMS, Azo cuts burning urinnation, 2 extra Strength Tylenol last about 6 + hours, Was to leave stent in 3-5 days…Accidentally pulled it out on day 4 — thread got caught between toilet and leg as i sat down..Everthing felt great for a few hours then it was pain almost exactly like kidney stone, and huge urgency… right now i have about 5 mg Diazepam and 2 xtra strength Tylenol– it STOPPED spasms, an allowed normal urination, AN EXTENDED BLADDER IN SPASM…DOEST RELEASE URIN— DIAZEPAM IS GREAT MUSCLE RELAXANT WITHOUT lots of scary paralysis…and it enhances the pain-relieving ability of the Tylenol. THIS IS A BETTER PAIN PROTOCOL. HOPE DOCTORS MAKE NOTE. If you cannot control pain…go to ER… ask for Toradol IV ( the tablets dont work. It may break the pain cycle…and it isnt narcotic ( not Opiod) . I hope my experience helps you, i also hope This IS all …over in the 4-5 weeks, and pray for no more kidney stones.

MBA

*I had a URS surgery to remove a ureteral stone on 28 November. A DJ stent was also placed in left ureter.
*After 3 weeks, I had suffered from a high fever of ~106 due to infection of stent.
*After 4 weeks, in the end of December, stent had been removed.
*Even after 4 weeks of stent removal, although not very often, I feel very little pain in my lower part (I guess in the bladder) and sometimes very little burning sensation in the ureter
*Is it normal, and if it is normal then after how much time I will be recovered.

Carla A

I had ureterscopy 1/12/18 with stent placed for self removal the following Friday. Unfortunately, I accidentally dislocated the stent on 1/16 while drying off from a shower. The end of stent was protruding from urethra. Doctor asked me to try to keep it in another 24 hours, which I did. I was having no discomfort or pain at the appointed hour, so I simply pulled stent out without taking pain medication first. (I was taking Azo for bladder symptoms and it worked.)

It took me a day to understand that I was getting severe kidney/ureter/bladder pain 60-90 minutes after eating. Yesterday, it was so severe that I was taking narcotic pain reliever. Today, the pain is less, but still significant. I’ve taken 2 Tylenol, and gone to bed. Anybody else have pain after eating and what have you learned?

Anonymous

I also had removal on 1/12/18 and have still been having pain in side the procedure was done on, sometimes close to the stone pain I was having. I also have been getting pains in my stomach when I eat, and bloating constipation and pain all around belly area. I really feel bad after I eat. The doctor is sending me for a renal sonogram Friday so maybe I will find out what’s going on.

GJK

I also had emergency surgery on Thursday ( Jan11/18) and was allowed to remove the stent in the shower today, Saturday. It’s been 2 hrs since removal and I too am experiencing pain as severe as the kidney stone attack itself! Why are the docs continuing to use these stents if there are so many people having so much pain?! It’s crazy! I sure hope I’m not left with this pain forever!!

Anonymous

I had stone removal surgery on 12 jan and a stent was put for 2 weeks (doc said it is put for better healing of urethra). The stent didn’t pain that much except while passing the urine. Later I found out the reason of immense pain which was the back flow of some amount of urine to kidney. It also pained when I used to change my sleeping posture. I would say those two weeks were little painful. After stent removal I had bleeding and also little pain for two days. Today though, I don’t have blood in urine but still I have little pain in kidney and bladder area whenever I walk or change posture while sleeping (people say it is due to the little cut I got in urethra pipe while stent removal, and these will take time to heal. And Its funny, because the stent was only put to heal and now this thing only caused the wounds again) . Sometimes I have bad pain (although bearable) but I can’t think or find a logical reason for that. I hope everything gets fine in a week or two.

Susan J Cade

15 mins after stent was removed I experienced cramps and spasms that continued for 2.5 hours causing vomiting. The pain was intense. However, it did subside and now 48 hour later just a twinge I kidney area. No need for meds. Still pushing fluids.

GJK

Good to hear! Praying that mine will subside soon

dee

iam in so much pain

Pankaj Maurya

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.

Ani

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.

Anna

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).

Brenda Dickison

If u have a lot of stones,have ur parathyroid checked out ,it could be why. That’s what I’m going thru now.8 stones in 1 yr. n 8 mos. They kept getting bigger n bigger.now I have 1 on each side 11cm. Have to have a tube in my back . GOOD LUCK

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

Mohd nazri

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

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.

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

Mandy V

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

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.

Renee

I had my stent removed today in the office and I am having severe flank pain as well. It is as bad as the stone pain. How long did your pain last.

Joanne

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

Mohammed khaja pasha

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

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.

David W Carolla

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

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

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

katherine murray

When I had my stent in I was seeing blood the whole 2 weeks. Pain was bad for the first 3 or 4 days.

JL

Same experience – pain for the first 2 – 3 days but blood (not just pink, red blood) in the urine for the entire time until it was removed. Once it was removed the blood was 95% less and there was still a little bladder irritation.

Glenn and Beverly

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…

jennyct

How long did it take for her to feel better? I am so afraid.

Christina Graham

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 .