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Of note, the medication used in the study, rofecoxib (brand name Vioxx), was withdrawn from the US market in 2004 due to concerns about cardiovascular side effects and it is no longer available.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

Hi everyone,
I had my stent removed yesterday afternoon. I had the laser surgery to blast 6 stones in the left kidney. The biggest one being 8mm. The surgery and stent remove have both been extremely painful! I went back to the ER two days after surgery for sereve pain in left kidney. After my stent was removed yesterday I was in a great deal of pain for a few hours.. I felt better through out the night and all day today. Now it is after dinner and I have sereve pain in left kidney again. :(. I wish I knew how long these waves of pain are going to last 🙁

Ozcar Tapia

My stent was removed 3 hours ago, and I experienced upset stomach and poo some blood. Is this normal?

Colin

I went in to have 2 kidney stones removed
Any way was put to sleep
When I woke up I was told no stones were see
But they left a stent in ?

No I am in pain from this stent and never had any pain
What so ever before going in

So it’s been just over 3 days and after 7 it’s coming out
I hope I have minamal pain after as the stones were gone

Fingers crossed

Mario

I had a stent rwmoved 3 days agao. Day one i jad some pain during pee time aswell as day 2. Day 2 i passed a stone about 4mm stone was saod to be 6mm. Day 3 pain is gone the onlybtjing that worries me is that now i am starting to have pain in my right flank area where the atent was. I didnt have that pain in day one. Everytime i take a deep nreath i get a sharp pain like if its swollen. Any ideas?

Amit

Dear All,
I had my stent removed almost 6 days back and I must say that I have had No major pain from the day of the removal till now, but on and off there is some discomfort. I had my stent removed in an operating room with general anesthesia for 5 minutes. My experience taught me, that the post stent removal experience largely depends on how sincerely one follows the doctor’s advise before stent removal, I was advised to drink 6 litres of water a day and I did that along with meds. I also did not try anything extra, except for lots of fluids, meds and complete rest, Also one should go for the stent removal not based on anxiety but when the doctor feels it’s the right time. My urine was bloody and then yellow when the stent was put in, however, I kept drinking clean water, coconut water and lime juice as much as I could, and in two weeks my uring was crystal clear. I got my CBC and Urine culture done and the reports were Ok, I was given a green for stent removal. I have not stopped drinking around 6 litres of water a day ( 6 -1 litre bottles are marked by me every morning) and my urine has never been bloody or yellow after stent removal and pain is minimal. So, my experience and doctor tells me drink as much fluids as you can. I’m not sure of one thing tough, when should I resume physical exercise like running or brisk walking.

Wishing everyone a speedy and painless recovery.

Warm Regards
Amit

Kent

I had my stent removed two months ago and I am still having bladder pain. When i go to the gym and do cardio it will hurt two days in a row and two extra strength asprin will not touch the pain. If i lay on my side when i go to sleep that also causes great pain. I told my urologist about it last month and two days ago. He blew it off and now i don’t see him for a year. Not that he did anything for it.

Michelle

Anybody have a upset stomach or nauseous after stent removal? My husband removed his Sunday and about 12 hours after he started getting upset stomach and pain in the middle of his stomach above belly button.

Varun

I am having the exact same problem. My stomach has never been more upset. It’s the same kind of pain, but below the belly button. 🙁

i had a hysterectomy on the 4th of April this year along with a bladder repair because my bladder was accidently cut, i have had ureter stent’s in ever since and get them removed on the 17th of may, i guess it should be no surprise to experience more pain from stent removal since i have been in pain so much from indwelling catheter that i had to wear for 14 day’s, got the indwelling catheter removed on the 18th of april to a UTI that i needed 3 prescriptions for and finally went away but dealing with bladder pain spasms and irritated bladder and urethra, now i know what to look out for as every body’s post i have read

Kevin Williams

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!

Kevin Williams

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.

Joe

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.

Linda

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?

Jeane

Oh my gosh I’m not happy 🙁 stent has been in two weeks she removed this morning…it fills like I have kidney stones left in my kidney moving down my lower abdomen I just want to cry 🙁 I hope pain only last 8 to 10 hours of from stent removal.

Nancy

I had my stint removed 4 hrs. Ago and the pain in my back and side is as bad as the kidney stones. I don’t want to be a baby and go to the emergency room but it’s bad! How long did yours last

greg

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.

Tammy

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?

Steve

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

lynda

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

John Groves

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

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

Harry Richards

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.

Steve

Hi Harry, out of interest how is the pain now? Had my stent out today and In quite a lot of pain.

tina

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

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.

Emily AndersonMaskell

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

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

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

Deb Huskey

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

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.

Janice

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

lori roscoe

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

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

lori roscoe

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!!!!

Brenda

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

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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