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Of note, the medication used in the study, rofecoxib (brand name Vioxx), was withdrawn from the US market in 2004 due to concerns about cardiovascular side effects and it is no longer available.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

Had a stent removed today. I’ve had a stent in me since September the 8th. This one had strings, and it hurt like hell when my doc pulled it out. It had been in me for five weeks, so that may have had something to do with it.

Otherwise, I’ve got some side pain that I needed to take two oxycontin for. Not really terrible, but definitely something I don’t want to feel for two or three days. Also pissed blood for several hours after it was removed.

The stone that I had was 9mm in my right ureter. It was broken up via shock wave lithotripsy on October 21. I passed a bunch of teeny pieces while the stent was still in place. However since the stent was removed I’m starting to pass larger pieces.

I voted in the poll for stent pain a #7. It never really hurt while it was in me, but I knew it was there. Constant irritation of my bladder making me pee many many more times than I normally would.

Glad it’s gone.

Kidneystoner

I had my stent removed 4 hours ago. I have been in severe pain ever since. Not to mention I have to go back in next week for a cysto to retrieve the other stent because there’s no string visible. This is not my first rodeo unfortunately I’m a kidneystoner! However, I’ve never experienced pain post stent removal before. It was so severe that I had to go get a toradol shot and more nausea meds because the pain made me vomit something terrible. I don’t get much relief with the narcotics, the toradol is the best for my stones. I sure hope I can find relief soon. This last 2 weeks have been horrible! Hang in there!

I’m in severe pain after my stint removal today at 3 pm. I thought I would be pain free but it feels as though I have a kidney stone all over again the size of a golf ball. I didn’t know you could have a stone that big, but I did.

Mary

Just wondering how your feeling now post stent removal ? I had stone removed from right kidney, 10/27/2016, stent placed of course, and removed about 5 days later. However, today, 11/10/2016 the pain in my kidney is worsening along with the feeling of menstral cramping, which is not menstal cramping as I don’t get periods anymore. I feel worse now, than I did day of surgery. I am just surprised by this discomfort as I expected after stone removal to feel so much better. I have terrible back pain on both sides. I refuse to take the pains meds as they make me sick as can be even with the assistance of zofran. Any advice would be appreciated. I did call doctors office, spoke to nurse who said there may be some bruising ? But other than that, she said to wait it out another week. Ugh.

Two trips to er, after euteroscopy, first trip, back felt like knives in it, constipated bad, morphine, tests, and hrs on toilet getting unplugged. Went home exhausted after 18 hrs emergency, but fabulous nurses and staff
Next day back to e,r, water all over floor, lay there for hours, no attention, finally X-ray, doc came pulled stent out, no pain killer,
Trying to get surgeon for three days , called wrong number, will know today, but only thing that helps hot baths, extra strength Advil, won’t constipated u. U must take stool softners and Metamucil, or u will suffer.

Janine L Johnson

Two years ago, following stone removal, the stent was left in for 3 days and upon removal, I endured 6 hours of intense pain, worse than the original attack pain. Yesterday I had a stent removed after 4 weeks, due to two different procedures to remove stones and did not suffer at all. I believe it had to do with the speed with which the stent was removed. Previously, the nurse just yanked it out. This time I asked her to do it slowly and she did. I think this had a lot to do with not traumatizing the kidney itself with unnecessary and violent movement. Some nurses just don’t know what they’re doing or just don’t care.

Teresa

I’m a 51 yr female. Had laser on 9.5 stone Saturday that got lodged in tube near right kidney. I have a stint with string and around 11:30 I took a hot shower and the sponge got tangled in string. It pulled and was very uncomfortable. I am now unable to control my pee the medicine they gave me stains everything and pee pad is not working so I read this site and got the courage to pull it out early. It suppose to stay in a week. I had the emergency surgery Saturday (during Hurricane Matthew). My pain is worse now than when I had the stone!!! I’m taking hydrocodone acetaminophen 5-325 just took one with a nausea pill the prescription says 1 or 2 every 4 to 6 hrs. I also have hydromorphone 2 mg (I haven’t tried this). I don’t know want to go back to the ER of this is normal… I’m gonna try to wait not sure if I should go ahead and try another hydrocodone or the hydromorphone… I also read Aleve works wonders. Also extremely constipated… Any suggestions… Currently don’t have insurance so trying to avoid unnecessary costs bit this pain is noooo fun!

Stephanie Starr

Teresa I’m having the same issues had my stent removed today and 2 hours after I got home the pain started. How long did it take for your pain to stop

Dena Meyer

I had stent removed yesterday and they said the pain would start between an hour or two after removal and last a couple hours. The pain started shortly after I left the office and I had intense pain (worse than stone or surgery) and Kidney spasms for about 6 hours. Now today is better but still feel a twinge of pain here and there. I was not prepared for the pain I felt after stent removal.

Tara

Hello Teresa! I was reading your post and I can’t believe that u and me are same lol! I did went to ER on Saturday evening after I took a nap with very bad severe pain and feel like someone have put knife in my back! I was screaming and I couldn’t be still and it hurts so bad feel like I am dying. I was waiting for an hour to get me in IV and gave me pain meds. Abt 30 mins later I was rush to ultrasound and my ER dr called my urologist dr he came to rescue me! I didn’t know he will come bc we r in middle of hurricane Matthew! He came in my room told me immediately that I need a emergency surgery on my right kidney and he saw big stone sitting on my kidney that couldn’t passed. He placed the stent in my right side and stayed in hospital for 3 more days. Recent on 10/28 I have other surgery to do laser and blast the stones.He gave me pain meds then last Friday I removed my stent. I still get pain from there and here. Yesterday I already out of my pain meds. Well last night I got fever over 100 and I took tyendols. I jus don’t know if I need go to ER or call my urologist dr or call my family dr??? Thanks!

Leann

I had my stent removed yesterday after having it in for 10 days after having kidney stones removed I’m having severe abdominal pain, not sure if this is normal or not but the pain is excruciating and I don’t know if I should go to the er or just deal with it

Modie

Definitely make sure you have some pain meds from your dr. I think the pain post stent removal is pretty normal and obviously super frustrating. Pain meds and HEAT are really helping me through. This morning i had a post stent flare up (almost like initial contractions pain in kidney/back area) and once i hopped into a hot bath the pain seemed to drop by 50% almost instantly. Im not convinced my pain is helped by the meds at all?!?!
I read a couple threads on here saying icing the area of oain really helps some people as well.

Good luck! Keep us posted

Robert Hill

I believe it is normal. Here’s why. I have a CT scan of my right kidney when in severe hydronophrosis. And another 3 weeks later after a stent had been placed. The first shows a very large kidney, the second my right kidney is smaller than my left. The stent allows the kidney to drain 24/7. Normally there would be a pressure buildup, since the ureter is usually closed. While the stent is in place, no pressure. Remove the stent, it all has to go back to normal. Since pressure buildup is what causes the pain when a stone plugs us up, pressure buildup back to a normal state probably causes the pain when the stent is removed. My dad says it lasts two to three days. Guess all we can do is deal with it, and hope for the best.

I have a second stent in me now. And a bottle full of oxycontin from both the first and second ureteroscopys. Guess I’ll make sure to save some for after the second stent is removed, whenever that may be.

Robert Hill

The above is just conjecture on my part. I am no expert. But when my right kidney swelled up much larger than my left after getting plugged up, it hurt like hell.

Now my right kidney is noticeably smaller than my left. Cannot help but believe, that when it returns to normal size after the stent is removed, it will, once again, hurt like hell.

Take it for what it is. I’m happy my doctor gives me copies of the CT scans.

Xxx

After server flank pain, I was diagnosed as obstructive bilateral ureter calculi of 8 mm -13mm in each ureter. Immediately I was taken to Op. Theatre and lithotripsy was done on both the sides on 3/9/16. The same day Double J ureteral stent was placed on both the ureters. I was bleeding for 24 hrs post operation. Pain was huge even on medications. The next day pain faded away. I was given tamsulosin for 14 days. Tmrw I m gonna be removed those stents. After reading those above reviews, I feel nervous. God must help me. Will post my review after I get removed my stents. Buh byee.

Xxx

Xxx:
As I told, today I had removed my bilateral stents in the operation theatre. I was given local anaesthetic drug injected in. Then they applied some gel like substance to create numbness on my pipe. But I had no numbness feel. I was on little pain while they pulled out my first stent. Again doctors asked me not to be rigid while pulling out the sent. So, on removing the second stent, I was relaxed and the pain was not more. So don’t be in panic. just make yours muscles relaxed.

Pain.. I didn’t get any pain after removal of stents. only discomfort is, burning sensation during urination is there. it will gradually get faded after a day I hope.

I hope my experience on stents will make ppl be calm without any fear.

Thank you dudes.

Tammy

So today I had my stent removed in doctors
Office. No string and I was scared to death about this procedure.
Worst part was the stinging from gel on the scope. Process was max.. 20 seconds if that. It was nothing like I thought. More uncomfortable feeling then pain.
Cramping just a little tonight and hurts when I pee, but pressure feeling in the bladder is gone!!!!

Karla

God I hope my experience is the same . I’m going tomorrow to have my stent removed.
I haven’t had so much trouble with it as long as I stay fully hydrated at least 60 Oz to 1 gallon of clear liquids a day. drown self over here. BUT even then I do experience days that I have lots of flanks pain burning after urination and blood in urine. WHICH they say is normal .
Trip to the ER 10/10/16 lead to x rays and ct Scan. they put a Stent in and I was in the hospital for two days due to massive infextion the kidney stone cause. 10/27/16 I had the lithro.done that was super painful.
I have had two children . One c section , one natural and I have to say this has been more painful than both together.
Pain medication -percocet and dilaudid haven’t really knocked out the pain. Just numb it a little and make you pass out .

Good luck all

Zandria

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…

Lydia

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.

Crystal Rost

I had six 3cm stones 3 in each kidney and one lodged and the stent put in after surgery I had the stent out today but took two days off and am hoping to go back to work tomorrow

Had a 9mm stone removed on Tuesday 27th sept & my stent removed on sept 30. I experienced Severe pain Immediatedly, similar to a kidney stone.
Have been experiencing the pain 3-5 hrs daily.
I’m praying it stops soon.

Stacy Hill

I know how you feel. Took stent out yesterday, sent me back to ER. It was worse cramping then the kidney stone. What I dont get is that Dr told me I could go right back to work the day after surgery with the stent still in. I am thinking is he crazy? I have high pain tolerance too.

Modie

Lol no youre not a wuss. I had a stent pulled at 10:30 this morning. Only mild pain in my kidney area twice for about 30 min at a time. Other than that i felt freaking great! Until about an hr ago and now im going through pain in kidney area that is definitely comparable to the initial pain of the contractions. My muscles are tense in the area but not rock hard…. ugh but close. Not so sure about work if this keeps up. I took a double dose of my pain meds and dont feel like its having any effect. You’re not a wuss and from what im reading online not that uncommon. The first time i had a stent for stones the post stent (and stone) troubles were almost worse than the stones themselves. I had a lot of bloodclots that time (not this time though). So we’ll see.
Hang in there. That sucks you have more stones to go 🙁 tell the dr!!!

Johnny

I just had stent removed 2 hrs ago. I read u had clots. The other day I had severe pain for about 2 hrs. Passed clots and pain was gone.today I have similar pain and passed something looks like clear clots tiny blood amounts in it still pain reckon it’s clots hurting.

Sandi

I had a 17mm stone removed on 10/5/16. Today I had the stent removed. The pain was minimal during thd removal, but about 2 hrs later extreme pain hit me. The worst pain I’ve ever experienced (and I’ve had a vaginal child birth!) I understand the reasoning behind the pain. The ureter has been held open by the stent all this time and now the kidney has to experience pressure after all this trauma. I made it through the pain, had to call my husband in for the rescue, Toradol and heating pad was the only thing that finally helped. The narcotics didn’t touch it. I was seriously terrified and would have called an ambulance if my Dr hadn’t told me to expect the pain. He said I would be compelled to go to the ER but to wait it out. I waited it out for the longest 2 hours of my life! Now I’m scared that the pain will return once pressure builds up on the kidney again. I’m going to pre-medicate tonight and hope for the best.

ken

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.

cherie wiggins

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

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.

Jewell

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.

Modie

Female bits i assume? Did you have any luck with this? I have heard of guys getting an injection if something into the urethra area but my dr said no. Always be sure to hassle your dr!

Missy

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.

Ryan

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.

Dave Wilbers

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.

Lisa

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

syed

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?

Modie

From what im gathering maybe 0-5 days that the pain can turn on and off. I felt amazing this morning after getting my stent pulled but now the pain came back and the meds arent cutting it (9 hrs later). If your meds are working i think you should be thankful! :p im totally asking my dr about yours

Jorge Pedraz

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 .

Janet

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…..

Janet

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…

man in pain

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

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

Janet

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?

Matthew

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

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

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!

maritza

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

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