From a Patient’s Perspective: The Ureteral Stent: Friend or Foe?

Even though different people respond to stents in different ways, I suspect anyone who’s ever lived with a ureteral stent remembers the experience.  I have had two, and both were, indeed, memorable.

Prior to undergoing a pyeloplasty, (a surgical procedure to correct a urinary tract obstruction) I was informed that a stent would be in place for about seven weeks.   I also recall being told, or perhaps reading, that such stents cause “discomfort” in some patients.  In my mind the term “discomfort” equates to nothing more than an annoyance or a nuisance, so going into the surgery I was not overly concerned.  For the first couple of days following surgery, perhaps because of post-surgical pain killers, it seemed the stent would be absolutely no problem.  I could hardly feel it.  “This will be a piece of cake,” I thought.

Then, shortly after going home, I became increasingly aware that some apparently sharp object was attempting to drill a hole through the wall of my bladder.  In fact, the image of a shish-kabob skewer came to mind.  At the same time, there was the sensation that something was tugging on my right kidney, trying to pull it down from its usual location.  It was difficult to find comfortable positions…and it felt as though gravity was becoming my worst enemy.  Urination was frequent and painful, and my urine continued to be bloody for the entire seven weeks.  Involuntary tears came to my eyes and waves of nausea were common.  Finally, I discovered that sitting in a recliner and tipping it back approximately half way seemed to relieve the worst of the pain, and that allowed me to get a little sleep at night.

After seven long weeks, I welcomed the removal of that first stent.  A generous application of lidocaine made the procedure entirely tolerable, and I watched on the monitor as the stent was grabbed and the upper curly-cue began its descent down through the ureter.  Once I was free of the stent, the relief I felt far surpassed the minor discomfort associated with its removal.

About a month later, I accepted a second stent with guarded optimism.  This one was placed following lithotripsy for a 1+ cm stone in my left kidney.  It seemed logical to me, since this ureter was not compromised or swollen, that this stent should not hurt nearly as much as the first.  Unfortunately, I was wrong about that. Once again, the same familiar painful and distressing physical sensations returned.  And once again I sought relief in the recliner.   The stent allowed stone fragments to pass, but I was elated to be rid of it after only three weeks.

The second stent experience left me with a new determination to do everything I could to prevent future stone formation.  If making a few adjustments, such as drinking much more water each day, can prevent new stones and another stent placement sometime down the road, then I was ready to change old habits.   Accepting the inevitability of new stones, then treating them as they become problematic, is no longer acceptable.  My new plan is to be well-informed and pro-active and do all I can to discourage new stone formation.  In fact, it’s the vivid memory of previous painful stents that continues to be the most powerful motivator.  In a way, then, those stents are still serving a most valuable purpose, and I should remain grateful for them.

Editors note: Bonnie writes about her experiences as a stone patient in her posts. If you have experiences as a patient you would like to share, feel free to add a comment or send her an email at: ask@kidneystoners.org

 

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151 Responses to From a Patient’s Perspective: The Ureteral Stent: Friend or Foe?

  1. Donna says:

    Hey just a tip! I have a strange kidney with two tubes coming out instead of one, so I had to get two stents instead of one for a 6mm stone…

    I have found, besides the bladder spasm pills, that the greatest relief is carrying a bottle of cold ice water to the bathroom with me. I sprinkle some cool water on the tissue paper and press that against my urethra area as I pee; this GREATLY relieves the spasming/tense feelings that follow peeing. Try it!

  2. JoshuaRR says:

    Here was my journey (scroll down for my concrete three lessons learned if you want to cut to the chase)

    Day 1 (surgery day, Friday 10/3)-Laser used to zap 2 8mm stones in my left kidney. Took hydrocodone and the dye pills as recommended. Pain when urinating (PWU) was a 5 out of 10, with 10 being lying on the floor praying for death (as happened when I first had a stone attack and didn’t know what was going on). Lots of blood in urine, as far as I could tell with the dye stuff. Little to no discomfort except while/after urinating.

    Day 2-Drug regimen as usual. Incredible pain while starting to urinate, as if my kidney was being gripped in a glass-crusted vice and squeezed. Pain would build and then recede. PWU 7 out of 10 pain in the morning, moving to “almost 9″ over the course of the day-a tiny bit more and I would have been vomiting. That night, I wake up in the middle of the night to pee and pain levels had retreated to 6. Used deep breathing techniques to mitigate the pain. I discover that I can manage the onset of the pain a little by controlling how fast I let my bladder empty each time I’m in the bathroom, essentially replacing a massive wave of pain with several smaller waves as I start and stop the flow. Heating pad seems to help (I use this every day during recover) Can’t poop, take stool softener.

    Day 3-Drug Regimen as usual. PWU down to 5. Still no fun at all, but more manageable. Start to notice some general discomfort at times other than urinating, but it’s genuinely just discomfort, not acute pain by a cute name. Waves of pain seem to last a little longer, but since they are less acute it feels better. Take stool softener again, keep fingers crossed. Later that night, stool softener kicks in, much to my relief.

    Day 4-Back at work. Dropped the hydrocodone for over-the-counter ibuprofen, max dose regularly. Dye pill stuff as usual. Pain is manageable and I keep to a very regular bathroom schedule, having found that when I pee with a full bladder, it doesn’t hurt as much. Also, chamomile tea seems to make it a little better-could just be the heat or could be something about the herb. Pain levels vary between 4 and 6, but I’m able to work at my desk 6 hours or so. No longer need stool softener, all systems are “go”. Take a hydrocodone before bed to ensure that I sleep.

    Day 5-PWU has dropped to a 4, more like a really strong pinch deep inside than the ground-glass feeling. Still seeing lots of blood, and feeling the need to urinate more often, but controlling it by sticking to the schedule. Over the counter ibuprofen and other meds as usual.

    Days 6-11- Pain stays at around a 4, but I gradually reduce the over-the-counter ibuprofen so my guess is that the pain was actually less but I was masking it less as well. The waves of pain seem slightly shorter as well. I really don’t like the idea of too many pain killers, but I take a full OTC dose before bed so I can be sure to sleep. Working most of the work day, and keeping to a bathroom schedule becoming less important. Less blood in urine, and I move to 1/2 dose of the dye gradually. Actually had 3 days of no OTC Ibuprofen except at night to make sure I could sleep.

    Day 12&13-Stent must have moved, PWU moves back to a 6 and the waves last longer again. Nowhere near Days 1 & 2, but noticeable more painful than it had been for several days. I go back to max dose of OTC Ibuprofen and dye, and notice much more blood again. Fades back down by bedtime on day 13. Seeing larger drops of blood in the toilet, almost like clots.

    Day 14-Can now go to the bathroom whenever and up my water intake since I don’t need to be on a schedule. Take a full dose of OTC Ibuprofen as I had a very busy day planned at the office, including several public presentations so needed to be as close to 100% as possible. PWU levels back down to 3, with very short duration.

    Day 15 (Friday 10/17 two weeks after laser zap)-pain levels down to 1, no meds. Stent comes out via cystoscopy at dr office. Started off uncomfortable, got very painful for about 2 seconds then just uncomfortable again, and some of the weirdest sensations I’ve ever had. Needed to pee right after, and keep feeling that way for several hours. Drank lots of water to keep things going the right direction. Fresh blood in urine, but only a little stinging and that’s been fading.

    Happy it’s over!

    Lesson 1: It’s really painful for a few days. It does get better, but if I ever do it again I’ll take at least 4 FULL days off work if possible.

    Lesson 2: It’s awful at times…but I knew why and had some control, so I’ll still happily take the last two weeks over actually trying to pass two big stones-which could attack at any time. (first attack attack ever was 2am…Christmas morning…in a hotel…in Paris)

    Lesson 3: Follow the doctor’s orders. I stayed within the parameters he set for reducing medication/switching to OTC so I had comfort that I could go back up whenever I needed to.

    Bonus lesson: I’m thankful that I live in a time when all these treatments exist, even if far from perfect.

    A ton of thanks go out to my team in the urology dept. at my hospital. You all rock! Great communication, followup, and rapid response time to queries.

    Good luck, fellow stonethrowers! Stay strong!!
    -JRR

  3. Lyn says:

    Oh, and don’t even get me started on the bladder spasms or the incredible pressure when I pee! Feels like I’m involuntarily trying to push out another child! Anyone who has the spasms, the only thing I can say is keep on your meds! I’ve been given pyridum (sp?) and it works wonders as long as I don’t miss a dose. I call it my OPP…orange pee pill lol

  4. Lyn says:

    I have had bilateral stents in since Sept. 11th. Nothing to do with stones, I had a surgical procedure that caused damage to my bladder. I also had a cath for 3 weeks. I thought ALL of my discomfort and pain came from the cath and couldn’t wait to have it removed. Once it was I realized that all the ‘sharp poking’ pains were coming from the stents, not the cath. The urgency to pee is horrible, the stents are always feeling like they’re moving or poking me. They come out next week and I CAN’T WAIT!

    • Ani says:

      my mom had stents placed in both her kidneys 2 weeks ago and had 2 kidney stones removed from the left kidney ( I don’t remember the exact size) Of course she is having lots of pain as suspected but she is also having lots of bleeding and blood clots come out. Does anyone experience this problem or know if the bleeding is normal after stent placement.

  5. Kathy says:

    Anyone out there ever had bilateral stents? Am going in for PCNL on right kidney with bilateral stents placed. They will be taking out the left kidney stones 4 days later via the ureter. Am hoping they will remove right stent at the second operation. If not, I anticipate some real discomfort from what I have read. Urologist assures me that the tube in right kidney will be what really bothers me (not the stents)- it comes out after 1-2 days.

  6. Rich says:

    Earlier this week I had a 6mm stone fragmented by laser. A stent (with an extraction string) was placed during the procedure. Two days later the stent was removed. I was very uptight about how painful the removal would be but it was removed in about two seconds without a lot of discomfort.

  7. Cathleen House says:

    I don’t have kidney stones but have narrowing of the urine tract, where I’ve recently had a stent placed also some of it removed (two weeks ago yesterday), I’ve been having a lot of pain and a constant tugging feeling from my bladder due to the stent, like the whole gravity sensation and after reading these comments I feel like its going to be ok and I am normal!
    So thank you all!
    Can’t wait to have this removed next month it can’t be as bad as the pain I’ve had and at least it can hopefully save my kidney

  8. Sherri says:

    I had a stent placed on 03 Aug due to a 14.6mm stone obstructing my right kidney. Creatine level was high and my GFR was 28. I’m very thankful that the stent relieved the blockage and my lab results have returned to normal. I have since had unsuccessfully lithotripsy and awaiting approval for laser treatment. The pain I have experienced from the stent varies from just a dull irritation to excruciating pain where I have been afraid to urinate. I am also experiencing incontinence on a daily basis. My doctor does not like to prescribe narcotic pain meds and I have went to the emergency room twice due to extreme pain and infection. I want the stent removed
    but I know the stone will just obstruct the ureter again.

  9. Steve Saunders says:

    I have had a stent in almost continually since October of 2013 due to stricture in left ureter.

    Now following bouts of sepsis, 13 emergency admissions, 6 ops I am due to have a pyeloplasty in a month or so time.

    This latest stent has been in for about 8 weeks and is now causing lots and lots of pain.

    I am currently taking paracetomol 1gm 4 times a day and up to 60mg codeine 3/4 times a day.

    I am now at my wits end (so is my wife I feel) and cannot relate the feeling as being “discomfort” any longer. It is now pain on level 8 out of 10. Pain is in several areas. bladder, ureter (midway point, I think), perimium and kidney front and back. Opps, nearly forgot… left testicle as well.

    On the good side… Have only had one stent removed under a local (Lignocaine) and felt nothing. Over and done with in less than a minute.

  10. I have suffered from kidney stones for about 5 years, off and on. Most recently, my last one, prompted my doctor to have me more thoroughly checked out after I had experiencing severe bloating. After a panel of blood tests, they revealed that my GFR (Glomerular Filtration Rate), which measures how effective one’s kidneys are functioning, was hovering around 30, only a few points away from renal failure.This alarmed my doctor and set forth a series of x-rays and ultrasound that revealed that both of my ureters were dilated indicating I was experiencing an obstruction of some kind. A stone was also discovered and had passed over several days, but remaining concerned about the dilation, my doctor sent me to a urologist who ordered a CT scan immediately followed by stent placement in both ureters suspecting that I may possibly have lymphoma. I have since had a full body CT/PET scan, both of which revealed that the cluster of lymph nodes in the area of the ureters were enlarged along with one other location under one of my armpits. A series of blood tests drawn over a greater period of time also indicated that my lymphocyte count dramatically dropped from 28 to 13. I’m now awaiting a biopsy to confirm what’s going on.Although I believe the stones were medically induced by having taken Triamterene for six years, in my case, I view the last stone as a “lucky stone” as without it, this new discovery would probably never had been made.I will submit that the stents are completely aggravating leaving to feel most of the time that I have to pee real badly (I equate this to Chinese water torture…no pun intended), I am able to find similar relief from both sitting and when I’m horizontal. Blood almost always accompanies urination, often times quite bad, and terminating a stream of urine often sends a jolt of pain through me that literally makes me shiver. It is dreadful. My urologist tells me that, depending on my success with a potential regimen of chemotherapy and/or whatever else they may deem best for me, while the stents are meant to be temporary, I may have them for up to six months or longer. I dread this possibility along with a firm cancer diagnosis, still forthcoming, which conveys to me that I probably have a very long and challenging journey ahead. In light of all of this, I still view that little stone as one of the greatest blessings of my life for setting in motion an early detection of something far more serious.I would like to note in closing that Triamterene has a known history for causing kidney stones as well as raising glucose levels. If you are taking this medication and have either (or both) of these two known side effects, consult with your doctor.

  11. Colin Payne says:

    I have had a stent placed in my right ureter 4 days ago while I wait for to have a 7mm stone to be destroyed by laser. This is my second stone in 3 years and I am very eager to adopt habits that will discourage any more. This is the first time I have had a stent and from some of the stories I have read I feel I have been quite lucky. I have had very little back or groin pain and I am controlling it with ibuprofen. However the constant feeling that I need need to use the toilet is driving me crazy. It happens when I am standing or lying down and I have had to start sleeping in an armchair wih my feet on a footstool. I am desperate for the surgery so I can get back to normal.

  12. jane edison says:

    Just had a second stent put in Aug. 25/14. My problem is bladder tumors and my first stent was unbearable and had to be removed in a week. This one is not as painful but I can feel it in my left lower back. Removal date in 10 days. With my first stent child bearing was easier and I went thru that with no meds. Lol. Good luck to u out there. There is an end in site. Must get back to my heating pad.

  13. jane edison says:

    Just had a second stent put in Aug. 25/14. My problem is bladder tumors and my first stent was unbearable and had to be removed in a week. This one is not as painful but I can feel it in my left lower back. Removal date in 10 days. With my first stent child bearing was easier and I went thru that with any meds. Lol. Good luck to u out there. There is an end in site. Must get back to my heating pad.

  14. Emma says:

    I’ve had stents for 4 years due to blockage from infection and have to say the pain is awful and makes you feel down. I ended up on large doses of opiates and antidepressants… Stent removal is a piece of cake and takes seconds so no worries there, I’ve opted for nephrostomy this time as cannot bare the pain of the stent.

  15. Those of u waiting to have this done, I agree having read all the comments
    I wouldn’t of gone for 6 stone removal and a tenting
    In my right kidney, to return in 6 weeks for the last
    Large one , but I’m glad I have, I agree that if u
    Can lie tilted back and take regular pain relief it is bareble , I find
    When I need the loo it ats the end when I feel
    Very sore for seconds, incontience pads are a must
    It upset me at first but I’m alive and greatful .
    My greatest fear is doctors being tight with meds
    But it’s ok if u have enough . If u are in to much
    Discomfort u can always have the stent removed, I’m a wimp
    And I’ve done 5 days have 5 weeks left will let
    U know if I keep it in.
    I never realised stones varied mine are tough
    Typical , so from now on I’m going to be good
    Luck everyone x

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