How is a ureteral stent placed?

Photograph of a ureteral stentIf you ever wondered how ureteral stents are placed, we’ll explain the process to you here step by step. Ureteral stents are typically used in two situations: 1) When a stone is causing blockage of the ureter and drainage needs to be established.  2) After a surgery to improve healing of the ureter or kidney.

Diagram of a ureteral stent in position.

How to place a ureteral stent in 8 steps (with video below):

1. Use a cystoscope to locate the ureteral orifice where urine drains into the bladder. (A cystoscope is a camera that can be placed into the bladder).
2. Pass a soft flexible wire called a “guidewire” into the ureteral orifice.
3. Use x-ray imaging to monitor the guidewire as it is advanced up the ureter.
4. If there is a blocking stone, contrast fluid can be injected using a soft hollow temporary stent. The contrast fluid will outline the ureter to improve guidance. The fluid can also push the stone back up the ureter in some cases.
5. Advance the guidewire all the way into the kidney
6. Thread a ureteral stent over the guidewire and push it up into the kidney using a “pusher”.
7. Remove the guidewire once the ureteral stent is in the correct position. The stent has a natural curl at both ends which will keep it in place. Once the guidewire is removed, the curls can develop.
8. Confirm correct placement of the stent using x-rays and by visualizing the stent in the bladder.

(Occasionally, stents are also placed in the opposite direction, from the kidney down to the bladder. This is done when access is obtained into the kidney during a percutaneous nephrolithotripsy (PCNL) procedure or when it is not possible to place a stent from below.)

Video of ureteral stent placement in a patient with an obstructing left kidney stone in the ureter.

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.

48
Leave a Reply

39 Comment threads
9 Thread replies
0 Followers
 
Most reacted comment
Hottest comment thread
43 Comment authors
  Subscribe  
Notify of

I have been using a lithotripsy machine since 1987, https://chromhearts.com/ I have noticed these blisters do occur it’s not from latex for these machines are latex free, the blisters are from the shock way entering the body it’s not often but it does occur mostly on fair skin individuals nothing to worry about.

Thank you all for your posts. My stent will be removed Oct 14th 2023. I am worried because I have ALL the symptoms of a UTI STILL!! The Physician assistance told me it is because of the stent. Curious. I am so tired of pull ups and three remind pads filling up while I stand and strive to get to the bathroom. I pray after all these months of UTI and one antibiotic after another with no relief, the stone comes out and I can fill healed. I HOPE.

Farrell Lusher

I had my surgery to put the stent in on July 6th and I had it removed yesterday. I am so glad I found this site before I went in. Honestly, the thought of them sticking a camera up me was way worse than him actually removing the stent. From start to finish is was about a minute and there was only one small point that I felt any pain, or maybe it was just discomfort and not really any pain? I did not even feel the stent coming out of me. The Urologist did say I would probably have pain in the kidney for the next couple of days, but so far, no pain at all! The first time I urinated after I got home, I was all worked up and ready for the major cramping in the kidney but nothing! I am so happy now that I can pee and not feel like someone punched me in the kidney!

Farrell Lusher

So I found out that I had a 7mm kidney stone stuck in my Ureter on my left side. The Urologist advised going up and grabbing the stone and putting a ureteral stent in. I had the procedure done on July 6th. I am so glad I found this site before I went in. I was able to ask more questions and be prepared for what came after the surgery. My doctor said it would hurt to urinate after the surgery, but I really did not comprehend how much it did hurt. When I was in recovery, they said I had to pee before I could go home. So they gave me a plastic urinal and I headed to the bathroom. Holly Cow did that hurt!!! I would say it was a 9.75 on the pain scale because not only did my kidney cramped up really bad, it felt like …. I really can’t describe what it felt like, maybe peeing our hot icicles?? I had to sit down after I was done just so I would not pass out. The pee looked like fruit punch. Before I left, I went again since I did not want to have an accident on the way home. That time the pain was a 9.25. The pain went down almost every time I urinated and after about 10 -12 hours, it no longer hurt when the pee came out, but the kidney still really hurt, about a 7-8 on the pain scale. The next morning it was down to a 6 and by the third day down to a 3. The only really good thing for me was the pain mostly went away about as soon as I was done. Kidney hurt a bit for about 3-5 minutes. Luckily for me, I did not seem to need to pee more often than normal.
Here are somethings that I did that helped me out:
1) I took the pain pills, not sure how much they really helped, but hopefully they deaden the pain a bit.
2) I had a heating pad that seem to help. I placed on my side after every time I went to the bathroom.
3) That first night, I ended up peeing in the bathtub because I had very little control on my stream. It was really gross seeing all those blood clots coming out but a lot easier to clean up afterwards.
4) Keep a pill chart. It is easier to remember/ know when to take your next medication

Regenia Frasier

I have kidney stones in my right kidney, went for surgery on the 12th of February, woke up and discovered the surgery was not done, had to put a stent in for 3 week, then surgery again on the 5th of March. One of my stone is7mm which is to big to pass, hopefully they will be able to crush them all, this stent is no joke

Currently struggling with the same story...how did everything go?

I have a similar story…7mm stone in left kidney…stent placed and I have a shock wave procedure done and it wasn’t successful. So now I have to have procedure done again. What happened with your stone?? Did you get it resolved?? Just looking for some answers and advise. Thank you.

Doris

has reduced kidney function. Dr. has inserted stents into his kidneys but has to be replaced every 4 months. He is told there is a procedure that they can do so the stents can be done through the back. Does anyone know what that procedure is called?

Toni

I had my stent inserted through my back, and a tube sticks out of my back and drains into a bag Attached to my leg. When they find out if the stent works, they will remove the tube out of my back, and it will drain into my bladder. I didn’t have stones, I had scar tissue squishing my uriture so the stent is supposed to be permanent for me. They called the procedure nephrostomy, (not sure of the spelling). Good luck and I hope all goes well for you.

vadivel

I have recently stone surgery and some stones are still some stones are pending. Doctor kept stenting. He told to smash those pending stones by machines.

Is it fine?

shiva kumaru

hello sir. my name is shiva. how you removed ur remaining stones sir.?

E Rose

Thanks for the informative video, I had this done successfully a few days ago, the need to urinate feeling passed after 6 -8 hours. Mine remains in for 3 weeks but I was in very bad shape when I was operated on. My Urologist was amazing!

Had surgery aug 11 unsuccessful 2nd attempt on 9/21 I have faith

Rosalind Rawlings

Just had a stent fitted and awaiting laser treatment in 2 to 4 weeks. As this is the first
day I am not surprised to be passing so much blood. Hopefully, that will subside. I
have the constant feeling of needing to pee. It feels like pressure on my groin all the
time. Anyone else suffering from this? Would like to hear from you.

DebW.

I feel the pressure on my groin as well. I also feel pain along the entire length of the stent when I move. I didn’t realize that the stent was in the entire length of the ureter. I’m mentally more at ease now that I know what I’m feeling.

Buffy

I have had kidney stones for 6 months and in two days I will be having surgery number 5!!!!! The first time my Urologist tryed the stent procedure but when I woke up from surgery I was told I still had the stone and that it was extremely impacted into my bladder. I since then have had 2 unsuccessful Lithotripsy. Then a surgery were they put a tube in my back that goes about 6 inches into my kidney and I have a urine bag hanging from my hip. It sucks for a lack of better words!!!! I have had that for 2 months!!!! So in 2 days they are going to try the first surgery again. It has been a very long 6 months of hell and severe pain. I will take any and all prayers!!!!

Michael Meehling

Hi saw your post. How are you feeling now. It seems like you’ve been through a lot. I just had to stones remove one in my left kidney and one stuck in my urethra around my prostate. Laser lithotripsy broke the one in my kidney up And then a stent was placed there and Dr. broke the one in my urethra up as well with a laser. Went back February 8 had my stent removed surgery was on February 5, 2018 A lot of blood in my urine especially when trying to pay I could feel the back pressure running out my Lefew door causing a lot of flank void in pain. Stan was taking out and an outpatient office and that was very painful as well. Thought maybe he would let me pull mine out at home that way I would avoid having the cystoscope placed in my urethra again. Please share your experience with me. thanks I hope everything worked out well for you.

Clayton Perry

I had a stent place last week due to 2 stones blocking the passage
Yes it is a feeling that stays with you and having a not so good feeling
Makes you want to pee more often and pain in the area where stint is
While using the bathroom. Lost one kidney to cancer 7 years ago so this is a life or
Death ordeal for me. Stint to stay in for 13 days and as I understand a string
Is tied to it and it will be pulled out in the doctors office. Don’t
Know what to expect there

Amie

Hi all! On December 17th I got a kidney stone and on the 20th they put in a stent to help relieve the excruciating pain until I was able to have a lithotripsy, which I received a week ago. I have had nonstop nausea and stomach pain since my stent placement. I am so tired of feeling sick all the time! It’s exhausting! Did anyone else get these awful stomach issues?

This week I have started getting those back spasms that are indicative of a kidney stone even though I still have a stent. I was told that I shouldn’t get thirst types of pain. I go in on jan. 25th for my follow up X-ray, but I am wondering if this is common?

Thanks!

benyamin

hello,
my father is 83,suffering from demnetia and recently he suffering repeated urinary tract infection ,followed by urinary blockage.urologist decided to do surgery by inseting stant in the ureter,please let me to know your openian.
meanwhile he benian prostate cancer, and undergone radiotherapy treatment.