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, Pasadena, and La Canada, CA. He is the founder of the website.
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39 Responses to How is a ureteral stent placed?

  1. dolores says:

    I have had kidney stones 8 times in the past year. on labor day I was admitted to the hospital yet again with a severe kidney infection in right kidney to find another stone a stent was placed and I am have surgery 9/21 to have stone removed I was also told I have scar tissue and a balloon type thing would be placed in my tube to expand it I have a fantastic urologist and the pain meds are Percocet and for urination with out pain I recommend asking your urologist for phenazopyrid its a small dark pill that helps with urination pain I am pain free hopefully this will help everyone experiencing pain with stents

  2. Robert Hill says:

    On me, they had to push the stent past the stone. The fluid did not push the stone back up into my kidney. The stone is tightly wedged in place, the Doctor was unable to get it out. He’s going to try again on the 29th. He’s hoping that by putting the stent next to the stone, it will expand my ureter and allow him better access to the stone. Man, I hate this stuff!!

    If he cannot get it out next time, I guess the only option will be to go in and get it physically. YUCK!!!!!

  3. Marietjie says:

    Hi I got a stint today in my right kidney after CT scan showed a stone of 11.9mm. During procedure they used laser and could only remove half of the stone. My question is will I still experience alot of pain until the stint and the other half is removed?

  4. Rob 50 says:

    I have had 4 kidney stones in my lifetime I just recently had outpatient surgery to have a 3 millimeter Stone removed and have a 2 millimeter stent put in between my kidney and my bladder I have found That there is persistent pain when you urinate But as you know you have a constant urge to pee If you will allow yourself to relax And let yourself basically feel as though you are peeing Let your body relax the pain will subside and you won’t experience as much cramping because you’re trying to hold back your urine my friend I am 50 Try using a guard There isn’t really much else I can tell you but I do believe this advice will help some of the pain to subside during your time with that stint in your body they suck Keep in mind that with the pain subsided and this will be only temporary the embarrassment I mean of going to the counter and purchasing a leak guard I have found I’m most comfortable with depend real fit but it’s only temporary:-(

  5. Irfan says:

    Dr mike I hav done bilateral ureteroscopy for bilateral ureteric stone removal with laser lithotropsy and they told me that there was severe obstruction in left ureter so they did ballon dilatation also with insertion of bilateral dj stunts 24.11.2015
    Now stunts are causing me more pain and difficult to tolerate. But I still hav a 2.5 x 1.5cm stone in left lower calyx they advised for me PCNL on 4.01.2016 after 5 weeks and they told me they will remove stunt during PCNL and they will put a new left ureteral catheter for few days.
    Now I called my docter and told him regarding pain due to stunts. He told that if I have trouble with stunt they can remove it after 2 weeks and can put in left ureter again at time of PCNL. My question is

    1 is it safe to remove stunt now and to place it again at PCNL as in my mind ureter will still hav inflammation after removal of stunt and reinserting stunt can be difficult
    2. PCNL is safe to do just after 6 weeks of ureteroscopy or better to giv some time to settle down thing as left kidney stone is silent, and better to do after 4-5 months interval

    Plz reply me for satsfaction thanks

  6. Irfan says:

    Ureteral guide wire can cause injury to ureter or it is safe

  7. Michelle says:

    I had Uterine Cancer stage 2 in 2013-2014. I was recovering from the Chemo and Radiation, as well as a total Hysterectomy. I was Cancer free. 7 months later I went for my first PET scan and it was discovered that I was in the first stage of Acute Renal Failure, my ureter and developed so much scar tissue from the radiation that urine was backing up in my kidneys. So, I was Stent ed and now I have to go into surgery every 3 months to have my stents replaced. The pain is excruciating for the first 2 months after placement and it never gets better. But, I am thankful to be alive. For that, I will endure the pain.

  8. Maritess says:

    My mother is already 75 years old and she has been in the ICU for 8 days now, her right kidney is no longer working and the left is being cateteered because a stone has been seen there. Because of this her lungs are having water now but as of today it has been minimized. And the ventilator and oxygen were just removed today. The doctor said she will undergo the STENT procedure and then SHOCK WAVE after. Is it alright to undergo both at her age and her condition? Please advise.

    Thank you,

  9. shari says:

    i had a renal stent removed yday. How is the body positioned during this process? Bcuz my lower abdomen is sore.

  10. Nadine Kebodeaux says:

    I recently found out I have a 3.4 mm kidney stone lodged in the ureter between the kidney and bladder. The urologist is planning to place a stent in the ureter on the 21st because I have not passed the stone to my knowledge. He says a string will be attached to pull out the stent after a week. My question is since I only had bad pain on Feb 6th for one hour and on Feb 26th for 5 hours, and no pain now, how will I know when I pass the stone from the ureter. Also, I had radiation to my pelvic area in 2006. Will this increase the danger by having the stent inserted since the radiation shrunk the tumor I had and possibly other things. Please advise me.

  11. Melene Nahodil says:

    My husband had a stent put in place a week ago. There is constant blood in his urine, and blood clots. Is the stent causing the clots and should it be removed?

  12. Abdulwahab says:

    I had a 6 mm stone in my right kidney and was taken to ER twice last Sunday and was sent home twice with different pain killers and given appointment with the urologist for following Wednesday. The pain was extra ordinary when I saw the urologist on Wednesday I fell in his clinic that he had to call the hospital to arrange a room and have the surgery to place stent. He and the sergeant both advised me that the shock wave could cause other damages i.e. Blood pressure if it hits pancreas or damage in the kidney. Yes the stent might be a painful solution but safe and they placed stent last Thursday and now I feel very much relieved. I am having pain with pee but that is fine. The urologist gave me three weeks until the stone passes out. He has already booked a day surgery after three weeks either to remove the stent if the stone passed out or to go through the stent and reach it and remove it thenremove the stent too. He advised that I can not have the stent stayed inside for ever as it is not right or recommended. Now I feel much comfortable and less worried as my kidney functions right and stent helps the urine to flow without having the stone blocking the path. I am not taking any pain killers any more as I am able to stand the pain caused during the urination as the ureter shrinks to prevent the urine from travelling back to Kidney which at this time presses the stent and that causes the pain. Imagine how God created us as for every function there is a purpose that no one else can relate this system but only Almighty Allah.

  13. Sharon Williams says:

    I have a family member that had kidney stones removed. The doctor put stints in the opening of both kidneys because he said there were stones to far up for him to remove, and the stints would allow the stones to flush out of the body. This took place about one and a half years ago, the stints have never been removed, the family member has bloody urine and can’t do physical movement because of the pain. The doctor has told him he would remove them for 13,000.00 dollars, which he doesn’t have. My question is are the stints causing serious damage to his body?

  14. ANNA says:

    Always pain at lower right site and feel pain at my lower abdomen when pee sometime and very hard to stop pee because feeling pee continue but just a bit come out.

  15. nadeem says:

    My father age 77 diabetic MRI says cancer spread bit in bladder and bone doctor advised stenting pl advice at this age what to do
    If at this age stenting n removing of stent can damage his health further
    Please urgent suggestions

  16. Pingback: Understanding Ureteral Stents | Urology Care of Central New Jersey

  17. kate says:

    my dad has history of kidney stone. Last Thursday he had bad pain, went to urgent care, urine and blood were collected both show clear of bacteria, CT next day review 6mm stone in one of his kidney fever and 101 appeared on the same day. Went to ER, they decided that he needed an stent to relief pus that was build up from infection. And i was told he has sepsis, because of hi fever from kidney infection. Post stent surgery, his temp shoot up to 106, was admitted to ICU, its been 2 days post procedure, he still have fever of 39.9C and despite vanco and myromycin?antibiotic, fever won’t go down, unless we give tyleno, but fever shoots back up after 4 hrs or so, it is never gone totally. culture from urine sample collected after the stent, show that enteroccocus was found, however, i was told preliminary result did not show bacteria in blood, but they say long time is needed to have the final blood result. Now i wanted to know is it normal to have hi fever like this after placement of stent? and will it be possible that the stent procedure is actually the one causing such high fever? i am very worried because, my dad is over 65 and i am worry prolong hi fever will effect other organs in his body?

  18. Sharon Lightfoot says:

    I went to ER on November 1 with excruciating pain in left abdomen. Scan revealed large kidney stone blocking ureter. A stent was recommended. I was taken up to Urology area. They told me it would only take about 5 minutes. They only gave me the “Laughing Gas” that I’ve had in dental office. The 5 minute procedure turned into 45-50 minutes. It was torture and horrible!! I didn’t realize that a resident doc was doing this. After I screamed and yelled at them several times the regular dr came in and finished the procedure in 2 minutes. I have been reading lots of articles online. Every article states that the procedure is done under anesthesia. Is it common to not to do this without going under? I am supposed to have the kidney stone removed in 2 days. I was told that I would be under general anesthesia for this. I’m very nervous.

    • Dr. Mike Nguyen says:

      Ureteral stent placement is usually done under general anesthesia. However, it can also be performed under local anesthesia (just numbing jelly) or sedation (like what you received). I don’t think there is good data on what the actual breakdown is in term of percentages but it’s not extremely unusual.

      Actual treatment of stones is usually done under general anesthesia. The exception is in some cases of shockwave lithotripsy (ESWL) at the discretion of the urologist and anesthesiologist. If you have concerns, talk to your physician to make sure that you will be under general anesthesia.

  19. Anubhav Saxena says:

    Dear sir,

    stent is placed in right side kidney due to lower structure in ureter on dated 27/10/13
    but due to last 10-12 days very discomfort in the lower part of bladder every time with blood and some pieces clots
    Sir, may be possible stent is move from actual position

    anubhav Saxena

    • Dr. Mike Nguyen says:

      Stents can “migrate” and slip down or up. This can result in increased pain. The best way to check for this is with a simple plain x-ray (a “KUB”).

      However, stents can cause discomfort and blood even if they are in the correct position. Talk to your doctor to see what he or she would advise.

  20. jenny says:

    I had a stent put in my right kidney 2 days ago,I am in excruciating pain all over my abdominal area.almost like a gastro cramp is this right,

  21. I have passed 4 stones on my own 4 years ago 2 stones on each side at the same time it was painfull but they were small enough to pass now i have a bigger one on my left side kidney their going to put a ureter stent in this information and videos really make me more relaxed thank you so much for this info.

  22. sagar ingale says:

    wanted to thank you for the information of placement of stent. I will be having this procedure for the second time, and your information was very comforting to read what will actually be happening.

  23. donald nerf says:

    Hi everyone

    I have bladder cancer. the doc went in and removed the cancer. I have a blockage in my right kidney. They put a stent in and it’s been very painful the whole time. and every time i try to work. I start bleeding and it burns when i pee. is this normal

    thank you

  24. Hari Kumar says:

    Hi All,
    My father aged 57 (diabetic) recently had stent removal from both sides. Post procedure he started having fever reaching upto 102 degree celisias with chills. Is this normal ? Is it common to get fever after stent removal ? We met the doc and he just says it is normal.. Please suggest.

  25. Lynne Hoppel says:

    I wanted to thank you for the video of placement of stent. I will be having this procedure for the second time, and your video was very comforting to watch what will actually be happening. I appreciate your efforts Dr. Nguyen in the research you are performing.

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