All about ureteral stents

Photo of a ureteral stent

Photo of a ureteral stent

What is a stent?

Ureteral stents are soft, hollow, plastic tubes placed temporarily into the ureter to allow drainage around a stone or or to speed healing after a stone surgery.

When are they needed?

Stents are used for various reasons in patients with kidney stones. They may be placed in patients to help reduce pain from a stone, when infection is present to allow drainage, or when a stone is preventing a kidney from working adequately. Stents are also commonly placed after surgeries for stones, as in ureteroscopy, to allow healing and prevent swelling of the ureter.

Diagram of ureteral stent

Stent in normal position

How is a stent placed?

Stents are placed during surgery by sliding them over a soft “guidewire” which is placed up the ureter, which is the tube draining the kidney. See a video below of a stent being placed.

How is a stent removed?

Stents can be removed in two different ways. Sometimes, a string is left attached to the end of the stent. This string is allowed to come out of the patient’s urethra, the tube where he or she urinates. The string can be used to pull on the stent and remove it. In cases where a string is not left attached, a small camera called a cystoscope is inserted into the patient’s urethra after numbing medication has usually been administered. The cystoscope is then advanced into the bladder and the stent is grasped with an instrument and removed. See our post on stent removal for a video and more details.

How long can a stent stay in?

In general, most stents should only remain in for no longer than 3 or so months. If a stent is left in too long, it can form stones directly on it, making removal difficult.

What are the symptoms of having a stent?

While some patients with stents have minimal discomfort related to them, other patients will report symptoms that can range from being annoying to being severe enough that the stent has to be removed. These symptoms can include:

  • Sensation of needing to urinate
  • Seeing blood in the urine
  • Bladder spasms
  • Burning sensation during urination
  • Pain in the back during urination or when moving
  • Pain in the bladder

Is there anything that can help reduce the discomfort of a stent?

Different medications may be given to help reduce the discomfort of a stent. The most effective appears to be those from the alpha blocker class of medications including tamsulosin (Flomax) and Alfuzosin (Uroxatral). Other types of medications commonly given for stent discomfort, such as oxybutynin (Ditropan) or phenazopyridine (Pyridium), do not appear to be successful at reducing stent related discomfort in placebo controlled studies.  Traditional pain medications are also less successful at reducing stent discomfort.

Hasn’t anyone come up with a better stent?

Research into improving stent designs will hopefully reduce the discomfort associated with them. Innovative stent designs currently being tested include stents embedded with medications to reduce discomfort and stents that dissolve by themselves.

 

1,840 Responses to All about ureteral stents

  1. Campbell says:

    One disturbing commonality associated with posts wherein patients describe their medical issues and then articulate their doctors response frequently includes how the patients concerns were either flat out ignored, or dismissed until which time as the patients condition declined to a level requiring immediate intervention. This type of negligence is always unacceptable. Too often these days, medical practices have evolved to become assembly lines allowing for seven minutes or less with each patient quadrupled with red tape and bureaucracy. If you’re not captivating your doctors attention, and you truly feel there’s something wrong; you must speak up. Remember, a doctors reputation and their status with licensing boards, committees, and hospitals is of vital importance. They have a responsibility to their patients first, above all else. It seems in every job there are repetitious daily struggles that get the best of us. Sometimes we repeat certain efforts or procedures so many times we forget how what has become so commonplace to us, is likely very unordinary and frightening to others. You’re children asking for another snack right before dinner every day and night before long you automatically respond without the faintest modicum of concern. Doctors, hearing similar complaints from nearly every patient day in and day out develop a wide range of mechanisms for countering such typical complaints. This is highly predictable human behavior. One important responsibility however, that each of us has a basic responsibility to hold ourselves accountable too, is ensuring a constant reminder of how our internal protections may afford us the pleasure of minimizing certain things we continually experience; that in reality, procedures so commonplace for medical professionals, are in fact very unsettling, scary, and often painful experiences for patients and their families.

  2. Candais says:

    Hello. Stone maker here! I recently had a 7mm stone drop and was rushed to ER for emergency removal via ureteroscopy. The Dr. placed a stent in Saturday and I had an appointment to have it removed Tuesday. It was soon after because after I awoke from surgery to find I had a stent in I was very unhappy and demanded to have it removed. This was my third surgery for stones and the last one (where I was hospitalized for 5 days with severe infection [Septic]), I was not given a stent and I did just fine healing. He agreed to remove it after 4 days, but during those 4 days it was nothing less than painful and I was in Pjs and on my back the entire time, afraid to even move. After the removal, I left the clinic and within minutes of leaving a 6mm Stone dislodged and fell and I was back in the ER with another surgery (4th) the next day. Dr told me before surgery that I was getting another stent but this time it would be smaller and softer, and he was not negotiating. He gave me Piridiam and Flomax, and mostly I’ve had no trouble. The day of surgery, and about 4 days later, it was hard every morning. The first pee in the morning is the worst- It burns and you have bladder spasms (feels like a UTI) for about an hour, but once I got the Piro and water flowing again the pain was tolerable. The key to stents is drinking so much water you almost want to puke. For those who have excruciating pain when you pee, the key really is to drink a lot of water, more than you’ve ever had before. If you aren’t rushing to the bathroom every thirty minutes or less with a stream that either bursts or lasts for what feels like forever, you’re not drinking enough. The second week it was in I hardly knew it was there. I go back in 3 days… say a prayer this 5mm I have left doesn’t drop!!! Oh, I was also told that the stent was there to allow any shards of stone left from surgery to pass easily. 3 days after surgery a 1mm and a 2.5mm (approx.) passed while I was at work.

  3. Josephine Jones says:

    I had 7mm kidney stone, also acute kidney injury stage 1 & a bad water infection. I had stone removed as emergency op and a stent put in. I was told it would be in for 10 days but I not heard anything. Also I have blood dripping into toilet when I pee and have continuous urge to go every 5 minutes. Is this normal?

    • Jeff says:

      I have blood dripping into toilet when I pee and have continuous urge to go every 5 minutes. Is this normal?
      Yes, unfortunately this is normal. It doesn’t sound like your doc did a very good job of explaining what to expect. I had my second stent placed today following a ureteroscopy to remove an 8 mm stone. The urge is constant and my urine looks like Hawaiian Punch. Hawaiian Punch = good; tomato juice = bad. I had a message waiting from my doc when I got home after the procedure with my appointment time for stent removal.

  4. Eileen Lyons Whelan says:

    treatment if stent falls off the ureter and falls into the bladder? Stent was to be removed 6 weeks after surgery and 4 1/2 weeks later it was diagnosed that the stunt is now in the bladder. Is this an emergency?

  5. Over a month says:

    I’ve had my stent placed over a month now. First week after my procedure the pain was excruciating I literally cried every time I had to urine. I called my Dr after a week of pain he prescribed a bladder muscle relaxer and it helped a lot. I stopped using the medication because I didn’t have any discomfort at all now almost 2 weeks since I stop the meds suddenly the pain came back running from my right lower back to the front of my leg which is even worst because now I can’t move properly or stand straight without having any pain. I called my Dr. office last week, he told me he was going on vacation and when he came back this week his staff would give me a call to schedule the removal as of today no call yet! This is torture.

  6. Rich Greninger says:

    I have a hiatel hernia. Using flowmax, the pain sympathetically goes to my left side solar plexus and varies between a 4-5/10 at night causing me to rise and apply heat via a microwaved bean bag every 2 hours.

  7. Candace long says:

    I just had a 6.7mm stone removed the agent scared me mine has to stay 3 weeks. Feeling discomfort and wanting to rest and nothing else. This kidney stone has been debilitating to my life so I will soldier through stent discomfort. I feel for all of you. I’m going to take cleavers tincture and juniper berries & nettles for my kidneys. Also any anti-inflammatory I can get.

  8. Mary Kidd says:

    I live in New Zealand and I have had a stent put in around a large stone in my left kidney which was badly infected. I had told my GP there was something wrong with me for weeks, but he never believed me and was only diagnosed after going to another doctor. After being discharged from hospital, I was remitted two days later with pancreatitis,which is painful, but not as painful as a twisted and burst bowel which I had 5 years ago. With the stent in, I have that horrible urge to go to the toilet all the time and it burns when I pass urine. The stent is due to be removed on Dec 4th. Can’t wait. I am wondering if the pancreatitis was caused by the kidney problem as I don’t drink. .

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