We previously went over how to place a ureteral stent. In today’s post, we go over the steps of removing a stent. Ureteral stents are removed using two basic methods:
1) By pulling on a stent string, if the string was left in place.
2) Placing a camera into the bladder (cystoscopy) to directly see and grab the stent with a small grasping device.
Removing a stent with a string left in place:
In some cases, your urologist will leave a string attached to one end of a ureteral stent. The stent string is a long piece of thread that will start from the stent and drape out the urethra, where it is visible at the urethral meatus (where urine comes out). A diagram and photos of a stent with a string attached are shown below.
To remove the stent, the visible string is firmly held and steady continuous pulling is applied until the entire stent comes out. The curls at the end of ureteral stent are flexible, so the stent should uncurl and come out easily.
What’s the advantage of leaving a string?
- The stent can be removed without performing cystoscopy.
- Patients can remove their own stent without waiting for an appointment or having to come to the office.
- Stents can’t be “forgotten” when a string is attached. When no string is left attached, a patient may forget or not realize that a stent was left in place. Over time, these forgotten stents can form large stones on them, making removal very difficult.
What’s the disadvantage of a string?
- The string can get snagged on clothing or be pulled on accidentally, resulting in a ureteral stent being removed earlier than it was supposed to. This seems to more commonly occur with female patients.
- The string can be a minor annoyance.
- Some patients prefer not to have to remove their stents themselves at home using the string. They however can usually come to the office where the staff can perform this for them.
Removing a stent by performing cystoscopy (with video below):
When no string or only a portion of the string is left attached, your urologist will need to use a camera to enter your bladder through your urethra. He or she can then see the stent and use an instrument to securely grasp it and remove it. The process is usually quick and occurs in the clinic. It takes only a minute or so in most cases.
Steps in removing a ureteral stent with cystoscopy
- Use a cystoscope to enter the bladder. (A cystoscope is a camera that can be placed into the bladder).
- Identify the stent.
- Use a grasper to securely grab the stent.
- Remove the cystoscope, grasper, and the secured stent as one unit.
The video at the bottom of the page demonstrates all these steps.
How uncomfortable is stent removal using a cystoscope?
For the majority of patients, stent removal is not as uncomfortable as they expected. We often have patients react in surprise when they learn that the stent has been already been removed and the procedure is done.
Unfortunately, some patients do experience discomfort with stent removal, more commonly in men because of their longer urethra. This can be due to discomfort from the cystoscope itself or from the sensation of the stent being removed. While most patients do not feel the stent actually sliding when removed from the kidney, some do experience an uncomfortable sensation with this.
Is there anything that can be done to make it more comfortable?
- Lidocaine jelly placed into the urethra at the beginning of the procedure will help to numb the area but will not completely take away sensation.
- In men, and also occasionally in women, increased discomfort is related to tightening of the urethral sphincter as the scope is passed into the bladder. Trying to relax, take a deep breath, and not “clench” down during the cystoscopy process can sometimes make the process less uncomfortable.
- Anticipation and perception also seem to play a role: Researchers have found that patients who watch their own cystoscopy procedure on a video screen experienced less discomfort than those that did not.
Video of ureteral stent removal in a male patient.
Pain after stent removal:
In most patients, stent removal is a relief as their stent discomfort goes away. However, in some patients, severe pain may occur for several hours. This is thought to be due to spasms of the ureter or swelling and temporary blockage developing after the stent comes out.
Not enough is known about this phenomenon but one recent study suggests it may occur in as many as half of patients. In the study, patients given a single dose of rofecoxib did not experience this pain while those given placebo developed it in 55% of cases. Rofecoxib went by the brand name Vioxx and is no longer available in the U.S. as it was withdrawn by the manufacturer. The authors of the study report they now use naproxen as an alternative. You can read more about the study in our post “Severe pain after stent removal: How often does it occur and can anything prevent it?”
If you are thinking about trying naproxen, be sure to read the manufacturer’s warnings as some patients should not take the medication and check with your doctor first to make sure it’s okay in your situation.
I went to the ER on Sunday the 24th and in couple hours I was heading to the OR for surgery. They put the stent because of a 6mm stone and my kidney was full of liquid n swollen. Stayed in the hospital for 4 days, the pain, spasms, the urge to urine, and all that felt as it just cut me from the inside out. Now am waiting to see what will be my next step, either they shock it or they extract it. I am so hopping they just extract it. How is it once they takw out the stant and what most people have experience after? Hopefully it doesn’t hurt once they take it out.
I had lithotripsy for a 15mm stone. I am having my stent removed today (25th Feb 2019) and I can not wait. I have had the stent in for 2.5 weeks and it has been Hell. I have not been able to work. I have had extreme fatigue, constant need to urinate but never feeling empty, extreme cramping at the end of every urination for between 1-3 seconds (to the point where I cry), intense itching high up by the bladder, flank (kidney) pain on and off, nausea, being able to constantly feel the stent unless I am laying down and only being able to stand for roughly 30 minutes, then having to lay down due to the pain. I have never experienced so much continuous pain and discomfort in my life. Absolutely hideous!
I was chalk full of stones in my Kidneys along with a 9mm and 2 8mm and 2 6mm stones. I got two stents. I think the irritation of the strings is the worst, but there is a discomfort during each urination from the kidney down to the bladder. I get my stents out tomorrow, but now that most of the sourness is gone, I’m now considering doing it myself except that I still need to follow up with the Dr. I figure he has better techniques anyway. OMG
I had my stent removed this morning and it was a piece of cake compared to the pain the kidney stones caused, I had instant relief after it was removed and it did not have any pain while the doctor was removing it.. I am female and had the stent in for a week. I took AZO for the constant urge to urinate and it did provide some relief. This entire process has been more painful than giving birth via C-section .
I had my stent removed yesterday after having it in for 7 days. The removal was easy. I’ve had several bouts of kidney aching since then. I’m not taking anything for the aching but Im wondering how long this will go on? I get this ache about every 8 hours or so. Do you have any info on this? Doc said might be due to swelling?
I had the stent removed last night ( my self ) and I had the same bouts of kidney aching !!! I am wondering if this is normal or not
I was so glad to about everyone’s experience with stent removal,
Makes feel more comfortable having it done next week.
I was so afraid that I was going to have pain for another week or two !
Thanks everyone, so glad your comments !
I had the laser treatment and 2 stents inserted; one for each side. The first 36 hours post-procedure were pure hell! It felt like I had to pee all the time and when I did, I had pain originating from both kidneys and down all the way through the pipeline. Holy mother of pearl! I’ll take passing a kidney stone any day over that agonizing pain.
Both my stents are painful and the feeling of needing to go pee all the time never stops unless I’m sleeping. My Dr gave me a prescription of Oxybutynin 5MG. This medication is a godsend for stopping bladder spasms and helping with the bladder/lower abdominal pain, but the urge to pee never subsides.
I’m getting them both removed in just over an hour. Needless to say, I’m not looking forward to being awake this time when they go up the exit ramp and retrieve these stents.
I had kidney stone surgery on the 19th of December, having spent removed on the 26th, no string, but the frequent urination and burning is worse than my back surgery. Hopefully all will end after the 26th. Merry Christmas
Has anyone had the experience of the stent coming out on its own? It went in on Monday, when the stone was removed. Sunday I accidentally pulled on the string and immediately I was incontinent. I could feel the stent holding the urethra open. Of course, these things happen on Sunday! My partner did an experimental look-see could see the end of it, so he gently pulled it out with no problem. No pain, just a feeling of pressure when the second coiled end went through. My removal appointment is tomorrow, so I guess I’ll find out then what damage, if any, we did.
Turns out it’s not all that uncommon. Thank goodness that ordeal is over and hope to NEVER go through that again!
That’s good to hear..I had a stent removed after 5 months (normally it should be out before 90 days)..All the time i had it in, i felt this huge pressure on my bladder every single day and had to take pain killers which only helped a bit..Yesterday, after the removal of my stent, they had to put in another one which was supposed to stay in for two days..I accidentally pulled
it out last night..I had a pad on as i was leaking from urine and it caught on the string so i;m glad i read your post to see it’s quite common…Thank you..Btw, the minute the stent was removed yesterday, i was completely pain free for the first time in 5 months..So happy after reading all the posts..God bless you all xx
Omg, 5 months? I don’t know how you did it, you must be super human lol. I am so happy to hear that you are now pain free!
Had 2stents put in on sept 21. Have been miserable ever since. Go the 4th of Oct. to get out. Scared to death. They will never do this to me again. Will deal w/pain from stone first. Having to wear diapers cause I can’t control myself. Glad when this is over!
I’ve had 8 stones ranging in size from 3 mm to 9 mm over the past 3 years. The first urologist I went to performed ESWL on the 2 stones I had then, and inserted a stent. It was agonizing – the constant urge to pee, severe abdominal pain. He also didn’t manage to sufficiently break up the stones, and so I had to get a second ESWL. I told him, and wrote all over the consent form, that the stent had to come out, and that I did not consent to inserting another one. Once he took the stent out, everything was fine. It was pure hell having one. I really dislike that urologist, and I didn’t think he knew what he was doing, so a year later, when I grew 2 new stones, I went to a new urologist, who did ESWL, and didn’t insert a stent. No problems at all!
Then, this past summer, I developed a 5 mm stone in my left kidney (the first 4 were in my right) that completely blocked the ureter, and I ended up in the ER and then the hospital for 4 days with septicemia, and a new stent. The stent only bothered me for the first 2 days – burning and spasms upon urination – and then only when I exercised. Two weeks later, my new urologist used laser and a basket to remove the blocking stone, and replaced the stent with one with a string that I was able to remove myself. Neither the stent, nor pulling it out myself, hurt at all, although I could feel it when I exercised. I was stent-free for 10 whole days, when one of the remaining three stones in my right kidney blocked my right ureter, and I was back in the ER, where they put in yet another stent. This one only bothers me when I exercise, and it doesn’t hurt, just makes me feel like I need to pee. I have another ESWL scheduled for Monday to get rid of the three remaining stone.
I have concluded that how uncomfortable a stent is probably has a lot to do with the skill of the person putting it in. The first guy was utterly unsympathetic as to how much the stent hurt (or the in-office cystoscopy, for that matter), and dismissed my complaints with “nobody likes having a stent.” The guy I go to now says that he only uses a stent if the stone is over a certain size, that he uses the smallest, softest stent he can when he does use one, and that he takes it out as soon as he thinks its feasible. The difference between my experiences with these two doctors was like night and day!
I have the stent in for 8 days now. Being still I don’t feel it. If I walk around a store I feel it and some burning, then when I get home time for Tylenol. I took a week off from work. I am getting it removed today. (4mm kidney stone started this.)
I had the stent removed today. It was not pleasent but it was quick and tolerable. Nurse preps and doctor done in 2 minutes. Only a few seconds of burning going in. Once in bladder no discomfort. Then they pulled stent out, 5 seconds. I felt fine right after. 30 minutes later some burning, local anestetic may have worn off, took Tylenol for burning. Urinating – only slight burning at first but ability to go was 100% fine. Since we have to do it, go for it. It is not that bad.
I had a stent placed after laser lithotripsy on Aug 28. I had no pain from the stent, although the string attached to the stent did cause some discomfort. My urologist removed the stent today – I felt a burning sensation in my urethra for the 5 or 10 seconds it took for him to pull the stent out, but no real pain. For me the worst part of the entire procedure was the terrible pain I had when urinating, although the pain subsided about 36 hours after the lithotripsy. If your urologist gives you an option between string or cystoscopy removal, I recommend the string.
Between the time you had the stent put in place and having it removed, did you go to work or was it too uncomfortable?
Mine was in for 2.5 weeks and I was off work the whole time. Absolute agony!
I had the shockwave treatment and then the stent put in it’s been in one week and it’s been hell pain meds made me sick I can feel stent in from top to bottom try to eat feel sick hurt all the time will have to go get it out in office only getting grains and blood I feel like body is rejected stent cause of all the problems of course they never heard of that also makes me real week I could not go to work if I had to that goodness I’m retired I felt way better before all this I’m 63 and never had any problems till now this is for the birds having natural child birth was a lot faster
Going back Sept 12, for removal of stent and 10 mm stone. Couldn’t get it 4 weeks ago, giving time for ureter to repair. I’ve got to get back to work.
I’m in the same boat. Went to the ER on the 27th of July, first procedure on August 3rd (this is when they put the stent in) and the last one on August 23rd for the lithotripsy. I’ve been working on and off but definitely more off. I work at a doctor’s office and It’s very hard to work when I have to pee all the time and it feels like I pee acid. I need to get back to work and back to my life. I really hope this doesn’t happen again. Going to get the stent removed on September 4th. Can’t wait but also very nervous. This has been so difficult.
How did it go
I had simple kidney biopsy with complications that resulted in about 2 week hospital stay followed by 2 weeks in rehab. A stent was inserted about a year ago. I know there was no string. As far as I know it was never removed. My nephrologist referred me back to urologist to follow up and remove stent. Could there be any problems since it has been in for a little over a year?
I had a 1.7×1 cm stone that blocked the urine draining. Also kidney was swollen. Dr inserted a stent. Three weeks later I had lithotripsy to break up large stone bTwo weeks later had laser blast away two small stones. Dr removed first stent and put in a new one. No string. I go back August 23 to have it removed in doctor’s office.
Dr tried to remove my stent via cystocopy, could not find it. I now have to go through surgery for removal. How often does this happen. Thank you
Hey Linda. The same almost happened to me today. He had a hard time finding the string to pull it out. I was afraid he was going to tell me I needed to go to the hospital. After 10m he finally was able to pull it out. I guess is not that uncommon.
How could the doctor not find the string? My doctor left it out pretty long and taped the end of the string just above.
Good to hear he found it though. How long after the stent was taken out that you felt normal again?
I had a 5mm kidney stone removed via laser cystoscopy. I asked them to forgo the post-op stent but they insisted — and want to take it out in the office. I’ve been there twice and still have the offending device. I went there to have it removed today and took flomax, oxybutynin, norco and had a shot of vodka on the way to relax myself. The truth (as I had informed them previously) is that I cannot tolerate a cystoscopy while conscious. The Dr. prescribed a 10 mg Valium and made another appointment. I could take 3 of those, the norco, cannabis and half a bottle of booze and I still would not be able to tolerate this procedure. Period. It is malpractice in my opinion, that urologists do not offer even the in office sedation the dentists do. I’m going to have to go back the the ER and attempt to have it removed under sedation (outpatient).
I’m a female who has had three surgeries in last 6 months to place and replace a stent in right ureta, the first two leaving me in extreme pain, then a different doctor did the removal and placement of the 3rd stent and used a shorter tube, the result being no pain or discomfort whatsoever. Finally I’m pain-free, all because of the length of the tube, so keep this in mind anybody who is experiencing pain/discomfort. My three procedures were done with anaesthetic. Removal of third stent was done without anaesthetic and was only mildly uncomfortable. No pain at all when urinating.
I had surgery on 7-23-18 for a kidney stone. I have no idea if a string was left attached to the stent that was placed in me. The surgeon didn’t explain anything to me. But i can tell a stent or something is there, but now it seems i have to urinate every 10 minutes or so. It’s also painful i just want to pull whatever it is out.
I totally agree with you. I just had my stent done
Yesterday and its not comfortable. Lots of pain
With it. Also with me i have to urinate alot. My kidney stone is 15mm. So now i have to wait a week or two to have my stone removed with a shock wave device
I totally agree with you. I just had my stent done
Yesterday and its not comfortable. Lots of pain
With it. Also with me i have to urinate alot. My kidney stone is 15mm. So now i have to wait a week or two to have my stone removed with a shock wave device
I had lithotripsy yesterday but I don’t see any debris in the strainer when I void. Should I be concerned?
Just had my stent out today(Day 3 post utereroscopy) and was a little concerned after reading everything here. Stent was removed via a string pull in the doctor’s office. Took a hyrdocodone and Tamusolin before the appointment. There was definitely a sharp shooting pain(7-8) for me as it was being pulled out(lasted 1-2 seconds). Some pain, post the yanking(4-5), only lasted about 15 minutes or so and then I was good. First few urinations post removal have evidenced very little to no blood. Overall, think it has been good. Looking forward to a warm bath later this evening.
I have a kidney stent and I suppose to have surgery this past Friday to break up the stones but my surgery was delayed now I have to wait what are my what kind of danger I’m I in and how long can I go without this surgery.
I have had numerous stents for kidney stone shrapnel clearance after the breaking surgery during the last 28 years and have had them removed in many different ways. So far I have not experienced any pain or even mild discomfit from the procedures only immense relief.
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!
I have had a stent in for about 9 days and now that I have been off of baby aspirin for that amount of time, hope to have the stent removed and my 1.3cm (yes…centimter) stone blasted to dust. Only have slight discomfort from the stent and since it was put in, have had no pain from the stone itself.
Mine is 1.6cm. Had stent placed 6 days ago. 24/7 I have the urge to pee. It’s to the point where it’s painful. My kidney stone surgery isn’t till the 17th and I’m told the stent will remain for a couple weeks after that. They gave me Ditropan but so far it hasn’t taken effect.