Ureteral stents are like small straws which sit within the tube that carries urine from the kidney to the bladder, the ureter. They are usually about 2 mm (1/10th of an inch) wide and between 22-26 cm (8-10 inches) long. Most stents have a curl on either end which can be straigtened during insertion, but prevent movement of the stent out of position. In reference to the curls on the end of the stent, they are sometimes referred to as pig-tail or JJ (double J) stents.
Stents are placed for a number of reasons, but the most common reason is to relieve obstruction of the ureter, such as from stone. They are also placed following surgery on the ureter, such as ureteroscopy for stone, in order to prevent obstruction from spasm of ureter or blockage from stone fragments or blood clot.
ALL STENTS ARE TEMPORARY AND MUST EVENTUALLY BE REMOVED OR REPLACED. Most stents can remain in place for 6-12 months, but are often removed or replaced much sooner. If you have a stent which you believe has been in place for more than 6 months, please contact your urologist immediately. If stents are left in place for too long, stone may form on the stent making removal difficult. This is knowns as stent encrustation.
How are stents placed?
Stents are usually placed within the ureter through by placing a cystoscope into the bladder through the urethra. The opening of the ureter into the bladder is identified and the stent is inserted. This is known as 'retrgrade stent placement' and is exclusively done by urologists. Occasionally, stents are placed 'top down' - 'antegrade stent placement'. The renal pelvis is punctured through the skin and the stent passed from outside the body, into the renal pelvis and from there down to the bladder. This can be done by a radiologist, and sometimes by urologists. Proper positioning of the stent is confirmed with X-ray.
How are stents removed?
Stent removal is usually a simple, out-patient procedure. Flexible cystoscopy is performed and the end of the stent in the bladder is secured and the stent then pulled out through the urethra. This usually takes 1-2 minutes. No special preparation is required. You do not need to fast (stop eating) beforehand.
Very rarely, a stent may migrate (move) upwards such that the end in the baldder cannot be seen. In this case, a trip to the operating room for retrieval may be required.
What sort of symptoms can be expected with a stent?
A stent is a piece of plastic. While they are quite soft, they can irritate the bladder. In addition, urien can 'backwash' up the stent into the kidney. As long as the stent is in place, the following symptoms can be expected and are normal:
- Urinary urgency and frequency - you may feel the need to go to the washroom often, even though very little urine comes out.
- Stanguria - this is pain at the end of urination caused by the bladder wall collapsing down on the end of the stent in the bladder.
- Flank pain - you may feel pain in your side, especially when you urinate. This is urine 'backwashing' up the stent and putting pressure in the kidney. This is not harmful to the kidney.
- Blood and occasional clot in the urine.
Things that can be done to reduce stent symptoms.
Stents tend to be fairly well tolerated by most patients. In fact, some patients have stents which are replaced indefinitely. There are no specific limitations as to what activities can be done with a stent in place. However, some patients will have stent-related symptoms, occasionally severe. Things which can be done to reduce these symptoms include:
- Increase fluid intake if bleeding is noted. This will flush the blood out before clot can form.
- Bladder relaxants can help with urinary frequency, urgency and flank pain occurring with urination. Medications used include: oxybutyinin (Ditropan) and tolterodine (Detrol)
- Alpha blockers such as tamsulosin (Flomax) may decrease bladder sensitivity and relax the ureter
- Phenazopyridine (Pyridium) is a bladder anesthetic. Not all pharmacies carry this. Check here for more info.
Web Resources
CUA discharge instructions on ureteral stents. Please refer to our instructions first.
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