How Long Does a Ureteral Stent Stay In?

Most ureteral stents placed after kidney stone procedures stay in for about five to fourteen days, though the exact duration depends on why the stent was placed and how your body responds. After routine stone surgery, guidelines recommend keeping the stent in for as few days as possible to limit discomfort and complications. For people dealing with cancer-related blockages or other long-term conditions, a stent may remain in place for months or even longer. The answer that matters to you hinges on your specific situation, and the range is wider than many patients expect.

The Typical Timeline After Stone Surgery

The most common reason someone ends up with a ureteral stent is a ureteroscopy, a procedure to break up or remove kidney stones. In these cases, the stent serves as a temporary scaffold, keeping the ureter open while post-surgical swelling subsides and letting stone fragments pass more easily. American Urological Association guidelines recommend that stent duration after ureteroscopy be minimized to reduce discomfort, and research supports aiming for at least five days in patients who did not already have a stent in place before surgery.¹ That “at least five days” figure is not an arbitrary cutoff. Removing a stent too early can lead to swelling that blocks urine flow, sometimes sending patients to the emergency room.

Researchers have compared shorter and longer windows head to head. One randomized trial assigned patients to either a three-day or seven-day stent placement after ureteroscopy and found that both groups had acceptable outcomes, though the shorter duration naturally meant fewer days of stent-related symptoms.² In practice, many urologists settle on roughly a week as a comfortable middle ground. A prospective study tracking patients with extraction strings found a mean dwell time of just over five days, and the vast majority tolerated that duration well.³ Your surgeon may adjust the timeline based on what they found during the procedure, whether there was significant ureteral injury, and whether stone fragments still need to pass.

When Stents Need to Stay In for Months

Not all stents come out after a week. People with malignant ureteral obstruction, where a tumor presses on or invades the ureter, often need drainage that lasts far longer. Standard polymer stents can fail relatively quickly in this setting: one study found their median functional duration was under two months.⁴ That means frequent replacements, each requiring a separate procedure. Metallic stents were developed partly to address this problem. The same study found that metallic stents had a median functional duration of about five months, a meaningful improvement when a patient’s remaining life expectancy may be around a year.

Newer data is even more encouraging. A comparison of stent types after initial stent failure found that one particular metallic stent design achieved a median functional duration of fourteen months.⁵ Other metallic designs have reported mean indwelling times in the range of nine to twenty-one months.⁶ A meta-analysis confirmed that metallic stents have higher success rates than polymer stents, particularly over longer follow-up periods, though they do carry a somewhat higher complication rate.⁷ The choice between polymer and metal comes down to balancing how long drainage needs to last against the patient’s overall health, prognosis, and tolerance for possible complications.

For patients with malignant obstruction, the alternative to a stent is often a nephrostomy tube, an external drain placed through the back directly into the kidney. A systematic review comparing the two approaches found no clear difference in pain, quality of life, or failure rates, though nephrostomy patients had longer hospital stays while stent patients experienced more urinary symptoms like blood in the urine.⁸ For many patients, an internal stent with no external bag feels like a better trade-off even if it means periodic replacements.

Pregnancy and Pediatric Cases

Pregnant patients face a unique set of stenting challenges. The physiological changes of pregnancy, including increased calcium excretion and a ureter that is already dilated from hormonal effects, accelerate encrustation on the stent surface. Guidelines recommend that pregnant women have their stent removed within four to six weeks of placement and that they be counseled about the risk of complications before the stent goes in.⁹ Because imaging options are limited during pregnancy (no CT scans, limited X-rays), routine screening to make sure the stent is still functioning and hasn’t become coated in mineral deposits is especially important. Stents placed for obstructing stones during pregnancy often need to be exchanged every four to six weeks until delivery, when definitive treatment becomes possible.

In children, stent duration depends on the reason for placement. A comprehensive review of pediatric stenting found that when stents are placed during stone procedures, a short dwell time of roughly two weeks is generally adequate. Pre-stenting before stone surgery didn’t improve stone-free rates in children and actually increased the risk of infection, consistent with selective rather than routine use. For reconstructive surgeries like pyeloplasty, stents tend to stay in longer, often several weeks. A practical sizing rule, “age plus 10 centimeters” for stent length, helps ensure proper fit. A particular concern in pediatric care is minimizing the need for general anesthesia at removal, which has led to greater interest in extraction strings and magnetic retrieval systems for children.¹⁰

What Happens When a Stent Stays In Too Long

The longer a stent sits inside the ureter, the more it becomes a surface for bacteria and minerals to cling to. Bacterial biofilm, an organized colony of microbes embedded in a self-produced protective matrix, can coat both the inner and outer surfaces of a stent. Mineral encrustation, the buildup of calcium-based and other deposits, can develop alongside or independently of that biofilm.¹¹ The risk of encrustation climbs with time, but it is also influenced by individual factors: a history of kidney stones, urinary tract infections, metabolic conditions like high calcium levels or abnormal urine pH, and certain malabsorptive disorders all raise the risk.¹² Research looking at the chemical composition of stent crusts found that frequent stone formers were most likely to develop heavy encrustation on the kidney end of the stent, while infections and older age predicted encrustation on the bladder end.¹³

When a stent is genuinely forgotten, the consequences can be serious. A systematic review of forgotten ureteral stents found that encrustation occurred in roughly four out of five cases, and urinary tract infections affected about two in five.¹⁴ Another series reported that about 60 percent of patients with forgotten stents presented with infected urine, a quarter had elevated kidney-function markers, and over half showed signs of upper urinary tract obstruction on imaging. About 13 percent had a stent that had actually broken apart inside the body. Only about a third of forgotten stents could be removed with a simple outpatient cystoscopy; the rest required more invasive procedures, sometimes including multiple surgical approaches to clear the encrusted material and free the stent fragments.¹⁵ Case reports document stents forgotten for a decade or more, requiring complex multi-stage endoscopic procedures to resolve.¹⁶ The message is straightforward: keeping your removal appointment is not optional.

How Stents Get Removed

The traditional removal method is cystoscopy, where a small camera and grasping instrument are passed through the urethra to grab the lower coil of the stent and pull it out. It is a quick outpatient procedure, usually done under local anesthesia, but it can be uncomfortable, particularly for men.

An increasingly popular alternative is the extraction string. Your surgeon leaves a thin thread attached to the stent’s lower coil, with the string hanging just outside the urethra or taped to the inner thigh. At the scheduled time, you simply pull the string to remove the stent at home. In a prospective study of 168 patients with extraction strings, 79 percent successfully removed the stent themselves. Most rated the experience as “very easy,” and 90 percent said they would choose the string method again. The dislodgement rate, where the string pulls the stent loose prematurely, was about 3 percent, and only about 2 percent of strings detached from the stent and required a cystoscopy anyway.³ A controlled trial found that men who removed stents by string reported significantly less pain than men who had cystoscopic removal. Interestingly, this pain difference wasn’t significant for women, possibly because the shorter female urethra makes cystoscopy less uncomfortable to begin with.¹⁷

Magnetic stent retrieval is a newer approach. A small magnet is attached to the stent’s bladder end, and a magnetic catheter-like device is inserted through the urethra to grab it, no camera needed. A randomized trial found that magnetic removal took roughly half the time of cystoscopic removal and caused significantly less pain.¹⁸ This approach is especially appealing in pediatric patients, where avoiding general anesthesia for stent removal is a real benefit. Other cystoscope-free techniques have also been tested, including a method using a simple catheter-and-loop device that achieved a success rate above 95 percent.¹⁹

Dealing With Stent Discomfort in the Meantime

For many patients, the worst part of having a stent is not the removal but the days or weeks spent living with it. Common complaints include a frequent, urgent need to urinate, burning with urination, flank pain when the bladder is full, blood-tinged urine, and discomfort during physical activity. These symptoms are not a sign that something has gone wrong; they are a predictable consequence of a foreign body irritating the bladder and ureteral lining.

Several medications can take the edge off. A large systematic review and network meta-analysis found that the most effective drug combination for urinary symptoms and pain was an alpha-blocker paired with an anticholinergic, specifically silodosin combined with solifenacin.²⁰ Alpha-blockers relax the smooth muscle around the ureter and bladder neck, reducing spasms, while anticholinergics calm the overactive bladder contractions that cause urgency. A separate meta-analysis comparing two commonly prescribed individual drugs found that tamsulosin (an alpha-blocker) was better for body pain, sexual function, and overall quality of life, while mirabegron (a newer bladder-relaxing medication) was more effective at reducing urinary frequency and urgency and cutting down on painkiller use. Both drugs reduced symptom scores significantly without a meaningful increase in side effects.²¹ If your doctor hasn’t mentioned medication for stent symptoms, it is worth asking. Many patients tough it out unnecessarily because they assume nothing can be done.

Preventing the Forgotten Stent Problem

Forgotten stents are a recognized public-health issue in urology, not just a rare anecdote. Patients who miss their follow-up appointment, lose track of when the stent was placed, or change providers without transferring records can end up carrying a stent for months or years beyond its intended lifespan. Language barriers, lack of insurance, and psychiatric illness are known risk factors for losing patients to follow-up.

Digital tracking tools have shown real promise. A prospective study testing a smartphone-based stent-tracking application found that patients followed through the app had fewer overdue stents and fewer losses to follow-up compared to those given a standard appointment card.²² A multi-center study in Malaysia went further, comparing a smartphone stent registry with automated text-message reminders against a manual logbook system. In the manual group, 13 percent of stents were classified as forgotten, with a median indwelling duration of 141 days. In the smartphone-registry group, every single patient had their stent removed on schedule, and the median indwelling time was just 45 days.²³ These are not expensive interventions. They are essentially reminder systems. If your hospital or clinic does not have one, you can set your own phone alarm or calendar reminder on the day the stent is placed.

Biodegradable Stents on the Horizon

The ideal solution to both discomfort and the forgotten-stent problem would be a stent that does its job and then dissolves on its own. Researchers have been working on biodegradable stents made from materials that safely break down inside the body after a controlled period. One active area of research involves magnesium-based alloys, which degrade over weeks to months depending on their composition and can be tuned to match the intended drainage window. Early laboratory testing of magnesium-yttrium stent prototypes has shown promise, though the technology has not yet reached widespread clinical use.⁷ Anti-encrustation and antimicrobial surface coatings for conventional stents are also under active investigation, though clinical validation, especially in children, is still pending.¹⁰ For now, the stent still has to come out on schedule. But the field is clearly moving toward a future where the removal appointment becomes unnecessary.