How Painful Is a Stent for Kidney Stones?

Stent-related discomfort affects the vast majority of people who get one. Studies suggest that more than 80 percent of patients with a ureteral stent experience some combination of pain, urinary urgency, frequent urination, and blood in the urine.¹ The severity, however, ranges enormously from person to person, and understanding why that range exists can help you prepare for what to expect and make better decisions about managing it.

Why Urologists Place Stents After Kidney Stone Procedures

After ureteroscopy, the procedure most commonly used to break up and remove kidney stones, the ureter can swell from the instruments passing through it. That swelling risks blocking urine flow from the kidney, which causes flank pain and sometimes requires an emergency hospital visit. To prevent that, urologists often insert a small, flexible plastic tube called a ureteral stent that holds the ureter open while it heals.² The stent runs from your kidney down to your bladder, with a small curl at each end to keep it anchored. Most stents stay in for about one to two weeks, though some are left longer depending on the situation.

The irony is that a device placed specifically to prevent pain and complications itself causes discomfort in most patients. That tension, relief from one problem at the cost of a new one, is central to how urologists weigh the decision.

What Stent Pain Actually Feels Like

The pain from a ureteral stent is not a single sensation. It is a cluster of symptoms that affect people differently. The most common complaints include a frequent, urgent need to urinate, a burning or stinging feeling during urination, pain in the flank or lower back on the side of the stent, suprapubic pressure (low in the abdomen, just above the pubic bone), and occasional sharp spasms in the bladder area. Blood in the urine is also normal and expected, particularly after physical activity.

Where you feel the pain depends partly on your sex and the stone’s original location. A recent multicenter study found that men were more likely to report their most intense pain in the back on the same side as the stent and to experience burning during urination, while women more often reported abdominal and pubic-region pain.³ These differences held across multiple days after the procedure, which means they are not random but likely reflect anatomical variation in how the stent interacts with surrounding tissue.

The exact mechanism behind stent discomfort remains somewhat unclear, but researchers believe two main things drive it. First, the lower curl of the stent sitting inside the bladder irritates the bladder lining, triggering urgency and spasms. Second, urine can reflux backward through the stent from the bladder up toward the kidney, transmitting pressure to the renal pelvis and causing flank pain, especially during urination or physical effort.⁴

How Bad Does It Get?

Pain severity is measured in research using visual analogue scales (VAS), where patients mark their pain from 0 (none) to 10 (worst imaginable), and with the Ureteral Stent Symptom Questionnaire (USSQ), a validated tool that captures urinary symptoms, body pain, general health, work performance, and sexual function.⁵ When researchers use these tools, they consistently find that the experience splits into groups.

In-depth interviews with stent patients in a large U.S. research network found a clear three-tier pattern. About a third of participants fell into a “minimal impact” group whose daily lives were barely disrupted. Nearly half landed in a “moderate” group where some activities were significantly affected but others were not. And roughly a fifth experienced “substantial” impact, with the stent disrupting sleep, mood, work, childcare, exercise, social activities, and even driving.⁶ For this last group, the stent period can feel genuinely debilitating. Patients described being unable to sleep more than a couple of hours, avoiding leaving the house, or needing to take time off work.

Pain typically peaks in the first few days after placement and then gradually settles, though it rarely disappears completely while the stent is still in. Activity, urination, and sudden movements tend to provoke flare-ups throughout the entire stent period.

Who Tends to Have More (or Less) Pain

One of the more frustrating aspects of stent pain is that stent-related factors, like stent diameter or the use of a ureteral access sheath during surgery, do not reliably predict who will suffer most. A large multicenter analysis found that older age was associated with lower pain intensity, while having a chronic pain condition, a history of prior severe stent pain, or baseline depressive symptoms each independently predicted worse pain. Stent characteristics themselves, including sex, stone location, and access sheath use, were not significant drivers.⁷

This means the person matters more than the stent. If you have dealt with chronic pain in other parts of your body or if you have a history of anxiety or depression, your nervous system may amplify stent discomfort in ways that the physical device alone does not explain. Younger patients also tend to report more discomfort, possibly because older adults have lower baseline bladder sensitivity or different pain thresholds. If you have had a stent before and found it excruciating, that prior experience itself is a risk factor for a difficult time the next round. These findings have shifted the conversation among urologists from “what stent should we use?” toward “what patient-level preparation should we offer?”

Medications That Help

The first-line pain medications for stent discomfort are anti-inflammatory drugs. Multiple randomized trials have shown that NSAIDs provide equal or better pain control than opioids after ureteroscopy, with fewer side effects like nausea and vomiting. Opioid-free pain management protocols are now becoming standard at many centers, with fewer than one in five patients needing rescue narcotics in most studies.⁸ Over-the-counter options like ibuprofen or naproxen are commonly recommended by urologists for mild-to-moderate stent pain.

Beyond simple pain relief, two other drug classes target the urinary symptoms that make stent life miserable. Tamsulosin, an alpha-blocker originally developed for enlarged prostate symptoms, relaxes smooth muscle in the lower ureter and bladder neck. A placebo-controlled trial found that tamsulosin improved urinary symptom scores compared to placebo and reduced the need for painkillers, though it did not significantly improve body pain, general health, or work performance scores.⁹ The benefit is real but narrow: tamsulosin takes the edge off the urinary urgency and frequency more than the aching pain.

Mirabegron, a newer bladder-relaxing drug, has also been studied for stent symptoms. A meta-analysis of randomized trials comparing mirabegron to older anticholinergic bladder medications found that mirabegron was modestly better at reducing urinary symptoms and improving quality of life after one week.¹⁰ In practice, many urologists prescribe either tamsulosin alone or in combination with a bladder-calming drug, along with scheduled ibuprofen or a similar NSAID. The combination approach addresses different components of stent discomfort: the anti-inflammatory handles pain and swelling, the alpha-blocker eases urinary flow, and the bladder medication reduces spasms.

What Stent Removal Feels Like

For many patients, stent removal day brings as much anxiety as the original procedure. How the stent is removed makes a significant difference. There are two main methods: office cystoscopy, where a doctor passes a small scope through the urethra to grab and pull the stent, and string removal, where a thin string attached to the stent hangs outside the body and is pulled to slide the stent out, sometimes at home.

Office cystoscopy tends to produce the most discomfort. One study found average pain scores of about 5.3 out of 10 with this method.¹¹ String removal is considerably gentler. A controlled trial showed that the string group reported average pain scores of about 2.7 compared to roughly 5.7 for the cystoscopy group, a large and statistically significant difference. The benefit was especially pronounced for men, who experienced substantially less urethral pain with string removal.¹²

One practical note: a single dose of an anti-inflammatory taken before stent removal can dramatically reduce the pain that follows. A randomized, placebo-controlled trial found that over half of patients who received a placebo before cystoscopic removal experienced severe pain (scores of 7 or above) in the 24 hours afterward, while zero patients who received a pre-removal NSAID hit that threshold.¹³ If your doctor does not mention pre-medication before removal, it is worth asking about.

Does the Stent Itself Matter?

You might assume that a softer, thinner stent would hurt less. The evidence here is surprisingly mixed. A systematic review of stent material studies found that silicone stents and softer, more flexible designs generally reduced stent-related symptoms compared to stiffer polyurethane stents. But the authors cautioned that only one high-quality trial existed, making it impossible to draw a firm conclusion.¹⁴ Another randomized trial comparing firm and soft polymer stents head-to-head found no significant differences in urinary symptoms, pain, or general health at one or four weeks.¹⁵

Stent length and the position of the bladder curl seem to matter more. When the lower curl of the stent crosses the midline of the bladder (called a cross-trigonal position), it is significantly associated with urgency and suprapubic pain.¹⁶ A larger curl inside the bladder also correlates with more pain: patients whose stent formed a bigger loop in the bladder reported more discomfort than those with a smaller loop.¹⁷ Some research has explored short-loop tail designs to reduce the amount of material sitting in the bladder, with early results suggesting reduced pain on the worst days.¹⁸ In short, the stent’s positioning inside you likely matters more than what it is made of.

Can You Skip the Stent Entirely?

Not everyone needs a stent after ureteroscopy, and the trend in urology is moving toward stentless procedures when the situation allows. A prospective analysis from a large kidney stone research network found that patients who did not receive a stent had significantly lower rates of urinary symptoms and blood in the urine afterward, with no difference in stone clearance, complications, pain, or hospitalization compared to stented patients. No patient in the stentless group required an emergency stent placement.¹⁹

The catch is that going stentless is not always safe. It works best for straightforward cases: small stones, short procedures, minimal ureteral trauma, and no significant swelling at the end of the operation. Larger stones, longer procedures, and cases involving ureteral dilation or visible injury generally still warrant a stent to prevent dangerous obstruction. If you are facing a ureteroscopy and dread the idea of a stent, ask your urologist beforehand whether a stentless approach is feasible in your case. The answer depends entirely on what they find during surgery.

What Actually Helps Day to Day

Beyond medications, patients consistently report a few practical strategies that make the stent period more bearable. Staying well hydrated dilutes the urine, which reduces the burning sensation during urination. Avoiding caffeine and alcohol, both bladder irritants, can reduce the frequency and urgency. Some people find that sitting or lying in certain positions, particularly with the stented side up, eases flank pain, though this is individual. Heating pads over the flank or lower abdomen provide temporary relief for spasms.

Physical activity is a balancing act. Light movement is fine and may even help, but vigorous exercise, heavy lifting, and sudden twisting can trigger sharp pain and increase blood in the urine. Most urologists advise patients to resume normal activities as tolerated but to pull back when symptoms flare. Knowing what to expect also appears to make a real difference. Research on preoperative information suggests that patients who receive detailed guidance about what they will experience report faster declines in postoperative pain, lower anxiety, and greater satisfaction with their pain management.²⁰ Even just reading an article like this one before your procedure may, in a small way, reduce what you end up feeling.

Biodegradable Stents and What Is Coming

One of the more promising developments in stent technology is the biodegradable stent, a device designed to dissolve on its own inside the body so that patients never have to go through removal at all. There is growing interest among urologists and patients in biodegradable options that would eliminate both the removal visit and the complications of a stent staying in too long, like encrustation and infection.²¹ Materials being tested include polymers that break down in urine and magnesium-yttrium alloys that corrode at controlled rates while potentially offering antibacterial properties.²²

These stents are still largely in the laboratory and early clinical trial stages. The main engineering challenges are controlling the degradation rate precisely enough that the stent stays open long enough to protect the ureter but disappears before it becomes a problem, and ensuring the breakdown products are safe for the kidney and bladder. No biodegradable ureteral stent is in widespread clinical use yet, but the pace of research has accelerated over the past few years. For anyone who has endured a stent and sworn they would never do it again, the prospect of a stent that simply vanishes is compelling enough that it is worth keeping on the radar.

When Pain Crosses Into Something Else

Normal stent pain is unpleasant but manageable with medication for most people. Certain symptoms, however, signal that something has gone wrong and require prompt medical attention. A fever above 101°F (38.3°C) with chills can indicate a urinary tract infection that has spread to the kidney, which is a medical emergency with a stent in place because the stent itself can harbor bacteria. Complete inability to urinate, severe unrelenting pain that does not respond to prescribed medications, or sudden heavy bleeding that fills the toilet bowl with bright red clots all warrant a call to your urologist or a visit to the emergency room.

Stent migration, where the stent shifts out of position, is uncommon but can cause a sudden change in pain pattern. If your pain abruptly worsens or changes character after days of relative stability, let your doctor know. The distinction between “this is awful but expected” and “something is actually wrong” is mostly about trajectory and associated symptoms: stent pain that gradually improves or stays stable is typical, while pain that suddenly escalates or comes with fever, vomiting, or inability to pass urine is not.