A ureteral stent is a thin, hollow tube temporarily placed inside the ureter, the natural passageway connecting the kidney to the bladder. This device bypasses an obstruction, such as a kidney stone or swelling, ensuring that urine flows freely from the kidney into the bladder. The procedure is a common and temporary solution that prevents hydronephrosis, a serious condition where urine backup can damage the kidney. The stent protects kidney function until the underlying issue is resolved.
Common Discomfort While the Stent is in Place
The presence of the ureteral stent often causes a range of irritating and sometimes painful symptoms, which are considered expected side effects. The most frequent discomfort involves the bladder, manifesting as a constant, urgent need to urinate and increased frequency of bathroom trips. This occurs because the coiled end of the stent rests inside the bladder, acting as a constant irritant to the bladder wall.
Many patients experience bladder spasms, which are involuntary contractions of the bladder muscle that can feel like cramping or sharp pelvic pain. These spasms are often triggered as the bladder attempts to empty itself. They are sometimes managed with prescription medications, such as alpha-blockers or anticholinergics, to relax the muscle. Flank pain is also common, felt in the side or back corresponding to the stented kidney, especially during or immediately after urination.
Flank pain is caused by vesicoureteral reflux, a temporary condition where the stent allows urine to travel backward into the kidney when the bladder contracts during voiding. Hematuria, or the presence of blood in the urine, is also a common and expected side effect. The continuous rubbing of the stent against the urinary tract lining causes minor bleeding. This may result in pink, red, or tea-colored urine, often worsening with increased physical activity.
Understanding the Medical Risks and Complications
While discomfort is expected, there are more serious medical risks that require immediate attention, though they occur less often. One significant risk is the development of a severe infection, such as pyelonephritis, an infection of the kidney itself. The stent bypasses the natural one-way valve at the bladder connection. This creates a pathway for bacteria to potentially travel from the bladder up to the kidney, especially if a urinary tract infection is present.
Stent migration or displacement is another potential complication. If the stent shifts too far up into the kidney or down into the urethra, it may fail to drain the kidney properly or cause severe pain. This necessitates another procedure to reposition or replace it.
If a stent remains in place for too long, typically beyond three to four months, it can develop encrustation, where mineral deposits crystallize onto the stent material. Severe encrustation can block the stent, impairing kidney drainage and potentially requiring more invasive surgery to remove the hardened material. Persistent pain not relieved by prescribed medications, or the onset of a fever and chills, should be reported immediately. These symptoms indicate a developing infection or complication beyond typical discomfort.
Recovery, Stent Removal, and Follow-Up Care
The duration a ureteral stent remains in place is highly variable, depending on the reason for its insertion, but it is always temporary. For stone fragments or post-procedure swelling, removal may occur after a few days or weeks. More complex cases, such as ureteral strictures, may require the stent to be in place for months, with necessary exchanges every three to six months. Patients are advised to avoid strenuous activity, heavy lifting, or high-impact exercise, as these can increase discomfort and the risk of hematuria.
The removal process is a straightforward, quick, and low-risk procedure. The most common method involves a flexible cystoscopy, where the physician inserts a small scope through the urethra into the bladder to grasp and remove the stent using forceps. This in-office procedure typically takes only a few minutes and is performed with a local anesthetic gel, allowing the patient to return home immediately.
In some cases, the stent may be fitted with an external string, allowing a patient to remove the device themselves at home, following instructions from their urologist. After removal, patients may notice a temporary return of urinary frequency or slight burning for a day or two. These symptoms quickly subside as the urinary tract heals. Follow-up care involves maintaining a high fluid intake and attending scheduled appointments to confirm the kidney is draining correctly.