How to Relieve Kidney Pain After Stent Removal

Pain after a ureteral stent is pulled out is extremely common and can catch you off guard with its intensity. In studies that tracked patient experiences, roughly a third of people reported delayed severe pain after stent removal, and almost one in ten ended up seeking emergency care because of it.¹ The good news is that most of this pain is temporary, and there are effective steps you can take before, during, and after removal to manage it.

What the Pain Actually Feels Like and How Long It Lasts

People who have been through stent removal describe the aftermath in surprisingly consistent ways. The dominant sensations are cramping and spasms, often located in the kidney area, the lower back, or along the urethra. In a qualitative study that conducted in-depth interviews with patients, about a third reported pain on the day of removal, and most described it as cramps or spasms. For over half of those who experienced pain, it resolved within four hours. But for roughly a third of patients who had post-removal pain, it lingered between 24 and 48 hours.²

Here is the part that surprises many people: among those who described their pain intensity, nearly all said it was as bad as or worse than the pain from the kidney stone itself.² That comparison is worth knowing beforehand, because if your doctor tells you to expect “mild discomfort,” you may be blindsided. Planning for real pain relief ahead of the procedure is more productive than hoping it will be easy.

Take an NSAID Before the Stent Comes Out

The single most effective thing you can do is simple and cheap: take a non-steroidal anti-inflammatory drug (an NSAID like ibuprofen or diclofenac) before the removal procedure, not after the pain has already started. In a randomized, double-blind, placebo-controlled trial, more than half of patients who received a placebo experienced severe pain in the 24 hours after stent removal. Among those who received a single dose of an NSAID beforehand, zero patients had severe pain.³ That is a striking difference for something as accessible as a single pill.

The key is timing. NSAIDs work by dampening the inflammatory cascade and reducing the ureteral spasm that causes most of the kidney-area pain. If you wait until you are already in agony, the inflammation is well established, and the medication has to play catch-up. Taking it an hour or two before the procedure gives the drug time to reach effective levels in your bloodstream. Ask your urologist whether ibuprofen, naproxen, or a prescription NSAID like diclofenac is the best option for you, especially if you have kidney function concerns or stomach issues.

Alpha-Blockers and Why Your Doctor Might Prescribe Tamsulosin

Tamsulosin (commonly known by the brand name Flomax) is a medication originally designed for prostate symptoms, but it has a useful side job: it relaxes smooth muscle in the ureter. That same muscle-relaxing action can reduce the cramping and spasms that drive post-stent pain. In a placebo-controlled trial, patients who took tamsulosin along with diclofenac had lower pain scores on the first and second days after stent removal compared to those who took a placebo.⁴ Another study found that giving patients both diclofenac and tamsulosin two hours before the removal procedure resulted in less pain and less anxiety than either drug alone.⁵

This combination of an NSAID plus an alpha-blocker is probably the strongest non-opioid approach available. If your doctor only prescribes one drug for the removal day, it is worth asking whether adding the other would be appropriate. Not everyone can take tamsulosin (it can lower blood pressure and cause dizziness), but for most patients, the side effects are mild relative to the pain relief it provides.

Bladder-Calming Medications for Lingering Symptoms

Stent-related symptoms are not limited to flank pain. Many people deal with frequent urination, urgency, and burning that can persist after the stent is removed while the ureter and bladder lining recover. Two classes of medication target these bladder symptoms directly.

Antimuscarinics like oxybutynin and solifenacin work by calming overactive bladder contractions. In one study, combining tamsulosin with oxybutynin improved irritative urinary symptoms and quality of life more than either drug alone.⁶ A separate comparison found that while tamsulosin and oxybutynin were individually similar in relieving urgency and frequent urination, their combination was better than either one at relieving abdominal pain, urgency, and frequency.⁷ Another study looking at tamsulosin combined with solifenacin found the combination improved both pain and work performance more than tamsulosin alone.⁸

A newer option is mirabegron, which relaxes the bladder through a different pathway. In a randomized trial, patients taking mirabegron had less daytime urinary frequency, less nighttime urination, less urgency, and less flank and abdominal pain than the control group. They also used fewer painkillers overall and reported better quality of life during the stenting period.⁹ While most of this research focused on the period while the stent was still in place, the same bladder irritation can carry over into the days after removal, and these drugs may help bridge that gap.

How the Stent Gets Removed Matters

There are two main ways ureteral stents are removed: by pulling on an attached extraction string (which you or a nurse can do at home or in a clinic without a scope), or by office cystoscopy, where a small camera is passed through the urethra to grab and remove the stent. The method affects both the pain of removal itself and what happens afterward.

For the removal procedure itself, string removal tends to hurt less, at least for men. One controlled trial found that men in the string group experienced significantly less pain than men in the cystoscopy group, while for women the difference was not statistically significant.¹⁰ Another randomized study confirmed that pain scores during removal were higher in the no-string group.¹¹

But there is a trade-off. Patients who had their stent removed by string were more likely to visit the emergency room afterward than those who had it removed by cystoscopy.¹ The likely explanation is that string removal can happen very early, sometimes within a few days of surgery when the ureter is still inflamed, and the removal itself is less controlled. Meanwhile, office cystoscopy was rated by patients as the highest-pain removal method in the moment, but it tended to produce fewer complications. When asked which method they would choose again, patients were least willing to repeat office cystoscopy and most willing to repeat removal done under sedation in an operating room.¹

Stent Dwell Time and the Early-Removal Problem

How long the stent has been sitting in your ureter before it comes out can influence how rough the aftermath is. Research has found that when the stent had been in place for four days or fewer, the chance of an emergency department visit around the time of removal was significantly higher. After five or more days, that elevated risk disappeared.¹² This is worth knowing if your surgeon gives you a choice about timing. While everyone wants the stent out as soon as possible, pulling it before day five appears to come with a real cost in terms of pain and complications.

If you have a string attached and the plan is to remove the stent at home, ask your urologist when to do it. Removing it the morning after surgery because you cannot stand the discomfort is understandable, but the evidence suggests waiting a few more days may actually lead to a smoother recovery overall.

Why Opioids May Not Be the Answer

Given how severe the pain can be, you might assume a prescription painkiller is the obvious solution. The evidence tells a more complicated story. A large quality-improvement study tracking patients after ureteroscopy found that at one to two weeks after surgery, patients who were still taking opioids actually reported worse pain intensity and more interference with daily activities than patients who were not taking opioids.¹³

This does not necessarily mean opioids caused the worse outcomes. It is more likely that people with the most severe pain were the ones still reaching for opioids, while those with milder recovery had already stopped. But the study also found that patients who were prescribed opioids at discharge did not end up with meaningfully different reported outcomes compared to those who needed a “rescue” opioid prescription later.¹³ In other words, routinely sending everyone home with opioids did not produce better results than reserving them for the people who truly needed them. For most patients, a strong NSAID regimen with or without tamsulosin is the better first choice, with opioids available as a backup if needed.

What You Can Do at Home Without a Prescription

Beyond medications, there are practical measures that help with kidney-area pain after stent removal, even though the clinical trial evidence for most of them is limited.

Heat: A heating pad or warm water bottle placed on the flank or lower back can relax ureteral and abdominal muscle spasms. This is one of the most commonly recommended non-drug measures for kidney pain in general, and many patients find it offers meaningful short-term relief during the worst cramping episodes.
Hydration: Drinking plenty of water after stent removal helps flush the urinary tract and may reduce the stinging or burning associated with urination. It can also help move any small stone fragments that remain. Aim for enough fluid that your urine stays light yellow.
Activity level: Gentle movement like walking can help, but avoid heavy lifting or vigorous exercise for a few days. Straining can aggravate the healing ureter and worsen spasms.
Positioning: Some people find that lying on the opposite side from the affected kidney takes pressure off and reduces discomfort. Propping yourself up slightly rather than lying flat can also ease the crampy sensation.

One thing that has been specifically studied and did not work well is CBD oil. A review of pain management strategies after ureteroscopy noted that a 2023 study found cannabidiol oil had no significant effect on pain scores compared to placebo, though the researchers acknowledged they used the lowest available dose.¹⁴ If you were considering CBD as an alternative to conventional painkillers, the current evidence does not support it for this type of pain.

When to Go to the Emergency Room

Some degree of pain, blood in the urine, and urinary urgency is expected after stent removal. But certain signs suggest something more serious is happening and warrant immediate medical attention:

Fever or chills: These can indicate a urinary tract infection or, more seriously, a kidney infection that needs antibiotics quickly.
Pain that escalates rather than plateaus: Post-removal pain should gradually improve over hours. If it keeps worsening or becomes unbearable despite medication, you may have a retained stone fragment causing obstruction.
Inability to urinate: If your urine flow stops entirely, this is an emergency regardless of pain level.
Heavy bleeding: Some pink or light red urine is normal. Dark red urine with clots, or blood that does not clear with increased fluid intake, warrants a call to your doctor or a visit to urgent care.
Nausea and vomiting: Severe nausea can accompany a ureteral obstruction and may also prevent you from keeping oral pain medication down, creating a pain spiral you cannot manage at home.

About 9% of patients in one large survey ended up returning for emergency care after stent removal, so you are far from alone if this happens.¹ Do not feel embarrassed about seeking help. Emergency departments see this regularly and can provide IV pain medication, imaging to check for obstruction, and antibiotics if infection is developing.

Putting Together a Pre-Removal Plan

The research consistently points toward proactive management being far more effective than reactive treatment. If you have a stent removal scheduled, here is a practical sequence worth discussing with your urologist:

Two hours before removal: Take an NSAID (ibuprofen 600 mg or diclofenac, depending on what your doctor recommends) along with tamsulosin if prescribed.
Removal day and the next 48 hours: Continue scheduled NSAID doses rather than waiting for pain to return. Keep a heating pad handy and drink extra fluids.
If bladder symptoms dominate: Ask about adding oxybutynin, solifenacin, or mirabegron for a short course to calm urgency and frequency.
Opioids: Reserve for breakthrough pain that does not respond to the above measures. The evidence does not support routine use.

Most people find the worst is behind them within 24 to 48 hours. The first few hours after removal tend to be the peak, and if you have front-loaded your pain management with an NSAID and an alpha-blocker, you have already taken the steps with the strongest evidence behind them. Keep your urologist’s after-hours number somewhere accessible, stay hydrated, and give yourself permission to rest. The ureter heals quickly once the stent is gone.