An indwelling ureteral stent is a slender, flexible tube designed to be placed inside the ureter, which is the narrow tube that transports urine from the kidney to the bladder. These stents are typically made from silicone or polyurethane, materials chosen for their biocompatibility and flexibility within the body. One or both ends of the stent are often coiled, resembling a “pig-tail” or “double J” shape, which helps secure the stent in place and prevents it from shifting within the urinary tract. The stent serves as a temporary conduit, ensuring continuous urine drainage and maintaining ureteral openness.
Reasons for Stent Placement
Ureteral stents are placed to address various conditions that obstruct or threaten the normal flow of urine from the kidneys to the bladder. The most frequent indication for stent placement involves kidney stones, which can block the ureter, potentially leading to kidney swelling (hydronephrosis) and damage if untreated. The stent creates a bypass, allowing urine to flow around the stone and preventing further complications.
Beyond kidney stones, stents are commonly used to manage ureteral strictures, which are abnormal narrowings of the ureter that can restrict urine flow. These strictures may result from scar tissue, inflammation, or external compression from tumors. The stent holds the ureter open, maintaining patency and preventing urine buildup. Stents are also routinely placed as a precautionary measure after various urinary tract surgeries, such as those involving kidney stone removal or reconstructive procedures on the ureter. This helps prevent swelling and ensures proper drainage during the healing process, reducing the risk of complications. In cases where a ureter has been irritated or scratched during a procedure like ureteroscopy, a stent may be left in place for approximately a week to prevent the ureter from spasming and collapsing.
Managing Life with a Ureteral Stent
Living with an indwelling ureteral stent often involves experiencing a range of symptoms, which can vary in intensity among individuals. Common discomforts include flank pain, which may worsen during urination or physical activity, as urine can reflux back towards the kidney through the stent. Bladder irritation, increased urinary frequency, and a persistent urge to urinate are also frequently reported due to the stent’s presence in the bladder. Some individuals may also notice blood in their urine (hematuria), which appears as a pinkish or reddish tint and is a common side effect.
To manage these symptoms, adequate hydration is recommended to dilute urine and reduce irritation. Over-the-counter pain relievers, such as acetaminophen or ibuprofen, can help alleviate mild to moderate pain. In some cases, healthcare providers may prescribe alpha-blockers, which can relax the muscles in the bladder and ureter, potentially reducing spasms and improving urine flow. Activity modifications may also be beneficial; while most normal activities can be continued, strenuous exercise or heavy lifting might exacerbate discomfort for some individuals.
Contact a healthcare provider if certain symptoms arise, as they could indicate a more serious issue. These warning signs include a persistent fever above 101.8°F (38.8°C), which could signal an infection. Severe pain not relieved by prescribed or over-the-counter medications warrants immediate medical attention. An inability to urinate, or experiencing only small dribbles with increasing lower abdominal discomfort, suggests potential urinary retention and requires urgent evaluation.
Stent Removal Process
Stent removal is typically a straightforward procedure, most commonly performed using cystoscopic removal. During this procedure, a local anesthetic gel is often applied to the urethra to minimize discomfort. A thin, flexible instrument with a camera, called a cystoscope, is then gently inserted through the urethra and into the bladder. The healthcare provider uses the cystoscope to visualize the stent’s coiled end within the bladder.
Once visualized, small forceps are passed through the cystoscope to grasp the stent, which is then carefully withdrawn. The procedure is usually brief, lasting only a few minutes, and patients generally experience mild discomfort. Some stents are designed with an external string attached, which allows for removal without a cystoscope; the patient can simply pull the string, withdrawing the stent themselves. However, this method is not suitable for all patients or all types of stents, and a healthcare provider will advise on the appropriate removal method.
Following stent removal, temporary symptoms are common as the urinary tract adjusts. These may include mild bladder spasms, an increased frequency of urination, or a mild burning sensation during urination for a day or two. There might also be a small amount of blood in the urine immediately after removal. Patients are advised to increase their fluid intake after removal to help flush the urinary system and minimize discomfort. Any persistent or severe pain, fever, or difficulty urinating after removal should be reported to a healthcare provider.