A ureteral stent is a thin, flexible tube placed inside the ureter, connecting the kidney to the bladder. This device helps maintain urine flow when blockages occur, often due to kidney stones, narrowed ureters, or tumors. Some short-term stents include a string that extends outside the body through the urethra, allowing for easier removal by the patient or a healthcare provider.
Understanding Why the String Disappears
The disappearance of a ureteral stent string is common and does not mean the stent has moved or is gone. The string often retracts into the bladder or, less commonly, further up the ureter. This retraction can occur due to physical activity, sudden movements, or bladder spasms.
The string’s external position can be affected by the body’s natural movements or urinary system pressure. Its absence from external view simply means the accessible part of the string is no longer visible. The stent, with its coiled ends, is secured within the kidney and bladder, making complete dislodgement less frequent than string retraction.
Immediate Steps When the String is Gone
If your ureteral stent string is no longer visible, contact your urologist or healthcare provider promptly. They can assess the situation and provide specific guidance. Avoid any attempt to retrieve the string yourself, as this could dislodge the stent or cause injury.
While awaiting medical advice, monitor for any changes in your symptoms. Watch for signs like increased pain, fever, chills, or difficulty urinating. These symptoms could indicate a complication, though the main concern is ensuring the stent remains properly positioned for safe removal.
Retrieval Methods Without a Visible String
When a ureteral stent string is no longer visible, medical professionals typically use a cystoscopy for removal. This involves inserting a thin, flexible tube with a camera, called a cystoscope, through the urethra and into the bladder. The camera allows the urologist to visualize the stent directly.
Once located, tiny clamps or grasping instruments are passed through the cystoscope to grasp the stent. The stent is then gently removed through the urethra along with the cystoscope. This routine procedure is often performed in an outpatient setting, typically with local anesthesia or light sedation to minimize discomfort. The entire process usually takes only a few minutes.
Addressing Potential Concerns
Timely removal of a ureteral stent is important, especially if the string has disappeared, to prevent complications. One concern is stent migration, where the stent moves out of its intended position. While coiled ends generally keep the stent in place, migration can lead to ineffective drainage or increased discomfort.
Another issue is encrustation, where mineral deposits form on the stent’s surface, similar to kidney stones. The risk of encrustation increases with prolonged indwelling time. Encrustation can make stent removal more challenging and potentially lead to fragmentation.
A stent remaining in place beyond its recommended duration increases the risk of urinary tract infections (UTIs). The stent acts as a foreign body, facilitating bacterial colonization and biofilm formation, which can lead to persistent or recurrent infections. Untreated infections can progress to more serious conditions like pyelonephritis or urosepsis.
Leaving a stent in place for an extended period can also lead to chronic pain and discomfort, and in rare cases, impair kidney function. Addressing a missing stent string promptly ensures the stent can be retrieved before these issues develop or worsen. Healthcare providers manage these concerns by tracking stent placement and ensuring timely removal or exchange.