What to Expect After Kidney Stent Removal

About two out of three people experience at least some symptoms after a ureteral stent is removed, with pain, blood in the urine, urinary urgency, and increased frequency being the most common complaints.¹ The good news is that for most people these symptoms are short-lived, often resolving within a day or two. But the experience varies widely, and how the stent was removed, what medications you took beforehand, and how complicated the original stone procedure was all shape what those first few days feel like.

The First Few Hours After Removal

The most common sensations right after stent removal are cramping and spasms, often felt in the kidney area, the lower back, or along the urethra. In a qualitative study that interviewed patients in depth about their removal experience, roughly a third reported pain on the day the stent came out, and they most frequently described it as “cramps” or “spasms.”² More than half of those who had pain said it eased within four hours. For about a third of those with pain, though, the discomfort lingered between 24 and 48 hours.²

What catches many people off guard is how intense that pain can be. Among participants who described the severity, almost all said the post-removal pain was as bad as or worse than the pain from the kidney stone itself.² Some were temporarily unable to work, needed to lie down, or couldn’t get comfortable. A small number went to or considered going to the emergency room. One survey-based study found that about 32 percent of patients reported delayed severe pain after stent removal, and 9 percent returned for emergency care.³

Blood in the urine is also normal. It can range from a faint pink tinge to more visibly red urine, especially in the first 24 hours. Drinking plenty of water helps flush the system and usually clears this up faster. Urinary urgency and frequency are common too, since the bladder has been irritated both by the stent sitting inside it and by the removal procedure.

How the Removal Method Affects Your Recovery

Stents are taken out in one of two main ways: in a clinic using a cystoscope (a thin camera threaded through the urethra), or at home by pulling on a string that was left dangling from the stent at the time it was placed. The method matters for what comes after.

Office cystoscopy tends to produce more pain at the moment of removal. One study recorded a mean pain score of about 5.3 out of 10 for cystoscopic removal.³ A controlled trial comparing the two methods found that string removal was significantly less painful for men, with average pain scores of about 2.7 versus 5.7 for cystoscopy.⁴ Interestingly, the difference was not as clear for women in that same trial, likely because the female urethra is shorter and a cystoscope causes less discomfort passing through it.⁴

String removal does have a trade-off. One survey found that patients who removed their stent by string actually had more emergency room visits afterward compared to those who had cystoscopic removal.³ The likely reason is not that string removal causes more complications, but that patients at home lack the reassurance of a clinician telling them the symptoms they are feeling are normal. When cramping or bleeding hits at home with no one to check in with, a trip to the ER feels like the safe choice. Proper counseling before discharge, including a written information sheet and clear instructions about what is normal and what warrants a call, appears to reduce that anxiety.⁵

Medications That Make a Real Difference

One of the most useful things you can do before stent removal is take a standard anti-inflammatory painkiller. In a randomized, double-blind trial, more than half of the placebo group experienced severe pain (a score of 7 or higher out of 10) in the 24 hours after removal, while none of the patients who received a single dose of an NSAID beforehand had severe pain.⁶ That is a striking result from a relatively simple intervention.

Another trial tested diclofenac (an NSAID), silodosin (a medication that relaxes smooth muscle in the urinary tract), and a combination of both, all against a placebo. Each active treatment group saw average pain scores drop to roughly 2.9 to 3.1, compared to about 4.2 in the placebo group.⁷ The practical takeaway is simple: if your doctor doesn’t mention pre-medication, ask about taking an NSAID an hour or so before the procedure. It is cheap, widely available, and the evidence supporting it is strong. Patients who self-remove at home are typically discharged with paracetamol and ibuprofen as standard aftercare.⁵

Reducing Pain and Anxiety During the Procedure Itself

If your stent is being removed by cystoscopy, the clinic setting and the experience during removal shape how the rest of your day goes. A study comparing different comfort measures during rigid cystoscopic removal found that patients who received both local anesthesia and watched the procedure on-screen reported significantly less pain and higher satisfaction than those who got neither or only one of the two. In the group with no comfort measures, 85 percent said they would prefer a different approach next time, while among those with both interventions, no one asked for anything else.⁸

Anxiety plays a bigger role than many patients expect. A randomized trial that tested a comfort-oriented daytime removal protocol, which included elements like scheduling, environment adjustments, and patient preparation, found that the comfort group reported 24-hour pain scores of about 2.6 out of 10 versus 5.5 in the conventional group. Their anxiety scores were also significantly lower both before and after the procedure.⁹ This suggests that the psychological side of stent removal, feeling prepared, knowing what to expect, being in a calm environment, is not just about “mental health” in the abstract. It measurably reduces physical pain.

What Predicts Worse Symptoms Afterward

Not everyone recovers equally, and some factors tilt the odds toward a rougher experience. A study looking specifically at predictors of post-removal symptoms found that patients who needed a stone basket during the original procedure (a tool used to grab and extract stone fragments) were more likely to have pain afterward. People who found the stent uncomfortable while it was in place also tended to report worse pain after removal, which makes intuitive sense: their urinary tract may have been more irritated to begin with.¹

Surprisingly, a longer stent dwell time and the use of anticholinergic medication (drugs that calm bladder spasms) were associated with less pain after removal in that same analysis.¹ The stent dwell time finding is a bit counterintuitive. It may reflect that the ureter gradually accommodates the stent, so by the time it comes out, the tissue is less reactive. Or it may simply reflect that patients with shorter stent times had more complicated stone procedures and more tissue trauma to begin with.

When Symptoms Are Not Normal

Most post-removal discomfort is expected and harmless. But some signs need prompt medical attention. A fever above 38°C (100.4°F), especially with chills, could signal a urinary tract infection or even urosepsis, which is a serious condition where infection spills into the bloodstream. This is uncommon but not something to wait out.

A case report described a patient who developed urosepsis twice within 15 days, each episode shortly after a stent was removed. Both times, imaging had confirmed no residual stones before removal.¹⁰ This is an extreme and unusual scenario, but it illustrates why fever after stent removal is taken seriously. The stent can harbor bacteria in a biofilm that coats its surface, and once the stent is pulled, those bacteria can briefly wash through the urinary tract. If you develop a high fever, shaking chills, or feel suddenly much worse in the hours or days after removal, get medical help that day.

Persistent inability to urinate, severe unrelenting pain that does not respond to painkillers, or heavy blood clots in the urine that block urine flow are also reasons to seek care rather than ride it out at home.

How Long Until You Feel Completely Normal

For most people, the worst symptoms are over within one to two days. Mild urinary frequency, occasional twinges, or faint blood in the urine can persist for up to a week or so. Quality-of-life surveys comparing patients two weeks after stent removal show no significant difference from their pre-stent baseline, regardless of whether the stent was removed by string or cystoscope.⁴ So the two-week mark is a reasonable horizon for most people to expect a full return to normal.

During recovery, generous hydration is consistently recommended. It dilutes the urine (which reduces irritation), helps flush out any residual blood or debris, and may lower the chance of an infection taking hold. Avoiding strenuous exercise, heavy lifting, and sexual activity for a few days after removal is also standard advice, though exact timelines vary between clinics.

Why Leaving a Stent in Too Long Creates Its Own Problems

Some patients, hearing how unpleasant removal can be, put off the procedure. This is risky. Stents left in place beyond their intended time develop a mineral crust called encrustation, which makes them much harder to remove and increases the chance of complications. A large review covering 50,000 stent procedures found that encrustation and calcification occurred in over 800 cases, the vast majority in patients with long-term stenting.¹¹ A heavily encrusted stent may require additional procedures to break up the mineral deposits before it can be pulled, turning what would have been a brief office visit into a more involved surgery.

Certain populations face accelerated encrustation. A case report documented a pregnant patient whose stent, placed for obstructive kidney infection, became heavily encrusted due to changes in urine chemistry (specifically a higher urine pH that promotes phosphate crystal formation). The authors concluded that stents in patients with high urine pH may need to be replaced on a shorter schedule to avoid this problem.¹²

Ureteral Narrowing After Stone Procedures

A less commonly discussed concern after stent removal is the possibility of a ureteral stricture, a spot where the ureter narrows due to scarring. The stent itself doesn’t typically cause this; it is usually the original stone and the procedure used to treat it that create the scar tissue. After uncomplicated ureteroscopy, stricture rates are low. One prospective study tracked 263 procedures and found strictures in only about 1.5 percent of cases, predominantly in patients who had impacted stones.¹³

Impacted stones, ones that have been wedged in the ureter long enough to cause inflammation and damage to the surrounding tissue, carry a much higher risk. A study focused specifically on impacted stone cases found that 24 percent of patients developed a stricture at the stone site within about seven months.¹⁴ Strictures don’t always cause symptoms right away; they tend to show up as a gradual blockage weeks to months later, sometimes revealed by back pain, recurrent infections, or swelling of the kidney on imaging. If you had a complicated stone removal or an impacted stone, follow-up imaging is especially important so that any narrowing can be caught before it becomes a bigger problem.

When Children Need Stent Removal

Stent removal in children presents unique challenges, primarily around anesthesia. Adults tolerate office cystoscopy while awake (though not happily), but young children generally cannot. Cystoscopic stent removal in pediatric patients typically requires general anesthesia, with intubation or a laryngeal mask airway and intravenous medications. Some centers have moved toward non-cystoscopic techniques using a flexible feeding tube under lighter anesthesia, sometimes just inhaled sedation without an IV line. In at least one reported case, a cooperative older child had the procedure done without any medication at all.¹⁵

For parents, the practical implication is that if your child needs a stent removed, ask the surgical team about the removal approach early. If a non-cystoscopic method is available, it may mean lighter sedation, a shorter recovery, and less distress for the child. String-based self-removal, while standard for many adults, is generally not used in young children for obvious reasons of compliance and safety.

Practical Tips for the Days After Removal

A few straightforward habits make the recovery period easier to manage. Drink more water than you think you need. This is the single most commonly repeated piece of advice in the urological literature for a reason: dilute urine irritates the bladder lining less, flushes small blood clots before they can cause problems, and keeps urine flowing through a ureter that just had a foreign object pulled through it.

Take your painkillers on schedule rather than waiting for the pain to build. If you were given an NSAID, staying ahead of the inflammation is more effective than chasing it once it peaks. A warm bath or a heating pad on the flank or lower abdomen can ease the cramping and spasms that are most intense in the first few hours. Some people find that urinary frequency is worst overnight; limiting fluids right before bed (while staying well-hydrated during the day) can help with sleep.

Keep a mental note of your symptoms over the first 48 hours. Gradual improvement is expected. If things are getting worse rather than better, especially if you develop a fever, that trajectory matters more than any single symptom in isolation. And if you were given a follow-up appointment or imaging date, keep it. Strictures and residual stone fragments don’t always announce themselves with symptoms, and catching them early is far simpler than dealing with them once they’ve caused a blockage.

1
PubMed Central. Symptoms after removal of ureteral stents
2
PubMed Central. Patients’ Experiences with the Removal of a Ureteral Stent: Insights from In-Depth Interviews with Participants in the USDRN STENTS Qualitative Cohort Study
3
PubMed Central. Patient Experiences and Preferences with Ureteral Stent Removal
4
PubMed. Impact of ureteric stent removal by string on patient’s quality of life and on complications at post-ureteroscopy for urolithiasis: a controlled trial
5
PubMed Central. Implementing routine use of self-removed ureteric stents on extraction strings: prospective patient-reported outcome measures and complications
6
PubMed. A single dose of a non-steroidal anti-inflammatory drug (NSAID) prevents severe pain after ureteric stent removal: a prospective, randomised, double-blind, placebo-controlled trial
7
PubMed Central. A single oral dose of Silodosin and Diclofenac sodium is effective in reducing pain after ureteric stent removal: a prospective, randomized, double blind placebo-controlled study
8
BMC Urology. Pain and satisfaction during rigid cystoscopic ureteral stent removal: a preliminary study
9
PubMed Central. A Randomized Study of a Comfort-Oriented Daytime Double-J Stent Removal Protocol: Effects on Pain, Anxiety, and Patient Satisfaction
10
PubMed Central. Recurrent Urosepsis Following Stent Removal for Ureteral Stones: A Case Report
11
PubMed Central. Ureteral stent complications – experience on 50,000 procedures
12
PubMed Central. Difficulty in Removing a Ureteral Stent post Childbirth due to Encrustation: A Case Report
13
PubMed Central. Ureteral stricture after ureteroscopy for stones: A prospective study for the incidence and risk factors
14
The Journal of Urology. Ureteral Stricture Formation After Removal of Impacted Calculi
15
Elsevier / Journal of Pediatric Surgery Open. Double J ureteral stent removal following pediatric laparoscopic pyeloplasty without cystoscopy