Ureteral Stents

What is a ureteral stent?

Ureteral stents are thin, flexible silicone or polyurethane (plastic) tubes that hold your ureters open. Ureters are part of your urinary system. They’re narrow tubes of muscle that carry urine (pee) from your kidneys to your urinary bladder. Most people have two ureters — one ureter connects to each kidney, and each one connects to one side of the bladder. Healthcare providers place ureteral stents to prevent or treat blockages (ureteral obstructions). They may put a stent into one or both ureters, depending on the reason for the stenting.

Ureteral stents are about 10 to 15 inches long and about a quarter inch in diameter. They line the entire length of your ureter to keep it open. The top part of a ureteral stent has a coil that sits inside your kidney. The bottom part has a loop that sits inside your bladder.

Other names for a ureteral stent include:

• Urinary stent
• Ureteric stent
• Double-J stent

What is the reason for a ureteral stent?

Ureteral obstructions prevent pee from draining. A ureteral stent opens the ureter so pee can easily move from your kidney to your bladder.

Healthcare providers most commonly use ureteral stents to:

• Allow pee to bypass a kidney stone (renal calculi) that slows or stops pee flow
• Prevent a new blockage from developing after kidney stone treatment
• Prevent a blockage from postoperative swelling after kidney stone removal

Providers also use ureteral stents to treat obstructions due to:

• Blood clots
• Inflammatory bowel disease (IBD)
• Scar tissue buildup from endometriosis or other conditions
• Tumors
• Ureteral stones
• Ureteral junction obstruction

How should I prepare for ureteral stenting?

Before the procedure, a healthcare provider will explain how they’ll use a ureteral stent to treat your condition and ask for your consent. They’ll perform a physical exam to ensure you’re healthy enough for surgery and may ask you to:

• Provide your health history
• List all medications you’re taking, including vitamins and herbal supplements — some of these may increase your risk of bleeding
• List all of your allergies
• Take blood tests (estimated glomerular filtration rate or eGFR) to check how well your kidneys work
• Not eat or drink (fast) for at least eight hours before the procedure, but if you must take certain medications, take them with a small sip of water

Is a ureteral stent a major surgery?

Ureteral stenting is typically a minimally invasive urological surgery. In most cases, it’s an outpatient procedure. That means you’ll go home the same day you have the procedure. But you must have a family member or friend drive you home.

Who makes up my ureteral stenting care team?

In general, the following healthcare providers make up your ureteral stenting care team:

• Urologist
• Anesthesiologist
• Nurses

What happens during ureteral stenting?

A urologist usually performs ureteral stenting in a hospital or surgical center while you’re under general anesthesia. General anesthesia makes you temporarily fall asleep so you won’t feel pain or be aware of anything else in the operating room during the procedure. You’ll lie on your back for the procedure.

Once you’re asleep, the urologist will:

• Use an imaging test, such as fluoroscopy or a kidney ultrasound, to locate the obstruction and guide the procedure
• Insert a long, thin medical tool with a camera at the end (cystoscope) through your urethra and into your bladder
• Thread a thin, flexible wire (guidewire) through the cystoscope into the blocked ureter
• Use the guidewire to place the ureteral stent
• Gently remove the guidewire and cystoscope, leaving the stent in place

The coiled end of the stent sits in your kidney, while the looped part rests in your bladder. These parts hold the ureteral stent in place.

How long does ureteral stenting take?

In most cases, ureteral stenting takes less than 30 minutes to complete. But you may be in a hospital or surgical center for a few hours while healthcare providers prepare you for surgery and make sure you’re healthy before they discharge you. A provider will give you an idea of what to expect.

What happens after ureteral stenting?

After your urologist places the ureteral stent and removes the cystoscope, your anesthesiologist will stop giving you anesthesia. You’ll be conscious (awake) after a few minutes. But you’ll likely feel groggy. Providers will monitor your health and treat your pain once you fully wake up. They may recommend drinking lots of water over the next few days to help with your kidney and bladder function.

They’ll let you go home (discharge you) once they determine you no longer require monitoring. You must have someone drive you home.

You may notice some blood in your pee (hematuria) and have some general discomfort, especially when you pee. These symptoms are normal, and they should gradually improve within a few days. But you may still have traces of blood in your pee that come and go and have discomfort until your provider removes your ureteral stent. You may also pee more than you usually do (frequent urination) and feel discomfort or pain in your kidney when you pee. Call a healthcare provider if you have kidney pain.

How long does a ureteral stent stay in?

Most ureteral stents are temporary. Your urologist will remove the stent after your condition improves. Most people have the stent in for a few days or up to a few weeks.

Some people need ureteral stents for months or years. You may need a ureteral stent for an extended period if you have a tumor that presses on your ureters, or your ureters are narrow. Your urologist will replace the stent every three to six months. Replacing the stent reduces the likelihood of complications, such as urinary tract infections (UTIs).

How are ureteral stents removed?

Some short-term ureteral stents have strings that hang outside your urethra, where pee exits your body. A healthcare provider gently pulls the string to remove the ureteral stent.

If you need a ureteral stent for a few weeks or longer, it won’t have a string. Your urologist will remove it during a minor office procedure. They may also order imaging tests to ensure your condition has improved.

To remove the stent, your urologist will:

• Use a topical anesthetic to numb the area
• Insert a cystoscope through your urethra and into your bladder
• Use tiny clamps that attach to the cystoscope to grab the stent
• Gently remove the stent

How painful is removing a ureteral stent?

The area will be numb during ureteral stent removal, so you won’t feel much, if any, pain. But many people feel moderate discomfort or pain after the topical anesthetic wears off. It usually goes away after a few days.

What are the benefits of ureteral stenting?

It depends on why you need a ureteral stent. Some of the benefits include:

• It allows pee to drain from your kidneys to your bladder
• It allows you to pee comfortably
• It helps drain infected pee
• It allows your ureter to heal after surgery or from another condition

Without treatment, a ureteral obstruction may lead to life-threatening kidney failure or sepsis.

What are the disadvantages of a ureteral stent?

Up to 80% of people with ureteral stents have one or more of the following complications:

• Bladder irritation
• Bladder spasms
• Peeing more than usual
• Blocked, broken or dislodged stents
• Blood in their pee
• Pain or burning while peeing (dysuria)
• UTIs

You may also be at a greater risk of developing a sexually transmitted infection (STI). Bacteria and viruses can more easily enter your body through a wound in your urinary system.

A healthcare provider will talk to you about your likelihood of risk. They’ll also tell you how to handle any worrying signs that may appear while the stent is in place.

Why is a ureteral stent so painful?

Your body is unique, and how it reacts to a ureteral stent may be different than others. Some people may experience only minor discomfort, while others feel more pain. In some cases, this occurs because, when you pee, your bladder shrinks. As it shrinks, the looped end of the ureteral stent rubs against your bladder wall.

How do I relieve ureteral stent pain?

Ureteral stents can be uncomfortable or painful. You may have pelvic pain or experience a pulling sensation when you pee. Over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) can help relieve pain. Not everyone can take NSAIDs, so make sure to check with a healthcare provider first.

A provider may prescribe tamsulosin (Flomax®) to help with stent pain. This drug is designed for people with prostate problems. But it can help anyone with stent-related pain.

What is the recovery time for a ureteroscopy with a stent?

Most people can return to their typical daily activities within a week after receiving a ureteral stent.

What should you avoid after a ureteral stent?

Avoid strenuous activity for at least a few days after receiving a ureteral stent. This includes lifting anything heavier than 10 pounds, which is about the same weight as a gallon of water.

It’s also a good idea to avoid having sexual intercourse for at least a week after stent placement. This reduces your risk of developing an STI. Sex may also be difficult or uncomfortable.

When can I go back to work/school?

Most people can return to school or work a day or two after ureteral stenting. But you may need to take more time off if your job requires a lot of physical activity or heavy lifting.

What is the prognosis for someone who has ureteral stents?

Ureteral stents are generally safe. They don’t typically cause any long-term problems.

You may experience some uncomfortable or annoying side effects. But ureteral stents are helpful. They work well to resolve ureteral obstructions and let kidney stones pass. What you can expect as time passes depends on the condition the stents are treating and your overall health.

When should I call a healthcare provider?

Call your healthcare provider if you experience:

• Clots of tissue in your pee
• Dark, cloudy or foul-smelling pee
• Trouble peeing or severe pain or burning when you pee
• Kidney pain
• Nausea and vomiting
• Signs of an infection, including a fever or chills

Is a kidney stent the same as a ureteral stent?

A kidney stent is similar to a ureteral stent, but they’re not the same. In rare cases, a urologist can’t place a ureteral stent because of scarring or other problems. In these instances, you may need a kidney stent (nephrostomy). A urologist or radiologist will place the stent directly in your kidney. The kidney stent drains pee from your kidney into a bag outside your body (urostomy pouch), bypassing your ureters and bladder.

A kidney stent is different than a renal artery stent. A renal artery stent opens your renal artery to get more blood from your heart to your kidneys.