Placing The Stent Using A Cystoscope
You will need to have a small procedure to have a stent placed in your body. A doctor will use a small camera called a cystoscope. This camera goes up your urethra into the bladder. The doctor finds the ureter and passes the stent through the camera. To remove the stent, a doctor will again use the cystoscope. Removing a stent is another small procedure. 8
Time Your Fluid Intake
Youll want to drink plenty of water after you have a stent placed. This will help you flush blood and urine through your kidneys.
However, drinking too much water close to bedtime can cause you to make several additional trips to the bathroom at night.
To address this concern, try to drink plenty of water during the day and start to taper off your intake after dinner. This can help reduce the urinary frequency and urgency you may experience at night.
Your goal will be to keep your urine pale yellow whenever possible. This color indicates that youre hydrated.
When To See A Healthcare Provider
People will often assume that sudden flank pain is caused by a pulled muscle or overexertion, and, in many cases, it will be.
If the pain persists, worsens, or is accompanied by urinary symptoms or signs of infections, you should see your healthcare provider as soon as possible. This is especially true if you are experiencing high fever, chills, vomiting, or the inability to urinate.
Even if a kidney infection is mild, it can sometimes progress and lead to bacteremia if left untreated. This is a condition in which a local bacterial infection âspills overâ over into the bloodstream, causing systemic and potentially life-threatening symptoms, including irregular body temperatures, disruptions in breathing, a severe drop in blood pressure, and shock.
Given that acute pyelonephritis can strike in as little as two days, a rapid response is essential.
The same applies if you experience a dull but persistent pain alongside uncommon symptoms such as painful urination, chronic fatigue, or unexplained weight loss. None of these should be considered normal, and you shouldnât wait until there is visible blood in urine to seek care.
If you are pregnant, don’t assume that persistent back pain is pregnancy-related. Be cognizant if there is a dull ache across your lower back or along the sides of your back between the ribs and hips. If accompanied by symptoms of infection or changes in urination, call your healthcare provider immediately.
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Kidney Stent Side Effects
The kidneys connect to the bladder with a small tube called a ureter. Some medical conditions, such as kidney stones, can cause an obstruction in the kidney or the ureter. Kidney stents, also called ureteral stents, are thin, flexible, hollow tubes placed into the ureter to bypass the obstruction and allow the passage of urine. One end of the stent opens into the kidney and the other end opens into the bladder. The stent is not permanentthe urologist removes it after the obstruction is resolved. The procedure is relatively safe, but some side effects or complications may occur.
If you are experiencing serious medical symptoms, seek emergency treatment immediately.
When The Stent Was Placed During A Procedure For Stone Removal
If a stone is removed during the procedure, it is sent to the laboratory to determine its composition. This may take several weeks. Based on the laboratory results, along with blood and urine tests taken before treatment, your doctor can determine whether you are at high risk of forming new stones .
The results will be discussed with you during an appointment in the hospital or with your doctor .
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How Is The Stent Removed
The stent is removed by having a small procedure called a “Flexible Cystoscopy” under a local anaesthetic. You may experience some discomfort and see blood in the urine following the procedure. Simple pain relief such as Paracetamol will help the discomfort. You are encouraged to increase your fluid intake to clear any blood in your urine and help prevent a urine infection.
What Happens To Patients
As a result, there is no standard of care regarding how to optimally manage such patients. In all cases it is first imperative to rule out other potential sources of pain however, such workups often end with the same result a patient with bothersome flank pain and evidence of one or more nonobstructing stones on imaging.
Lacking a physiologic explanation to explain their symptoms, patients with pain and non obstructing stones are often sent for detailed workups, secondary and tertiary consultations and referral to pain specialists and even psychiatrists. However, in an age where flexible ureteroscopy can be performed quite safely and on an outpatient basis one must wonder whether such patients are being treated appropriately.
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While You Have Your Stent
After your stent placement procedure, you may feel a pulling sensation when you urinate . You may also have:
- Frequent urination, which is the need to urinate more often than usual.
- Urgent urination, which is a strong, sudden urge to urinate, along with discomfort in your bladder.
- Pelvic pain, which is pain in your lower abdomen .
These symptoms usually go away with time. Your healthcare provider will talk to you about what symptoms you might feel. Your healthcare provider may give you medication to help with bladder symptoms.
You may sometimes see blood in your urine while you have the stent. This may happen for as long as the stent is in place. Sometimes, it happens after increased activity or long car rides. If you see blood in your urine, drink more water than usual until the blood goes away.
Home Remedies For Kidney Stone Removal And Stent:
Pain, abdominal discomfort and urinary troubles after kidney tone removal and stent can be reduced or avoided by following simple home remedies:
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What Symptoms Can Be Caused By A Stent
Normal symptoms you may experience when a stent is in place include:
- Blood in urine Can range from light pink tinged urine, to a darker color similar to red wine.
- Dysuria this can be mild to moderate. Dysuria can usually be relieved by increasing fluid intake and avoidance of certain drinks, food, and some medications.
- Urgency the feeling/sensation you get when you have to go
- Frequency going to the restroom more often than normal. Frequency can range from every few minutes, to once an hour. Frequency will increase when increasing fluid intake.
- Spasms of the ureter or bladder. A cramping-like sensation in the mid to low abdomen, often described as feeling like a muscle cramp
Some symptoms are not normal with a stent in place, and you should see your doctor. These include:
- Constant dark bloody urine that does not ease up with increased fluid intake.
- Thick clots or tissue in the urine that is causing any difficulty urinating
- Urinary retention, meaning you are unable to urinate at all. Small dribbles of urine with an increasing discomfort in your lower abdomen can suggest the beginning of retention, and you should notify your doctor.
- Severe pain of any kind not relieved with any medications, either over-the-counter or prescription medication.
- Persistent fever over 101.8 °
Are There Any Restrictions
Your doctor will let you know if you have any restrictions following urinary stent placement.
Typically, you can perform most activities, work, and even sexual activity with a stent in place, providing it doesnt cause you great discomfort to do so.
There is one exception: when you have a stent with an extraction string. This is a special stent designed so you can remove the stent yourself after its been in place for a certain amount of time.
Stents with strings have a slightly higher rate of dislodgment. Avoid sexual activity while you have one in place to prevent dislodging the stent.
According to a 2015 study , people with stent strings also reported a bit more sleep disturbances than people who had stents without strings.
When you sleep, make sure the string is in a place where you can locate it easily. Sometimes, your doctor will tape the strings down to your leg or groin until you remove it.
Stent-related irritation can cause a lot of different symptoms including discomfort. Examples include:
- visible blood in urine
- incontinence, or loss of control over urine
- pain when urinating
Ideally, these symptoms will subside within a few days after the stent placement when youre more used to the stents presence.
A urinary stents presence can increase the risks of a urinary tract infection . Call your doctor if you experience some of the following symptoms, as they can indicate you may have an infection:
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Opinions Of Urologists In General
Though the physiologic basis of pain in the setting of obstruction is clear, it does not provide an explanation for one of the most commonly encountered conundrums in stone disease the symptomatic non-obstructing stone. These can be actual free stones that have not passed, stones attached to plaque, or actual plugs in the kidney tubules that are massed together enough to show up on a CT scan as stones though actually tissue calcifications.
There is perhaps as much variation in clinical opinion in such instances as any other clinical scenario in the field.
If one were to ask a group of urologists whether they believed that small nonobstructing stones could cause renal colic, opinions would range from absolute certainty to complete dismissal of the concept altogether.
Problems Caused By Ureteral Stents
Even though placing ureteral stents helps in preventing the blockage of urine in the kidneys, it has some problems. Many patients feel a lot of discomfort during the process, and there is no other option but to bear the pain for a few days or weeks. In this regard, let us look into some of the common problems caused by ureteral stents.
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What Happens During Ureteral Stenting
Stenting is typically an outpatient procedure. You go home the same day. A urologist, a doctor who specializes in conditions that affect the urinary system, performs the procedure.
Before the procedure, you receive anesthesia. Most often, you have general anesthesia, so youre asleep. You lie on your back for the procedure. Your provider:
- Uses X-ray imaging or a kidney ultrasound to locate the obstruction and guide the procedure.
- Inserts a small scope device with a lens through the urethra and into the bladder. The urethra is the tube where urine leaves your body when you pee.
- Threads a thin, flexible wire through the cystoscope into the blocked ureter.
- Uses the guidewire to place the ureteral stent. A curled part of the stent sits in the kidney, while another curled part rests in the bladder. These coils hold the stent in place.
- Gently removes the guidewire and cystoscope, leaving the stent in place.
What Is Known To Date
Such patients are frequently encountered. Despite a lack of physiologic explanation as to why these non-obstructing stones may cause pain, there is emerging evidence that they do and therefore that removal can cure it.
In 2006 Taub et al. described outcomes of twenty such patients who had chronic flank pain as well as radiographically evident calcifications within their papillae without obvious collecting system stones. Ureteroscopy with laser papillotomy to unroof and remove all evident stone was performed on twenty seven kidneys. Pain improvement was seen in 85% of cases with a durable improvement for greater than one year in nearly 60% of cases.
This study was then repeated on a multi-institutional level with 65 patients undergoing similar procedures over a ten year period. Overall there were 176 procedures performed in this cohort with patients reporting less pain after the procedure 85% of the time. The mean duration of response was 26 months with 60% of patients having sustainable improvements in their pain levels for over one year.
Finally, this clinical scenario is seen commonly enough that it garnered its own nickname at Massachusetts General Hospital where it has been described as small stone syndrome. In a retrospective review of patients treated there with ureteroscopic removal of small nonobstructing stones for reasons related to chronic pain, 11/13 patients reported being pain free after the procedure with the other two noting a partial response.
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About Your Ureters And Ureteral Stent
Your ureters are tubes inside your body that drain urine from your kidneys to your bladder. If one of your ureters is blocked, your urine wont drain properly. When this happens, your kidney fills with urine and swells. This is called hydronephrosis. It can be caused by a tumor pushing on your ureter, kidney stones, or scar tissue. If your kidney remains blocked for a long period of time, it can become damaged. If both of your ureters are blocked, this will cause both of your kidneys to become weak and can place you at risk for kidney failure. Blocked kidney require ureteral stent placement.
A ureteral stent is a thin tube thats placed in your ureter to help drain urine from your kidney . One end of the tube is inside your kidney and the other end is in your bladder.
Figure 1. Ureteral stent
Ureteral stents can be used for several weeks, months, or years. Theyre used to:
- Let urine flow through your blocked ureter.
- Keep your ureter open.
When To Call Your Healthcare Provider
Contact your healthcare provider right away if:
Your urine contains blood clots or you see a large amount of blood-tinged urine
You have symptoms similar to those you had before the stent was placed
You constantly leak urine
You have a fever over 100.4°F , or as advised by your health care provider
You have chills
You experience nausea or vomiting
Your pain is not relieved with medicine
The end of the stent comes out of the urethra
You experience new or worsening symptoms
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What To Expect After Ureteral Stent Removal
If your stent is only required for a short period of time, your doctor will then remove the stent from your ureters. This process, like the implanting of the stent, will require a recovery time that may be marked with symptoms and side effects that patients should be aware of.
The removal of a stent can, again, be followed by a period of frequent urination. When urinating, patients can expect to feel some burning or discomfort for a couple of days after the procedure. Despite this discomfort, patients are encouraged to drink a lot of water and other fluids to prompt the production of urine that will aid in flushing out the ureters and encourage a full recovery. You may also notice some blood in your urine. This is normal, although you should notify your doctor if it doesnt go away or gets worse after several days of recovery.
Some patients may instantly sleep better after a stent removal, while others may still be kept awake by discomfort or pain. Your doctor may encourage you to continue taking medications as you recover from the stent removalespecially if you suffered from sleep issues while the stent was in place.
Your doctor may have other recommendations or guidance to recover after a stent removal. Always follow your doctors instructions to support a smooth recovery and avoid the risk of post-stent complications, such as a urinary tract infection.
What Is A Ureteral Stent
Ureteral stents are small tubes inserted into the ureter to treat or prevent a blockage that prevents the flow of urine from the kidney to the bladder. The most common reason for ureteral stents is the treatment of kidney stones. Below are the answers to some of the questions we receive about ureteral stents.
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When To Call Your Doctor Regarding Your Ureteral Stent
While ureteral stents may be uncomfortable and unpleasant, they are typically a safe and routine intervention. However, patients should be aware of possible signs of an infection or other complications that may require emergency medical attention. Call your doctor if you experience any of the following symptoms while your stent is in place:
- A burning sensation while urination
- Changes in the characteristics of your urine, including color or smell
- Kidney pain or other abdomen pain
- Chest pain
- Other unexpected symptoms or side effects
A ureteral stent may not always be comfortable but, when compared to the pain and possible kidney damage caused by a ureteral blockage, the procedure offers a welcome alternative that preserves the health and function of your kidneys. If youre experiencing pain due to a potential ureteral blockage, talk to your doctor today.