How Does A Stent Work For Kidney Stones

What Is The Best Sleeping Position

While doctors havent established a single best position for reducing stent-related discomfort when sleeping, there are some reports that people feel better sleeping on the opposite side where their stent is placed.

However, this isnt backed up by research. You may have to try different sleeping positions to determine how you can get more comfortable.

Whats The Prognosis For Someone Who Has Ureteral Stents

Ureteral stents are generally safe. They dont typically cause any long-term problems.

Despite the risk of annoying side effects, ureteral stents are helpful. Ureteral stents often allow kidney stones to pass. They also work well to resolve ureteral obstructions. Left untreated, a ureteral obstruction can lead to life-threatening kidney failure and .

What Are The Advantages And Disadvantages Of This Treatment

The main advantage of this treatment is that it treats kidney stones without an incision. As a result, hospital stays and recovery time are reduced.

But, while SWL can work, it doesn’t always work. After SWL, about 5O% of people will be stone free within a month. In others, stone fragments of various sizes remain. Sometimes a repeat procedure is needed.

SWL has the potential to cause kidney injury. Whether or not SWL causes or leads to the development of high blood pressure and diabetes remains controversial. These possibilities are still being studied. You should ask your doctor about risks and benefits of SWL in your situation.

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Who Needs Ureteral Stents

Sometimes ureters can become blocked so that urine cant drain as usual. A ureteral stent can clear the ureter so your kidneys can work as they should.

The most common use of ureteral stents is to allow urine to flow through the ureter around a kidney stone thats blocking urine flow. Also, your provider may use a stent after breaking up kidney stones to prevent blockage from the passing fragments. Stents can also be used after kidney stone removal to prevent the ureter from getting blocked by postoperative swelling.

Healthcare providers also use ureteral stents to treat ureteral obstructions due to:

• Ureteropelvic junction obstruction .

What Is Shock Wave Lithotripsy

Shock Wave Lithotripsy is the most common treatment for kidney stones in the U.S. Shock waves from outside the body are targeted at a kidney stone causing the stone to fragment. The stones are broken into tiny pieces. lt is sometimes called ESWL: Extracorporeal Shock Wave Lithotripsy®.

These are what the words mean:

• extracorporeal: from outside the body
• shock waves: pressure waves
• lithotripsy

So, SWL describes a nonsurgical technique for treating stones in the kidney or ureter using high-energy shock waves. Stones are broken into “stone dust” or fragments that are small enough to pass in urine. lf large pieces remain, another treatment can be performed

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Is It Urgent That The Patient Be Treated With A Procedure Like This

lf the stone does not pass on its own, it will require treatment. lf you have an infection, severe pain, or if your kidney function is threatened, your doctors will act quickly. lf you only have one kidney or have had a kidney transplant, your stone will be treated more quickly. lf you have large stones or stones in both kidneys, your doctors will not wait to treat you.

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.

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Get Rapid Relief From Kidney Stones At Your Nearest Emergency Room In Frisco Or Fort Worth Tx

The pain and frustration of kidney stones can be debilitating and wreak havoc on a persons everyday life. Not only that, but some kidney stones can cause dangerous complications when left untreated. Dont sacrifice your comfort, health, and safety when it comes to kidney stones. If you suspect you may be passing a kidney stone or have previously been diagnosed with kidney stones that are now causing you painful or worrisome symptoms, visit your nearest iCare ER & Urgent Care location in Frisco or Fort Worth, TX today. Our exceptional and compassionate team of board-certified emergency physicians looks forward to giving you the relief and confidence you deserve.

What To Expect After The Procedure

The stent will be removed later on. Sometimes it is used temporarily before stone removal with another procedure.

Depending on the hospitals protocol, you will proceed to the recovery room or to your own room after the procedure. Your blood pressure, heart rate, and pain will be checked regularly. Ask your nurse about visiting hours for friends and relatives.

You will likely leave the hospital shortly after the procedure, when you are able to empty your bladder sufficiently and you have no fever or not in too much pain.

You may feel mild to moderate pain in your lower abdomen, and you may have a strong urge to urinate. These symptoms are usually caused by the inserted stent. Medication is available to treat these symptoms. Do ask your doctor.

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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.

What Happens Before Ureteral Stenting

Before a ureteral stent procedure, your provider may ask you to:

• Get blood tests to check kidney function.
• Give your healthcare team a list of the medications and supplements you take.
• Stop taking medications like aspirin that thin the blood.
• Fast for a specified amount of time before the procedure.

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How Will I Feel After Surgery

You may still experience pain after laser surgery. If you have a stent between the kidney and ureter, most pain will likely come from the stent because it can rub on the kidney or bladder. It also can make you feel like you have to urinate, and it may cause some blood in the urine. Men may have pain in the penis or testicles as well.

Your doctor will prescribe medications after surgery. Generally, these may include an antibiotic to prevent infection, pain medication, and perhaps something to treat bladder spasms and burning with urination.

Drink plenty of water to lubricate the stent and encourage any small stones to move out of the kidney. You will likely feel a more frequent urge to urinate, so you may want to stay close to a bathroom.

You can resume normal activities the next day, or as soon as you feel comfortable. Skip high-intensity workouts until after your stent is removed. Some pain medications restrict activities like driving, so check the warnings on the label. Your doctor will have additional recommendations for you to follow.

When Should I Call My Healthcare Provider

These symptoms are signs that a kidney stone may be blocking urine flow. Rarely, a blockage can lead to a serious infection that may pose a danger to your health.

• Blood clots in your urine.
• Dizziness or light-headedness.

A note from Cleveland Clinic

Shock wave lithotripsy is a safe treatment to get rid of kidney stones. Passing even tiny kidney stone fragments can hurt sometimes a lot. If you have shock wave lithotripsy, expect to feel some discomfort as stone fragments pass in the days and weeks after treatment. Pain may come and go until all the kidney stone pieces have worked their way out of your body. If you have other health issues, such as uncontrolled high blood pressure, shock wave lithotripsy may pose extra risks to you. Talk with your doctor about what to expect and whether shock wave lithotripsy is the right kidney stone treatment for your needs.

Last reviewed by a Cleveland Clinic medical professional on 03/24/2021.

References

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Why Would I Need A Stent

Stents are usually needed when plaque blocks a blood vessel. Plaque is made of cholesterol and other substances that attach to the walls of a vessel.

You may need a stent during an emergency procedure. An emergency procedure is more common if an artery of the heart called a coronary artery is blocked. Your doctor will first place a catheter into the blocked coronary artery. This will allow them to do a balloon angioplasty to open the blockage. Theyll then place a stent in the artery to keep the vessel open.

Stents can also be useful to prevent aneurysms from rupturing in your brain, aorta, or other blood vessels.

Besides blood vessels, stents can open any of the following passageways:

• bile ducts, which are tubes that carry bile to and from digestive organs
• bronchi, which are small airways in the lungs
• ureters, which are tubes that carry urine from the kidneys to the bladder

These tubes can become blocked or damaged just like blood vessels can.

Preparing for a stent depends on the type of stent being used. For a stent placed in a blood vessel, youll usually prepare by taking these steps:

Youll receive numbing medicine at the site of the incision. Youll also get intravenous medication to help you relax during the procedure.

Who Interprets The Results And How Do I Get Them

After the procedure is complete, the interventional radiologist will tell you whether the procedure was a success.

Your interventional radiologist may recommend a follow-up visit.

This visit may include a physical check-up, imaging exam, and blood tests. During your follow-up visit, tell your doctor if you have noticed any side effects or changes.

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What Does The Equipment Look Like

During ureteral stenting, a fluoroscope and a guide wire are used to place a stent into the ureter.

A guide wire may be inserted with the aid of a fluoroscope, an imaging device that uses x-rays to see structures on a fluorescent screen.

A stent is 10 to 15 inches long and less than a quarter inch thick.

During a nephrostomy, a fluoroscope, or an ultrasound, and a needle are used to place a catheter in the kidney.

A catheter is a long, thin plastic tube that is considerably smaller than a “pencil lead.” It is about 1/8 inch in diameter.

Ultrasound machines consist of a computer console, video monitor and an attached transducer. The transducer is a small hand-held device that resembles a microphone. Some exams may use different transducers during a single exam. The transducer sends out inaudible, high-frequency sound waves into the body and listens for the returning echoes. The same principles apply to sonar used by boats and submarines.

The technologist applies a small amount of gel to the area under examination and places the transducer there. The gel allows sound waves to travel back and forth between the transducer and the area under examination. The ultrasound image is immediately visible on a video monitor. The computer creates the image based on the loudness , pitch , and time it takes for the ultrasound signal to return to the transducer. It also considers what type of body structure and/or tissue the sound is traveling through.

How Are Ureteral Stents Removed

Some short-term ureteral stents have strings that hang outside the urethra, where pee comes out. Your healthcare provider gently pulls on the string to remove the ureteral stent.

If you need a ureteral stent for a few weeks or longer, the stent wont have a string. Your provider removes the stent during a minor office procedure. You may get X-rays or an ultrasound before removal. This imaging assures the provider that your kidney stone or other issue has resolved.

To remove the stent during a procedure, your provider:

• Inserts a cystoscope through the urethra and into the bladder.
• Uses tiny clamps attached to the cystoscope to grab onto the stent.
• Gently removes the stent.

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How To Prepare For The Procedure

Always ask your doctor about the treatment steps and any special instructions. These can differ by hospital and country.

Instructions may include:

• when to stop certain medications, such as blood thinners
• when to stop eating and drinking before the procedure to prepare for anaesthesia
• when to empty the bladder before the procedure
• when to arrange pain medication after the procedure, if necessarydiscuss this early with your nurse and/or doctor
• arranging for a ride home after your hospital discharge

Before surgery, someone from your health care teamusually the anaesthesiologistwill assess which type of anaesthesia is appropriate for you.

Depending on the country you live in and your hospital, types of anaesthesia can include:

• General anaesthesia
• A local anaesthetic with or without sedation

You may be asked to give a urine sample before the procedure to test for a urinary tract infection.

What Are The Potential Risks Or Complications Of Ureteral Stenting

As many as eight out of 10 people with ureteral stents experience:

• Bladder irritation, bladder spasms and frequent urination.
• Blocked, broken or dislodged stents.
• Blood in urine or painful urination.

Your healthcare provider will talk about your likelihood of risk. They will also tell you how to handle any worrying signs while the stent is in place.

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Emergency Management Of Renal Colic

Initial treatment of a renal colic patient in the ED starts with obtaining IV access to allow administration of fluid, analgesic, and antiemetic medications. Many of these patients are dehydrated from poor oral intake and vomiting. Although the role of supranormal hydration in the management of renal colic is controversial , patients who are dehydrated or ill need adequate restoration of circulating volume.

After diagnosing renal colic, determine the presence or absence of obstruction or infection. Obstruction in the absence of infection can be initially managed with analgesics and with other medical measures to facilitate passage of the stone. Infection in the absence of obstruction can be initially managed with antimicrobial therapy. In either case, promptly refer the patient to a urologist.

If neither obstruction nor infection is present, analgesics and other medical measures to facilitate passage of the stone can be initiated with the expectation that the stone will likely pass from the upper urinary tract if its diameter is smaller than 10 mm .

If both obstruction and infection are present, emergency decompression of the upper urinary collecting system is required . In addition, immediately consult with a urologist for patients whose pain fails to respond to ED management.

When Should I Call The Hospital Or My General Practitioner

• When you have a fever higher than 38.5°C
• When you experience a serious burning sensation when urinating
• When you are unable to urinate
• When you see large amounts of blood in your urine and it does not go away with rest and hydration
• When you continue to have severe pain in your side, despite the use of pain medication

Tell your doctor right away if bleeding or pain is severe or if problems last longer or worsen after you go home from the hospital.

Your doctor may prescribe an antibiotic to treat or prevent an infection or to relieve your pain. Report any signs of infectionincluding severe pain, chills, or feverto your doctor right away.

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What Does Recovery After Shock Wave Lithotripsy Look Like

As you recover from shock wave lithotripsy, you can expect to:

• Feel sore for a day or two: Right after shock wave lithotripsy, you may feel sore or stiff near the treatment area. Some people notice slight bruising along their side.
• See blood in your urine: Its common to see small amounts of blood in your urine. It may hurt to urinate. These symptoms usually go away after a few days.
• Collect stone pieces that you pass: Testing the stone may tell your provider what caused your kidney stones . Your provider may give you a urine strainer. It looks like a funnel with mesh at the bottom. It collects stone fragments when you pee.
• Drop off the stone sample for testing: You can store the stone fragments you collect in a specimen cup your provider gives you or a plastic bag. Follow your providers instructions. You may need to take it to your next follow-up visit or drop the sample off at a lab.
• Drink plenty of water: Staying hydrated helps stone fragments move through your body. Drinking water may also help you avoid constipation .