Stent Removal After Kidney Stone Laser
Similar to ureteral stones, kidney stones can be fragmented and removed with baskets. Occasionally, a kidney stone will fragment with a laser into very small. Jun 26, 2011 · In most patients, stent removal is a relief as their stent discomfort goes away. However, in some patients, severe pain may occur for several hours.
The stent is usually removed after a few days to a few weeks depending on the particular circumstances. Ureteric stents cannot stay in the body indefinitely (.
Following URS, clinicians may omit ureteral stenting in patients meeting all of the.
Index Patient 12: Adult, renal stone with pain and no obstruction.
The ureteral stent is typically removed in the office, usually within 1-2 weeks after the procedure but may be left for longer after complex procedures. If you have any questions, to schedule a consultation or if you need a second opinion, please contact us or call: 646-663-4421. Dr. Alex Shteynshlyuger is a board certified urologist in NYC who.
If you have had a stent inserted after kidney stone surgery, it is temporary and only needed for a short period of time. There are two main methods for removal. For most patients, the stent will only stay in place for 5-7 days. Is a stent necessary after kidney stone removal? The routine placement of a ureteral catheter or stent following.
The stent removal does not hurt at all, I removed mine myself. The after effect of bladder spasms and kidney pain had me going back to the emergency room.
To Deal With Inoperable Tumors
Most of the times, 12 months or higher indwelling times indicate keeping of the ureters in open condition, which further gets compressed due to tumor present in the nearby region of the ureter or because of the ureteral tumor itself. In most of the cases, these are of inoperable tumors and hence, to come up with an appropriate solution, doctors place stents to make sure easy drainage of the urine from the ureter. Reason for this is very simple, if patients and doctors compromise the drainage for a long time, it may cause damage to the kidney.
Ureteroscopy And Laser Lithotripsy
Along with SWL, ureteroscopy is a preferred method for the treatment of small-to-medium sized kidney stones located in any part of the urinary tract. Washington University was one of the first centers in the world to offer ureteroscopic stone treatment. Our highly skilled endourologists are available to offer advanced ureteroscopic stone management.
Ureteroscopy and laser lithotripsy are typically performed as a same-day procedure with the patient under general anesthesia. During the procedure, the urologist passes a small scope through the urinary opening into the bladder and from there up into the ureter, the small tube that drains urine from the kidney to the bladder. Once the stones are located, they are targeted with a laser that breaks the stone into smaller pieces, which are then extracted, or into tiny pieces of dust that wash out of the kidney with normal urine flow.
Often, a small tube, called a stent, will be placed temporarily to help the kidney drain after the operation. The stent is completely internal, and is generally removed after 3-10 days. Removal is performed quickly and easily in the office without the need for anesthesia.
Although slightly more invasive than SWL, ureteroscopy may be the preferred option if you have certain types of hard stones that dont respond to SWL, or a stone that is not visible on X-ray. In addition, ureteroscopy is often preferable to SWL for stones that are low in the urinary tract, in the region approaching the bladder.
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When Kidney Fails To Operate Adequately
Urologists recommend a stent for kidney stones in patients, when the presence of a stone in a kidney prevents the kidney to work in an adequate manner. Placement of ureter stents takes place after kidney surgeries for stones, as in the case of ureteroscopy to help in both healing and prevention of ureters swelling.
How Long Will I Have A Ureteral Stent
Most ureteral stents are temporary. Your healthcare provider will perform another procedure to remove the stent after the kidney stone passes, infection clears up or other problems resolve. Youll probably have the stent for a few days or weeks.
Some people need stents for months or years. People who have tumors that press on the ureters or narrowed ureters may need ureteral stents for an extended time. Your provider will replace the stent with a new one every three to six months. Replacing the stent reduces the likelihood of complications.
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Can I Take Out The Stent Myself
You should never attempt to remove a stent on your own, as more harm may be done than you might assume. This can include:
- Kidney, ureter, bladder damage or infection
- Severe pain
- Urinary retention
- Re-blockage of ureter with stone fragments not removed in original procedure leading to severe pain that will require another hospital/ER visit to replace stent
What To Expect Back Home
At hospital discharge, your doctor or nurse will give you instructions for rest, driving, and doing physical activities after the procedure.
Because surgical instruments were inserted into your urinary tract, you may experience urinary symptoms for some time after surgery. These symptoms usually disappear in a few weeks.
Symptoms may include:
- a mild burning feeling when urinating
- small amounts of blood in the urine
- mild discomfort in the bladder area or kidney area when urinating
- need to urinate more frequently or urgently
- pain resulting from an internal abrasion that needs time to heal
Try to drink fluids often but in small quantities. Sometimes a blood clot can cause pain . The urine contains a substance that will dissolve this clot.
If the pain remains despite the use of pain medication, contact the hospital or your doctor.
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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.
What Can I Expect After I Have My Ureteral Stent
After a stent is placed, you may have a string coming out of the urethra. This will be used to remove the stent in the future and should not be pulled on. In most cases, it will be okay if it accidentally is pulled out.
The side effects after a stent are placed can vary. If it was placed because of severe pain from a stone, stent discomfort is usually significantly less. Most patients will experience some discomfort which may include pain in the back, flank and pelvis, urinary urgency and frequency, and intermittent blood in the urine. You can continue your regular activities if you are not having significant pain or taking narcotic pain medications. You should notify your physician if there are any fevers or significant clots in the urine.
The stent is temporary and will need to be removed. Your physician should be able to tell you an approximate length of time the stent will be left in place, but this can vary significantly. Most stents after treatment for medium to small stones are kept in place for less than two weeks. Stents that have a string attached to them will be removed with the string on a follow-up appointment in the office. Stents without a string will require a minor procedure in the office. A flexible scope will be passed into the bladder and a grasper will be used to pull the stent out. After this most will have minimal urinary discomfort for 1-2 days.
If you have any more questions or concerns regarding ureteral stent, contact our urological experts.
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Should We Place A Stent Or Not After Stone Removal
For patients with stones in the kidney or in the tube draining urine from the kidney to the bladder that have been removed from the inside by a ureteroscope , how does placing a stent compare to not using a stent?
Urologists use small scopes and other tools to find, break up, and remove stones. Afterwards, swelling and blockage of the ureter can cause discomfort. To prevent that from happening, urologists often leave a temporary stent. It is unclear whether a stent makes things better or worse.
We included 23 trials with 2656 people who either had a stent or not. Whether they received a stent or not was decided by chance.
A stent may make people come back to the hospital for problems less often, but we are very uncertain of this finding. Pain on the day of surgery and on days one to three after surgery may be similar. People with a stent may have more pain in the long term , but we are also very uncertain about this. The need for another procedure may be similar.
People with a stent may be less likely to need narcotics , but we are very uncertain about this. There may be no difference in the risk of a urinary tract infection. Stenting may make people a little less likely to develop a narrowing of the ureter because of scarring and may make them slightly less likely to be admitted to the hospital. However, we are very uncertain of both findings.
Certainty of the evidence
Frequently Asked Questions About Shockwave Lithotripsy
We offer SWL services at our Barnes-Jewish Hospital and Barnes-Jewish West County Hospital locations
SWL is an outpatient procedure, and one of the preferred treatments for small- to medium-sized stones. It is considered a safe and effective procedure with an excellent track record. As it is an outpatient procedure, you will be home just a few hours after the procedure. Recovery is generally very rapid.
As with any technology, there are limitations. Certain types of stones are very hard and resistant to breakage with shockwaves. Other, less common stones are invisible on X-ray, which means that they cannot be targeted for treatment. Therefore, if you have a history of cystine, monohydrate or uric acid stones, SWL may not be the best treatment for you.
Also, very large stones or stones that have traveled into the lower part of the urinary tract may be better treated by other methods. There are also some patient factors, including other medical conditions, which may affect your suitability for SWL. For instance, patients who are on blood-thinning medications or who may be pregnant should not undergo SWL procedures.
Please call 362-8200 to schedule an appointment at any of our clinic locations.
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Frequently Asked Questions About Ureteroscopy
We offer ureteroscopy at our Barnes-Jewish Hospital and Barnes-Jewish West County Hospital locations.
Ureteroscopy is one of two preferred methods for the treatment of small- to medium-sized kidney stones. Ureteroscopy has a high success rate for stones throughout the urinary tract, including some stones that cannot be treated by SWL. If you have a history of cystine, monohydrate or uric acid stones, ureteroscopy may be the best option for you. In addition, ureteroscopy is preferred if you must remain on blood-thinning medication because of other medical problems. Recovery times are generally very short.
Despite its versatility, there are some limitations of ureteroscopy. Very large stones are better treated by other methods. Also, despite their small size and flexibility, there are rare instances when our scopes are not able to reach your stone. Finally, stents are often placed after ureteroscopy to help maintain drainage while swelling resolves many patients find these stents to be a source of discomfort until they are removed.
Call 362-8200 to schedule an appointment at any of our clinic locations.
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.
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Kidney Stone Surgery Recovery
Our urology experts will be there for you throughout your recovery to monitor your progress and ensure you are in good health.
We may prescribe medication like tamsulosin to relax and open your ureter for a period after surgery. Tamsulosin can make it easier for stones or stone fragments to pass. We may also have you use a strainer to collect stone pieces if they pass in your urine so we can test them.
If we placed a temporary stent in your ureter during surgery, we will remove it during an office visit two to 10 days after your procedure.
Side Effects And Complications
The main complications with ureteral stents are dislocation, infection and blockage by encrustation. Recently stents with coatings, such as heparin, were approved to reduce infection and encrustation to reduce the number of stent exchanges.
Other complications can include increased urgency and frequency of urination, blood in the urine, leakage of urine, pain in the kidney, bladder, or groin, and pain in the kidneys during, and for a short time after urination. These effects are generally temporary and disappear with the removal of the stent. Drugs used for the treatment of OAB are sometimes given to reduce or eliminate the increased urgency and frequency of urination caused by the presence of the stent.
Stents often have a thread, used for removal, that passes through the urethra and remains outside the body. This thread may cause irritation of the urethra. This may be increased for patients who were born with Hypospadias or other conditions that required a similar corrective surgery. Care must be taken to ensure that the thread is not caught or pulled, which may dislodge the stent.
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What Happens After Ureteral Stenting
Someone should drive you home when your provider says its safe to go. Your provider may recommend drinking lots of water after the procedure to help with kidney and bladder function.
You may notice some blood in the urine and have some discomfort. These symptoms are normal after the stent placement and should gradually improve in a couple of days. However, you may see traces of blood and have discomfort until your provider removes the stent. You may also experience frequent urination and pain in the kidney that gets worse when you urinate as long as the stent is in place. The blood in your urine may come and go randomly.
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 .
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What Is A Ureteric Stent
A ureteric stent is a specially designed small, hollow tube which is put inside the ureter through the bladder using a telescope passed along the urethra
It is curled at both ends to keep the upper end fixed inside the kidney, and the lower end in place inside the bladder.
The reasons of inserting a stent are blockage of the ureter from stones, ureteral stricture and after surgery or instrumentation into the ureters.
Stent removal can usually be done under local anaesthetic using a flexible telescope.
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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How Is A Ureteral Stent Removed
A ureteral stent that’s going to be in place for only a few days to a week usually has a string attached to the end of it. This string comes out of the urethra and is taped to the child’s leg. This type of stent is removed either at home or in the doctor’s office.
Stents that are in place for several weeks or months are removed by the urologist in the operating room.