What To Expect From A Ureteral Stent
Ureteral stents are an implant used to correct a blockage in one of the ureters in your body. The ureters are tubes that allow urine to drain from the kidneys and enter the bladder. When blockages occur, urine backs up in the kidneys, which causes swelling that can lead to permanent kidney damage if left unaddressed.
Blockages can be caused by kidney stones, a tumor or other object pressing on the ureters, or scar tissue that develops in the ureters. A ureteral stent is a thin tube inserted into the ureters to open the passage and allow urine to properly drain from the kidneys.
If your doctor decides this implant is necessary to preserve your kidneys health, youll want to be prepared for what to expect once the stent is implanted and after the stent is removed.
Deep Sedation With Propofol
Patients received an injection of 0.2;mg glycopyrollate about 20;min before induction of deep sedation. Sedation was induced with propofol 2;mg/kg without muscle relaxation and was maintained using propofol 10;mg/kg/h. After induction, the anesthesiologist applied a face mask and assisted with ventilation with 100% O2. After the procedure, the patient was transferred to day care unit and was discharged when they displayed normal orientation of time and space with vital signs within the normal range.
How Is A Ureteral Stent Removal Procedure Done
Ureteric or ureteral stent refers to a specially designed hollow tube comprised of a flexible plastic of about 25cm to 30cm length. Urologists place it within the ureter and hold it in the right place by using a coil at every end.
The main function this stent is to open the ureter to allow draining of the urine towards the bladder of a patient from the kidney. Doctors usually insert it after doctor performs the process of ureteroscopy.
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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.
What If The Doctor Suspects That I Have A High Risk Of Forming New Stones
If the results show that you have a high risk of forming more stones, your doctor will do a metabolic evaluation. This is a series of blood and urine tests to determine the possible causes of your stone formation. Depending on the test results, your doctor will recommend preventive measures or further tests. Besides changes in your lifestyle, you may be advised to take medication that reduces the risk of stones recurring. Generally, the medication will cause few to no side effects.
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Insights: Why Urologists Use Ureteral Stents
If you have kidney stones, you may receive a ureteral stent. This is a soft, hollow, plastic tube placed in the ureter . The top portion of the stent has a small curl that sits in the kidney and the opposite ends curls in the bladder.The stent allows urine to drain easily from the kidney into the bladder.
The stent is often used when there is a blockage in the ureter and allows urine to drain around the blockage.
This helps decrease the pain associated with the blockage and allows your kidney to function as normal as possible. In some cases, you may get a stent if you also have an infection associated with the kidney stone. In this case, it would help drain the infected urine.
If your kidney stone requires surgery, a stent may also be placed in the ureter after kidney stone surgery to allow your ureter to heal and to protect it from swelling. Ureteral stents can also help your ureter heal if there is any damage from other causes.
The stent may cause some discomfort, but you can continue your normal activities with a stent in place. Removing the stent requires a minor in-office procedure by your doctor.
How Should I Prepare
Your doctor may test your blood prior to your procedure.
Prior to your procedure, your blood may be tested to determine how well your kidneys are functioning and whether your blood clots normally.
Tell your doctor about all the medications you take, including herbal supplements. List any allergies, especially to local anesthetic, general anesthesia;or to contrast materials. Your doctor may tell you to stop taking aspirin, nonsteroidal anti-inflammatory drugs or blood thinners before your procedure.
Tell your doctor about recent illnesses or other medical conditions.
Women should always inform their physician and x-ray technologist;if there is any possibility that they are pregnant. Many imaging tests are not performed during pregnancy so as not to expose the fetus;to radiation. If an x-ray is necessary, precautions will be taken to minimize radiation exposure to the baby. See the Safety page;for more information about pregnancy and x-rays.;
In general, you should not eat or drink anything after midnight the day of your procedure. However, you may take your routine medications with sips of water. If you are diabetic and take insulin, you should talk to your doctor as your usual insulin dose may need to be adjusted.
You will be given a gown to wear during the procedure.
Plan to have someone drive you home after your procedure.
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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.
What Are Ureteral Stenting And Nephrostomy
Urine is normally carried from the kidneys to the bladder through long, narrow tubes called ureters. The ureter can become obstructed due to conditions such as kidney stones, tumors, infection, or blood clots. When this happens, physicians can use image guidance to place stents or tubes in the ureter to restore the flow of urine to the bladder.
A ureteral stent is a thin, flexible tube threaded into the ureter. When it is not possible to insert a ureteral stent, a nephrostomy is performed. During this procedure, a tube is placed through the skin on the patient’s back into the kidney. The tube is connected to an external drainage bag or from the kidney to the bladder for internal drainage.
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When Should You Call For Help
anytime you think you may need emergency care. For example, call if:
- You passed out .
- You have chest pain, are short of breath, or cough up blood.
or seek immediate medical care if:
- You have pain that does not get better after you take pain medicine.
- You have new or more blood clots in your urine.
- You are unable to urinate.
- You have symptoms of a urinary tract infection. These may include:
- Pain or burning when you urinate.
- A frequent need to urinate without being able to pass much urine.
- Pain in the flank, which is just below the rib cage and above the waist on either side of the back.
- Blood in your urine.
- A fever.
Watch closely for any changes in your health, and be sure to contact your doctor if you have any problems.
How Are These Procedures Performed
Image-guided, minimally invasive procedures such as ureteral stenting and nephrostomy are most often performed by a specially trained interventional radiologist in an interventional radiology suite or occasionally in the operating room.
This procedure is often done on an outpatient basis. However, some patients may require admission following the procedure. Ask your doctor if you will need to be admitted.
You may be given medications to help prevent nausea and pain, and antibiotics to help prevent infection.
You may be connected to monitors that track your heart rate, blood pressure, oxygen level and pulse.
A nurse or technologist;will insert an intravenous; line into a vein in your hand or arm to administer a sedative. This procedure may use moderate sedation. It does not require a breathing tube. However, some patients may require general anesthesia.
If you receive moderate sedation, you will be asleep but have the ability to be awakened. The sedation will be administered and monitored by your physician and nursing staff.
If you receive a general anesthetic, you will be unconscious for the entire procedure, and you will be monitored by an anesthesiologist. If you receive conscious sedation, you will be monitored by a nurse who will administer medications to make you drowsy and comfortable for the procedure.
Your IV line is removed before you go home.
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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.
Ask Your Doctor About Alpha
These medications help reduce spasms in the ureters, which can cause cramping, and help keep the ureter open.
If you find you have cramping and discomfort related to your stent, ask your doctor about this medication option.
Common side effects of alpha-blockers include:
- dizziness when standing up
- retrograde ejaculation
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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.
Place A Camera Within The Bladder Or Cystoscopy To View And Grab The Stent Directly By Using A Small Size Of A Grasping Device
When urologists have to perform the process of cystoscopy or do the procedure without any string or attaching only a particular portion of it, they should use a camera to allow entering of the bladder from the urethra.
In this way, they view the stent and use a particular instrument to both remove and grasp it in both safe and secured manner. This is usually a quick process and takes place in a clinic only and it requires hardly one minute in most of the cases. On broad classification, steps involved in the process of ureteral stents by the help of cystoscopy are:
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Uncomfortable Feelings In The Ureteral Stent Removal Process
Ureteral Stent removal does not give any uncomfortable feeling to a majority of patients. However, a few patients may feel discomfort in case of stent removal and commonly in men, as they have long urethra. This problem is because of the feelings of discomfort in the cystoscope or because of the sensation of the ureter stent at the time of its removal.
Side Effects And Symptoms After Stent Placement
Once a kidney stone stent is implanted, you can expect to notice some changes in your body, including some symptoms of discomfort as your body recovers after the stents placement.
Symptoms may include a frequent urge to urinate, which will likely decrease over time. The urge to urinate may come on suddenly, so patients receiving a ureteral stent should be mindful of their proximity to a bathroom in the days following the procedure. You may experience pelvic pain as your body recovers, and you may also notice blood in your urine at times while the stent is in place. This is usually not cause for alarm, although you can mention it to your doctor if youre concerned.
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Pull The Stent Of A String If It Remains In Its Original Place
Urologists may leave an attached string towards a particular end of a stent at the ureteral area. String of a stent is a long piece and is a thread like structure that starts from a particular stent and drape out towards the urethra, which remains visible at the meatus of the urethral area.
In order to remove the ureteral stent, doctors hold the visible string firmly and apply continuous and steady pulling until and unless the stent comes out completely. Curl present at end portion of the stent is of flexible in nature to allow uncurling of the stent and its removal in an easy way.
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 To Remove Your Stent
Once the stent is removed you will probably experience some pain the next time you pass urine and you may also notice blood in your urine. This is quite normal and it will pass.
Make sure you drink enough fluid to keep your urine a pale yellow colour. This will reduce the likelihood of blood clots in your urine.
If you feel that you are unable to remove the stent by yourself, dont be concerned. Contact Urology Associates and arrange a time to have the stent removed by a nurse.;;
When To See Your Doctor
Your doctor will probably schedule a follow-up appointment a week or two after removing a kidney stone. At this appointment, the doctor will make sure you’re recovering as planned, and if you have a stent, it will probably be removed at this time. Always keep your follow-up appointments.
After kidney stone removal, complications may occur. Common complications include blood clots near the kidneys, nerve palsies, pancreatitis and obstruction caused by leftover kidney stone fragments. You should see a doctor if you suspect any of these complications. You should also see a doctor immediately if you’re having trouble urinating, you have an increasing amount of blood in your urine, your pain is unmanageable, you have chest pain, you have a fever or you’re vomiting.
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