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.
How Is The Stent Removed
If the string is visible outside the body, it can be simply removed in office without the use of any procedures or specialty equipment. This is used for short term stents . A nurse practitioner can do this in the office within days of your surgery.
Ureteral stents that do not have a visible string, or were placed to allow a longer healing period, will require a minor in-office procedure.
A small, flexible scope called a cystoscope is placed into the urethra that allows the doctor to visualize the stent from inside the bladder. Then, the doctor grasps the stent with tiny clamps attached to the scope and removes the stent.
A physician must do this procedure, and it must be scheduled ahead of time. An X-ray may be required prior to removing the stent to ensure no large stone fragments are visible. Large fragments that havent passed may require additional procedures. In these cases, the stent would remain in place.
What Does A Kidney Stone Stent Look Like
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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.
Inserting A Kidney Stent
The procedure for inserting a ureteric stent is relatively straight-forward. A patient is usually placed under general anesthetic before inserting the stent. A special telescope called a cystoscope is then passed through the urethra into the bladder.
The stent is then placed into the ureter and kidney via the opening of the ureter in the bladder. The correct position of a stent is then checked by taking an x-ray.
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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 °
How Is The Procedure Performed
The procedure is usually performed with the patient asleep . Sometimes a local anaesthetic, with or without sedation, is administered.
During this procedure, a tube with a tiny optic camera is inserted through the urethra into your bladder. The bladder is inspected, and the ureteric opening is located. The urologist may use x-ray images taken with a contrast agent in the ureters to assess the urinary tract and to locate the obstruction.
The stent is placed during surgery by sliding it over a guidewire placed in the ureter .
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What Can I Expect After Surgery
Before your child is discharged you will be given written information about his care at home and any questions you have will be answered.
- Diet: Resume regular diet as tolerated. Have your child drink plenty of fluids, as there could be blood in the urine. This will keep the urine clear and make it less irritating to the bladder and urethra while peeing.
- Activity: May return to school or daycare when pain is well controlled.
- Bathing: Ok to take a bath the day of surgery. Bathe in plain water for the next week. A daily warm bath will help healing and provide comfort.
- Medicines: Pain can be controlled by alternating Acetaminophen and Ibuprofen®. Do not give aspirin because it may cause bleeding.
- If your child is prescribed an antibiotic, follow your surgeonâs specific instructions.
- Your surgeon may provide a prescription for medicine which should help relieve bladder spasms while the catheter is in place, follow your surgeonâs specific instructions. Do not give the bladder spasm medicine the night before his catheter is scheduled to be removed.
You’ll Have Physical Limitations After A Stent Procedure
A stent procedure usually doesn’t take more than 60 minutes, and most patients will be released from the hospital in one or two days.
According to Sanjiv Patel, MD, an interventional cardiologist at MemorialCare Heart & Vascular Institute at Orange Coast Medical Center, many patients can even return to a sedentary office job within a few days to a week after the procedure.
However, you shouldn’t lift more than 10 to 15 pounds for about a week after the procedure, and if your job requires manual labor or being on your feet all day, you should talk with your doctor before returning to work.
After receiving a stent, it is normal to feel tired or a bit weak for a few days, and it’s not uncommon to experience some pain or soreness at the catheter site. If you received a stent because of a heart attack, you will likely feel tired for several weeks, Patel says.
While you should be able to resume daily activities, like walking, eating, and daily hygiene shortly after the procedure, it’s wise to wait a bit longer for exercise or more rigorous activity.
“Be smart about what you do at home,” Patel says. “In the beginning for recovery purposes, take it easy for a week or two and ease back into physical activities.”
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Stent Length And Positioning
Stent length seems to play a relevant role in stent-related symptoms since it is directly related to bladder irritation. Several different ways to assess the ideal stent length have been suggested.
Lee, et al. used a reference table in which a corresponding stent length was selected for each given specific height range. Ho, et al. prospectively evaluated 87 patients and assessed their stent-related symptoms. They determined that a 22-cm stent would be more appropriate for those whose height ranges from 149.5 cm to 178.5 cm with a median of 161.9 cm.
Mathematic formulas have also been proposed to calculate stent length. Hao, et al. used the following: or the vertical distance from the second lumbar vertebra to the pubic symphysis minus 2 cm. Hruby, et al. calculated that the xyphoid process to pubic symphysis distance as well as acromium process to the head of the ulna distance can both be used to predict double J length.
In the pediatric population, a rule of thumb has been proposed to determine the suitable JJ stent regardless of gender or size, which is simply to add 10 to the age of the patient . .
Why Would You Need A Stent
If a fatty substance called plaque builds up inside an artery, it can reduce blood flow to your heart. This is called coronary heart disease and it can cause chest pain.
The plaque can also cause a blood clot that blocks blood flowing to your heart, which may lead to a heart attack.
By keeping an artery open, stents lower your risk of chest pain. They can also treat a heart attack that’s in progress.
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What Is The Recovery Time After A Stent Placement
Itll take about a week to recover from stent placement. Check with your provider to find out how active youre allowed to be for the next few days. The instructions vary depending on whether you had a catheter in your arm or your groin area.
Your provider will prescribe antiplatelet drugs for you to take to prevent blood clots in your stent. Youll take aspirin and/or clopidogrel, ticagrelor or prasugrel. Depending on your risk of bleeding, you may take these medicines for a month, several months or a year or more. Its very important that you take these medicines to keep blood clots from happening.
How Is A Kidney Stent Removed
Once the underlying condition that caused blockage of the ureter is resolved and the ureter is healed, the stent can be removed. Kidney stent removal is a short procedure.
The stent is removed using a cystoscope, usually under local anesthesia. Sometimes a stent can be left with a thread attached to its lower end that stays outside the body through the urethra. The doctors can remove such stents by just pulling this thread.
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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.
How Should I Prepare
Your doctor may test your blood prior to your procedure.
Prior to your procedure, your doctor may test your blood to check your kidney function and to determine if 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, orcontrast 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 tell their doctor and technologistif they are pregnant. Doctors will not perform many tests during pregnancy to avoid exposing the fetus to radiation. If an x-ray is necessary, the doctor will take precautions to minimize radiation exposure to the baby. See the Safety in X-ray, Interventional Radiology and Nuclear Medicine Procedures 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, ask your doctor if you need to adjust your usual insulin dose.
The nurse will give you a gown to wear during the procedure.
Plan to have someone drive you home after your procedure.
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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 .
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:
- Fever
- A burning sensation while urination
- Changes in the characteristics of your urine, including color or smell
- Kidney pain or other abdomen pain
- Chills
- 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.
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Summary Of Findings Safety Recommendations And Safety Observations
Summary of HSIB findings
The investigation identified:
HSIB makes the following safety recommendations
Safety recommendation R/2020/091:
It is recommended that the British Association of Urological Surgeons, in collaboration with other relevant specialties , develops national standards which support electronic and paper-based systems for stent logging/ tracking. These standards should include guidance on monitoring and human oversight.
Safety recommendation R/2020/092:
It is recommended that the British Association of Urological Surgeons works with the Patient Information Forum to review its stent patient information leaflet. This should include accessibility and clinical considerations, especially with regards to side effects and complications, and advice on the action to take should concerns arise.
Safety recommendation R/2020/093:
It is recommended that the British Association of Urological Surgeons provides guidance for staff working within the stone care pathway to promote consistent advice to patients as part of discharge planning.
Safety recommendation R/2020/094:
It is recommended that the British Association of Urological Surgeons encourages members to include information in discharge letters and other communication sent to GPs and patients regarding patients stent status, potential complications and the possibility of a retained stent.
HSIB makes the following safety observations
Safety observation O/2020/073:
Safety observation O/2020/074:
What Is Ureteric Stenting
A ureteric stent is a thin, flexible plastic tube which is curled at both ends to avoid damaging the kidney and urinary bladder and to prevent it from dislocating. The stent is placed so that its upper end is in the kidney and its lower end is in the urinary bladder.
Ureteric stenting is the procedure in which stents are inserted into the ureter through the skin and via the kidney, to allow urine to pass from the kidney to the bladder.
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Lifestyle Adjustments Are Crucial After A Stent
Once you have recovered from your angioplasty and stenting procedure, it is important to address what caused the plaque build-up in your artery that originally led to the blockage, Patel says.
If you’re a smoker, work on quitting, exercise 30 to 45 minutes a day, and avoid foods high in sodium. Patel also recommends treating other risk factors that can cause blocked arteries, such as high blood pressure, high cholesterol, and diabetes.
Why Is A Stent Needed
Stents are used for various reasons in patients with kidney stones. They can be placed to help reduce sharp pain from a stone or to allow drainage when infection is present or when a stone prevents a kidney from working adequately. Stents are commonly placed after surgery for stones to allow healing and to ensure that swelling does not block the drainage of urine after the procedure.
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When Should I See My Healthcare Provider
Contact your provider when:
- You have bleeding, swelling, discharge or numbness where the catheter went into your skin.
- You have a fever or chills.
- You faint or get dizzy.
- Your pulse isnt normal.
- You have chest pain.
A note from Cleveland Clinic
Although your angioplasty and stent will help your blood circulate better, youll still need to do your part and live a healthy lifestyle. That means eating healthy foods, exercising and avoiding tobacco products. Youll also feel your best when you keep taking the medicines your provider prescribed and keep going to your follow-up appointments.
Last reviewed by a Cleveland Clinic medical professional on 02/13/2022.
References
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.
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