A stent is a hollow tube that maintains patency until healing can take place or an obstruction is relieved. It allows urine to flow from the kidney to the bladder.
Indications for stenting include:
Relief of ureteral obstruction (stones, cancer, stricture) and provide drainage;
Promote healing of the ureter by providing internal support after a ureteral procedure or anastomosis;
Prevent potential complications by helping place a guidewire into the ureter;
Assist in dilating the ureter before the next ureteroscopy;
Bypass obstructions, either from internal or external causes;
Under general anesthesia in a cystoscopy suite, the ureteroscope is introduced into the bladder through the urethra;
The ureteral orifice is identified and an open ended stent is introduced into the orifice;
A flexible guide wire can be used to pass the stent up into the bladder, under direct vision through a cystoscope or under fluoroscopic guidance;
The guidewire is removed after documenting the stent is in the proper position;
Remove in 2-3 days after ureteroscopy in uncomplicated cases;
Remove in 1-2 weeks in cases of ureteral perforation or persisting concern of obstruction;
Can be removed in the office with topical anesthesia with a flexible ureteroscope and grasper;
Can be removed in the cysto suite under anesthesia for patients unable to tolerate topical anesthesia;
If required for long term use (extrinsic compression by tumor, stricture), stents should be changed every 6 months;
Frequently asked questions:
Will I be in pain after I have the stent pulled?
Most patients do not have pain after the stent is removed, but occasionally you can develop pain or colic after it is removed. This may occur either shortly after the stent is removed, but also can occur one or two hours later. Usually the pain is self-limited and will resolve within several hours.
Should I take pain medication before the stent pull?
If you are on tamsulosin (Flomax) prior to the stent removal, we recommend continuing it for 48 hours after the stent is removed. In addition, taking an ibuprofen tablet the morning prior to the removal of the stent may help to prevent pain after removal.
How long will I have the stent?
Stents are usually left for one week after stone surgery although occasionally they are left longer.
Some patients have stents placed that are to remain in place for the long term. These stents are usually changed at approximately 3 month intervals.
IT IS VITAL TO ALWAYS RETURN TO EITHER HAVE THE STENT REMOVED OR CHANGED WHEN SCHEDULED. STENTS WILL BEGIN TO FORM STONES ON THEM OVER TIME AND CAN BECOME DIFFICULT TO REMOVE IF NOT CHANGED REGULARLY.
Is it normal to have pain with the urge to urinate while the stent is placed?
Yes. The lower end of the stent is coiled in the bladder and can irritate it, causing symptoms of urinary frequency and urgency.
Should I be taking an antibiotic while I have the stent?
You should take the antibiotics as prescribed by the physician. Typically a short 3 - 5 day course of antibiotics is prescribed after stone surgery, however exceptions to this may occur.
Will I be sedated to have the stent removed?
Usually the stents are removed with local anesthetic instilled into the urethra prior to the procedure. This is done in the Urology Clinic and most patients tolerate the stent removal well. However if you have specific concerns please discuss it with your physician.
How does he remove the stent?
After numbing gel is placed into the urethra, a flexible scope is passed into the bladder, the stent is captured, and then removed. Typically the entire procedure takes less than one minute.
Is it possible for the stent to move inside me?
The stent is soft and flexible and will move with your body.
Is it possible for the stent to fall out?
The stents have a coil on each end, the upper end in the kidney and the lower end in the bladder. The coils usually keep the stent in place, but they can, on rare occasion, either slip out of the urethra or pull up into the kidney.
What do I do if the stent is falling out?
This is very rare. If the stent comes out, please rinse it with water and place it in a ziplock bag and bring it with you to your appointment. Your physician will then confirm that the entire stent is out. Please notify your physician’s office as soon as possible if your stent does fall out.
Is blood in the urine normal with the stent? The form I was given after my procedure says I should only have blood in my urine for up to 5 days. I am on day 5 and still have pink urine. Is that normal?
Yes, most patients will have blood intermittently with a stent in place. Usually it is most severe the first few days after surgery, but it can persist the entire time that the stent is in place.