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Stent Placement and Removal

Ureteral stents are soft, hollow, plastic tubes placed temporarily into the ureter to allow drainage around a stone or to speed healing after a stone surgery. Stents are used for various reasons in patients with kidney stones. They may be placed in patients to help reduce pain from a stone, when infection is present to allow drainage, or when a stone is preventing a kidney from working properly.

Stents are placed during surgery by sliding them over a soft “guidewire” which is placed up the ureter, which is the tube draining the kidney.

Stents can be removed in two different ways. Sometimes, a string is left attached to the end of the stent. This string is allowed to come out of the patient’s urethra, the tube where he or she urinates. The string can be used to pull on the stent and remove it. In cases where a string is not left attached, a small camera called a cystoscope is inserted into the patient’s urethra after numbing medication has usually been administered. The cystoscope is then advanced into the bladder and the stent is grasped with an instrument and removed.

Despite the fact that no skin incisions are used, the area around the ureter and bladder is raw and irritated. The stent is a foreign object which will irritate the bladder wall. This irritation is manifested by increased frequency of urination, both day and night, and also an increase in the urge to urinate. In some, the urge to urinate is present almost always. Sometimes the urge is strong enough that you may not be able to stop yourself from urinating. The only real cure is to remove the stent and then give time for the bladder wall to heal which can't be done until the danger of the ureter swelling shut has passed (varies from 2-21 days). You may see some blood in your urine while the stent is in place and a few days afterwards. Do not be alarmed, even if the urine was clear for a while. Get off your feet and drink lots of fluids until clearing occurs. If you start to pass clots or don't improve, call your physician.

When you get home:

Diet

You may return to your normal diet immediately. Because of the raw surface, alcohol, spicy foods, acidy foods and drinks with caffeine may cause irritation or frequency and should be used in moderation. To keep your urine flowing freely and to avoid constipation, drink plenty of fluids during the day (8 - 10 glasses).

Activity

Your physical activity doesn't need to be restricted. However, if you are very active, you may see some blood in the urine. We would suggest cutting down your activity under these circumstances until the bleeding has stopped.

Medication

You should resume your pre-surgery medications unless told not to. In addition, you will often be given an antibiotic to prevent infection. These should be taken as prescribed until the bottles are finished unless you are having an unusual reaction to one of the drugs.

Side Effects:

Bowels

It is important to keep your bowels regular during the post-operative period. Straining with bowel movements can cause bleeding. A bowel movement every other day is reasonable. Use a mild laxative if needed, such as Milk of Magnesia 2-3 Tablespoons, or 2 Dulcolax tablets. Call if you continue to have problems. If you had been taking narcotics for pain, before, during or after your surgery, you may be constipated. Take a laxative if necessary.

Problems you should report to us:

  • Fevers over 100.5 Fahrenheit
  • Heavy bleeding or clots (See notes above about blood in urine)
  • Inability to urinate
  • Drug reactions (Hives, rash, nausea, vomiting, diarrhea)
  • Severe burning or pain with urination that is not improving

Follow Up:

You will need a follow-up appointment to monitor your progress. Call your physician’s office to schedule an appointment when you get home or from the phone in your hospital room before leaving. Usually the first appointment will be about 3 - 14 days after your surgery and your stent will probably be removed at this time. Come early, as your physician may wish to get an x-ray performed prior to seeing you.