Your urinary tract is an interconnected system that includes various organs, muscles, and tissue. In both males and females, the urinary tract is comprised of two kidneys, two ureters, a bladder, and a urethra. It also incorporates the sphincter muscle—both the internal and external set—to help maintain bladder control. When you need to urinate, your brain will send signals to the sphincter muscles to relax, so that urine can flow from the bladder, through the urethra and outside the body. However, sometimes the process of urine formation is disrupted, and travel from the kidneys to the bladder becomes obstructed. There are several reasons obstructions may occur, but the best treatment option for this is the use of ureteral stents. To help you better understand what these are and how they can help, here’s everything you should know about ureteral stents.
What is a Ureteral Stent?
Ureteral stents are small, thin, flexible tubes that are surgically placed in the ureters to hold them open. This is done through a minimally invasive procedure in a hospital or surgical center. Ureteral stents are used to treat obstructions and blockages or prevent them from occurring in the first place. They’re made out of either silicone or polyurethan, are about 10 to 15 inches long, and tend to be ¼ inch in diameter.
Ureteral stents are meant to be the entire length of the ureter, as this helps keep it open without the risk of collapse. One end of the ureteral stent will be placed against the kidney, with a small coil that extends inside the organ to keep it in place. The opposite end of the ureteral stent sits inside the bladder to ensure that there are no further complications with obstructions.
Reasons You May Need Ureteral Stents
The most common reason someone would need a ureteral stent is because of a blockage in either one or both of the ureters. This results in problems with urine drainage, which can create a backup and cause issues with the kidneys.
People who suffer from severe kidney stones that impact urine output are the most common recipients of ureteral stents. Your urologist may also recommend getting a stent to help break up the stones and reduce the risk of complications from lingering fragments or after you’ve passed a kidney stone to combat any potential blockages from swelling or inflammation.
Other reasons you may need to get a ureteral stent include the presence of ureteral stones, tumors, blood clots, or scar tissue buildup from conditions like endometriosis. Individuals with inflammatory bowel disease (IBD) or ureteropelvic junction obstruction may also benefit from having ureteral stents inserted.
Normal Ureteral Stent Symptoms
Most people who have ureteral stents will feel them in place. While this can be annoying, it’s often still preferrable to the pain that’s associated with passing large kidney stones. Bladder irritation is the most common ureteral stent symptom, and it tends to cause frequent or uncomfortable urination. It's normal to experience a few mild side effects of ureteral stints, as discussed above. However, if you are in debilitating pain or notice any worrying symptoms, don’t hesitate to talk to your doctor. Although annoying, most of the side effects are considered to be safe and don’t cause long-term problems. Once the ureteral stent is removed, side effects should subside within 24 to 48 hours.
Potential Ureteral Stent Complications
Call your doctor immediately if you notice any serious side effects or symptoms. This may include a dull, aching kidney pain, clots of tissue in your urine, difficulty urinating or extreme pain, nausea, vomiting, cloudy or foul-smelling urine, or any signs of infection such as fever or chills. These could be signs of a serious complication that require immediate attention.
The Process of Ureteral Stenting
If your doctor recommends getting ureteral stenting, don’t worry. It’s performed as an outpatient procedure, and you can return home the same day. A urologist will insert and place the stent while you’re under general anesthesia. The process of inserting a ureteral stent from diagnosis to recovery is as follows.
Prior to Ureteral Stenting
Before undergoing a procedure for ureteral stenting, your doctor will likely want to perform further tests to confirm diagnosis and determine the underlying cause of the obstruction. This will include blood tests to check kidney function and, in some instances, imaging tests. You’ll also need to provide your doctor with a list of medications you currently take or have recently stopped taking. Make sure to include any supplements on this list and discontinue use of anything that thins the blood, such as aspirin. Your doctor will provide you with detailed pre-op information, including how long you need to fast prior to the procedure.
The Stenting Procedure
Prior to beginning the procedure, anesthesia is administered so you won’t feel anything. You’ll be asleep the entire time, and your doctor will likely position you on your back for optimal stent insertion. X-ray imaging or an ultrasound is used to locate the obstruction, and then your doctor enters a cystoscope through the urethra and into the bladder. Once in place, a thin, flexible wire will be thread through the cystoscope and into the blocked ureter. This is the device that your doctor will use to secure the ureteral stent. Once in place, the wire and cystoscope are removed, but the stent remains. No incisions are made during this procedure, which minimizes the risk of infection.
Post-Op and Recovery
Since you receive general anesthesia during the procedure, it’s important to have a ride scheduled. Avoid driving until the anesthesia completely wears off. You’ll also be advised to increase your intake of water to help optimize kidney and bladder function during recovery. It’s common for individuals who undergo ureteral stenting to notice slight signs of hematuria, or blood in the urine, and a degree of discomfort. However, these symptoms should gradually get better following recovery. Trace amounts may remain until the stent is removed, but if you notice any alarming symptoms, contact your doctor for a follow up appointment.
During the first week after your procedure, you may need to limit physical activity. It’s also important to avoid having sex for at least one week after stent placement to help reduce your risk of developing a urinary tract infection.
When Can Ureteral Stents be Removed?
Ureteral stents are temporary treatments, but they can be kept in place for several years if needed. In most instances, individuals have ureteral stents for only a few weeks. Your doctor will continue to assess your condition to determine the length of time you’ll need to have the stents in place. If this timeline extends past three to six months, you’ll need to have the stents replaced to help reduce the risk of complications. Most instances that require longer use of ureteral stents are caused by tumor growth or other external forces putting pressure on the ureter.
Once your doctor determines that the ureteral stents can be removed, you’ll return to your urologist for another outpatient procedure. While there are some sources that tell you how to remove ureteral stents on your own, avoid doing this unless explicitly instructed by your doctor. Removing a ureteral stent on your own can result in damage to the kidneys, ureter, or bladder, various infections, severe pain, urinary retention, and further blockages within the urinary system.
The stent will be removed by a cystoscopy, similarly to how it was inserted. However, removal only requires local anesthesia. Some short-term stents may also have a string attached to the end for easier removal. When the time comes, your healthcare provider will slowly pull on this string to remove the stent. Do not pull on the string yourself as it could result in otherwise avoidable damage.
If you experience symptoms of any type of urologic problem or underlying condition, don’t hesitate to see your urologist. By taking a proactive approach to your health, you can manage problems and encourage positive reactions to treatment, especially in regard to kidney stones and ureteral stents. If you need catheters during this time, Byram Healthcare has a wide selection of high-quality urological supplies that can be discreetly delivered to your door. We have a wide range of products to help support your lifestyle. Browse our urology product catalog today.
Byram Healthcare is a member of the National Association for Continence’s Trusted Partners Program, whose mission is to provide quality continence care through education, collaboration and advocacy. We continue to build partnerships in the clinical community to ensure we focus on what’s best for the patient.
