Ureteral Stent Removal After Stent Placement: Indications, Benefits and Risks

Ureteral Stent Removal After Stent Placement: Indications, Benefits and Risks
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Background

The urinary system consists of the kidneys, ureters, bladder and urethra. The kidneys filter wastes and minerals out of the blood and produce urine. The ureters carry urine from the kidneys to the bladder. The bladder holds urine until the body is ready to release it through the process of urination. During urination, urine passes through the urethra and out of the body. In some cases, the ureters become narrow or obstructed, which obstructs the flow of urine from the kidneys to the bladder. This can cause urine to back up into the kidneys, causing damage and scarring to the kidney tissue.

Indications

Doctors recommend ureteral stenting for several purposes. If a ureter has a blockage or obstruction, the stent can open the narrow portion of the tube and make it easier for urine to flow from the kidneys to the bladder. In patients who have had kidney stone surgery, stenting improves the flow of urine and prevents minerals from building up in the urinary tract and causing new kidney stones to form. If someone has an active case of kidney stones, placing a stent in the ureters makes it easier for small stones and stone fragments to pass through the urinary tract. Some urologists use urinary stenting before performing other procedures.

Stenting Procedure

A urinary stent consists of a durable, flexible material that is visible on an x-ray. The size used depends on the size and drainage needs of the patient. Some stents have coils on the end to prevent them from slipping out of place. For this procedure, an anesthesiologist uses general anesthesia to relax the patient. This prevents the patient from moving or becoming agitated during the stenting. The urologist uses a cystoscope to identify and visualize the opening to the ureters. Using a guide wire, the doctor places the stent in the ureter. The risks of this procedure include bleeding, lower abdominal pain, urinary frequency and infections. In some cases, the stent can perforate nearby organs such as the gallbladder or bowel.

Recovery

Most patients resume their normal eating habits and physical activities during the recovery period for this procedure. Anyone who has had a ureteral stent placement procedure should drink at least 6 to 8 glasses of water each day. Those who received general anesthesia for the procedure should avoid alcohol during the first 48 hours after surgery to prevent drug interactions. If you resume your normal activities and discover blood in your urine or experience pain, rest as much as possible. You should avoid strenuous activity for at least one week after the procedure. The stent may cause you to feel like you have to urinate more often.

Ureteral Stent Removal

When a doctor will remove the stent depends upon each patient’s individual needs. In some cases, ureteral stent removal occurs just a few days after stent placement. In other cases, the stent remains in place for one month or more. During the removal procedure, the doctor inserts a cystoscope into the urethra, identifies the location of the stent and removes the stent from the urinary tract. Some patients receive a topical numbing medication and undergo this procedure while awake. Others receive general anesthesia and are asleep during the removal procedure. Those who receive general anesthesia will not be able to drive after the surgery.

References

Surgery Encyclopedia: Ureteral Stenting

UW Health: Ureteral Stent Placement/Removal

University of Michigan Health System: Frequently Asked Questions About Ureteral Stents