Endoscopic placement of a thin, flexible tube between the kidney and bladder to maintain urine flow when the ureter is obstructed or oedematous after a procedure.
Indication
- Ureteral obstruction caused by stones, clots or oedema
- Temporary drainage after kidney stone surgery (PCNL, RIRS, ureterorenoscopy)
- Ureteral stricture or extrinsic obstruction (tumour, retroperitoneal fibrosis)
- Supporting healing after ureteral injury or repair
- Symptomatic hydronephrosis in pregnancy
- Urgent drainage required to prevent urosepsis
Preparation
- Fast for 6-8 hours before the procedure
- Urine culture and antibiotic prophylaxis when indicated
- Adjustment of blood-thinning medications according to physician's advice
- Anaesthesia assessment (general, regional or sedation)
How it's performed
- The patient is placed in the supine lithotomy position
- A cystoscope is advanced through the urethra into the bladder
- A guidewire is passed through the ureteral orifice up to the kidney under fluoroscopic guidance
- A double-J stent is placed over the guidewire
- It is positioned with its upper end in the renal pelvis and its lower end in the bladder
- Stent position is confirmed with imaging
Post-procedure
- Most patients are discharged the same day
- Plenty of fluids and monitoring of urine output
- Stents are usually kept in place for 4-6 weeks; planned exchange is recommended for longer use
- Stent removal is performed in the outpatient clinic with cystoscopy
- Seek urgent care if fever, severe flank pain or significant blood in the urine occurs
Risks
- Flank pain, bladder spasm, burning urination and increased urinary frequency
- Mild haematuria
- Urinary tract infection
- Stent migration or blockage
- Stone formation around stents that have been left in place too long
FAQ
How long does a stent stay in place?
Depending on the indication, ureteral stents are usually kept in place for 4-6 weeks and are removed at the planned date.
Does a stent cause pain?
Some patients experience flank pain, bladder discomfort or increased urinary frequency. These symptoms can usually be controlled with medication.
Does stent removal require surgery?
No. The stent is usually removed in an outpatient setting with a brief cystoscopy.
What happens if a stent is left in place too long?
Stents kept in beyond the recommended time carry an increased risk of blockage, infection and stone formation, so follow-up appointments should not be missed.
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