A ureteric stent insertion is usually performed to unblock a kidney which is being obstructed by something inside (such as a stone) or outside (such as a lymph node or tumour) the ureter (the tube that drains urine between the kidney and the bladder). Sometimes it is placed to encourage the ureter to expand, enabling a follow-up procedure involving a fine camera to pass up the ureter to the kidney (eg. to laser a stone). Often, a stent is placed or replaced during one of these procedures as a safety precaution, in order to prevent complications after these procedures.
The stent is a specially designed hollow tube, made of a flexible plastic material that is placed in the ureter. The length of a stent used in adult patients varies between 22-30cm. It is designed to stay in the urinary system by having both ends coiled; the top end coils in the kidney and the lower end coils inside the bladder to prevent it from dislodging. It allows urine to pass down the ureter, and can help to relieve/prevent pain, drain infection or help improve kidney function if the kidney is obstructed.
The procedure is performed under a general anaesthetic. A cystoscopy, (examination of the inside of the bladder and the urethra), is performed first with a special viewing camera. Dye is then injected into the ureter and x-rays are taken to outline the urinary collecting system from the kidney to the bladder. A guide wire is then placed up to the kidney and the stent is placed over the wire. An x-ray confirms good position of the stent.
In the majority of patients, stents are required for only a short duration.
This may be just a few days. However, a stent can stay in for up to 3 months without the need to replace it. When the underlying problem is not a kidney stone, the stent can stay in even longer.
WHAT CAN I EXPECT AFTER THE PROCEDURE?
- Burning when passing urine for 1-2 days
- Pain at the end of your void (stent scratching bladder or urine refluxing to kidney), which can be felt in the flank, groin or genitals
- Voiding frequency, urgency and incomplete emptying
- Some blood in the urine
- For some patients these “stent irritation” symptoms can persist and temporarily worsen until the stent is removed
WHAT ABOUT DIET?
- Drink plenty of fluids (8-10 glasses or 2-3 litres)
- Eat a diet high in fibre to prevent the need for straining when using your bowels
WHAT ABOUT EXERCISE/ACTIVITY?
- Avoid strenuous activity, heavy lifting or engage in sports for the next day unless otherwise instructed by your doctor
- Avoid driving a car, motorcycle or riding a bike for 24 hours after your procedure and do not walk home or travel alone by public transport
- Some activities such as exercise and bending can exacerbate stent irritation symptoms, but there are no absolute restrictions
WHAT ABOUT MEDICATIONS?
- You can resume your usual medications
- If your blood thinning medication was stopped, your Doctor will let you know when to recommence
- You can take 1-2 paracetamol every 4-6 hours for pain and discomfort (no more than 8 in a day)
- Ural sachets (urine alkaliser) available from chemists and supermarkets, reduce acidity of the urine and provide relief from symptoms such as burning and stinging
WHAT ARE THE POSSIBLE COMPLICATIONS?
- Significant bleeding, possibly with clots
- Urinary infection
- Urinary retention (unable to pass urine)
- Ureteric injury – this is very rare and is usually treated with leaving the stent in for a few weeks to allow the ureter to heal
NOTIFY GEELONG UROLOGY or your GP if you experience any of the following:
- Heavy bleeding – urine that looks like pure blood
- Increased discomfort, severe pain and burning when passing urine
- Cloudy or offensive urine
- Fever (temperature over 37.5 degrees), chills, shakes or feeling generally unwell
- Increasing difficulty or unable to pass urine
FOLLOW UP APPOINTMENT
Your doctor will generally speak to about the results of the procedure before you are discharged home and an appointment for your follow-up procedure or removal of the stent will be organised roughly in 2 weeks. If an appointment time is not given to you on discharge from hospital, you will need to phone Geelong Urology to make an appointment.
If you have any queries please contact Geelong Urology on 03 5229 9105 during business hours OR leave a message on the After Hours Urology Paging Service 03 9387 1000
