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Ureteral Stent Placement

(Ureteral Stenting; Uretic Stent)

Definition

Ureteral stent placement is a surgery to place a soft plastic tube called a stent in the ureter. The ureters are long tubes from the kidneys to the bladder. Urine leaves the kidneys through the ureter and passes into the bladder.

Anatomy of the Urinary System

The Urinary Tract
Copyright © Nucleus Medical Media, Inc.

Reasons for Procedure    TOP

If the ureter narrows or becomes blocked it can slow the flow of urine. The urine backs up in the kidneys and makes it difficult for the kidneys to work properly. The back up of urine can also cause damage to the kidneys and lead to more severe illness. A stent can help to keep a narrow or blocked ureter open. It may also be used to support a damaged ureter while it heals.

This procedure may be done because of:

  • Kidney or ureter stones
  • Tumors
  • Tear or rupture of the ureter from trauma
  • Complications from medical procedures
  • Infection
  • Blood clots
  • Pressure on the ureter from nearby structures

Possible Complications     TOP

Problems from the procedure are rare, but all procedures have some risk. Your doctor will review potential problems, like:

  • The stent may move or fall out
  • Tip of stent may irritate bladder and increase the frequency of urination or urge
  • Infection
  • Damage to the kidney or other nearby structures
  • Creation of an abnormal connection between bodily structures—fistula
  • Narrowing of the ureter—ureteral stenosis
  • More surgery if the stent doesn’t work properly
  • Stone formation on the stent
  • Reaction to anesthesia or contrast material used during the procedure

Before your procedure, talk to your doctor about ways to manage factors that may increase your risk of complications such as:

  • Smoking
  • Drinking
  • Chronic disease such as diabetes or obesity

What to Expect    TOP

Prior to Procedure

Leading up to the procedure:

  • Talk to your doctor about your current medications. Certain medications may need to be stopped up to one week before the procedure.
  • Let your doctor know of any allergies you have.
  • Arrange for a ride to and from the procedure.
  • Arrange for help at home.
  • Do not eat or drink anything after midnight, unless otherwise instructed.

Anesthesia

The type of anesthesia will depend on your comfort levels and overall health. Options include:

  • Local anesthesia—to numb the area of insertion
  • Moderate sedation—you will feel sleepy and pain-free, but easily aroused
  • General anesthesia—you will be asleep

Description of the Procedure     TOP

An imaging tool may be used so that the doctor can see the ureter during the surgery. A needle will be used to inject a contrast material through the skin and into the kidneys. The contrast will make the kidneys and ureter visible on image screen. The doctor will use the image to help guide the stent to the right area.

A cystoscope is a small flexible tube. It will be passed through the opening where urine passes out of the body. The scope is passed up into the bladder and ureter. The stent will then be passed through the scope until one end is in the kidney. The bottom end of the stent will remain in the bladder. Both ends of the stent are curled to help keep it in place. Once the images show the stent is in place the scope will be removed. Sometimes a string will be attached to the stent. The string will be left hanging through the bladder and out of the body.

Immediately After Procedure     TOP

You will be taken to the recovery room and monitored. The length of time you will need to stay will depend on the type of anesthesia used.

How Long Will It Take?     TOP

Less than one hour

How Much Will It Hurt?     TOP

You may feel some pressure during the surgery but anesthesia will prevent pain. Pain and discomfort after the surgery can be managed with medicine.

Average Hospital Stay     TOP

You may be able to go home the same day. If you have any problems, you may need to stay longer.

Post-procedure Care     TOP

At the Hospital

Right after the procedure, you will be in a recovery room. Your blood pressure, pulse, and breathing will be checked often. Recovery may also include:

  • Pain medications
  • Antibiotics if an infection is present or possible
  • Medication to prevent blood clots
  • X-rays may be used to view the stent

During your stay, the hospital staff will take steps to reduce your chance of infection such as:

  • Washing their hands
  • Wearing gloves or masks when appropriate

There are also steps you can take to reduce your chances of infection such as:

  • Washing your hands often and reminding visitors and healthcare providers to do the same
  • Reminding your healthcare providers to wear gloves or masks when appropriate

At Home

Your doctor may give you medications to ease discomfort or fight infection.

Common side effects to expect:

  • Urine will have a pinkish color
  • Increased urge to urinate
  • Frequent urination
  • Burning sensation during urination
  • Discomfort in the back near the kidneys

Certain activities may be restricted or limited during recovery.

Long-term stents will need to be replaced, often within 3-6 months. Removal or replacement can be done with the same surgery.

Some stents may only be needed for a short time. Most stents will need to be removed with a second surgery. Some stents can be removed at home by pulling on the string that was attached. The doctor will let you know when this stent can be removed.

Call Your Doctor     TOP

It is important to check your recovery. Alert your doctor to any problems. If any of the following occur, call your doctor:

  • Signs of urinary tract infection, including fever, pain during urination, general feeling unwell
  • Amount of blood in the urine increases
  • Pain that doesn’t go away with the pain medications you’ve been given
  • The stent comes out on its own
  • New or unexpected symptoms

If you think you have an emergency, call for emergency medical services right away.

RESOURCES:

National Kidney Foundation
https://www.kidney.org
Urology Care Foundation
http://www.urologyhealth.org

CANADIAN RESOURCES:

Canadian Urological Association
http://www.cua.org
The Kidney Foundation of Canada
https://kidney.ca

References:

Ureteral stent FAQ. Ohio State University Wexner Medical Center Department of Urology. Available at: https://wexnermedical.osu.edu/urology/ureteral-stents. Accessed September 7, 2017.
Ureteral stenting and nephrostomy. Radiology Info—Radiological Society of North America website. Available at: https://www.radiologyinfo.org/en/info.cfm?pg=ureteralNephro. Updated May 1, 2017. Accessed September 7, 2017.
What is extrinsic obstruction of the ureter? Urology Care Foundation website. Available at:
...(Click grey area to select URL)
Accessed September 7, 2017.
Last reviewed September 2017 by EBSCO Medical Review Board Adrienne Carmack, MD
Last Updated: 9/7/2017

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