Ureteral Stent Placement
(Ureteral Stenting; Uretic Stent)
Definition
Ureteral stent placement is a surgery to place a soft plastic tube in the ureter. The ureters are long tubes from the kidneys to the bladder. It carries urine out of the kidney into the bladder.
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Reasons for Procedure
Changes in the ureter can slow or block the flow of urine. Urine that can't flow freely will back up into the kidney. This can make it hard for the kidneys to work as they should. The back-up can also damage the kidneys and lead to more severe illness. A stent can improve the flow of urine. It may also be used to support a ureter while it heals.
Ureters may become narrow or blocked because of:
- Kidney or ureter stones
- Tumors
- Tear or rupture from trauma
- Problems caused by other medical procedures
- Infection
- Blood clots
- Pressure from nearby structures
Possible Complications
Problems from the procedure are rare, but all procedures have some risk. Your doctor will talk to you about possible problems, like:
- The stent may move or fall out
- Tip of stent may irritate the bladder and increase the frequency of urination or urge
- Infection
- Damage to the kidney or other nearby structures
- Abnormal connection between nearby structures—fistula
- Narrowing of the ureter—ureteral stenosis
- More surgery if the stent doesn’t work properly
- Stones forming on the stent
- Reaction to anesthesia or contrast dye 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
Prior to Procedure
The doctor will ask about:
- Medicine or supplements that you take. Some may need to be stopped up to 1 week before the procedure.
- Allergies or problems from other surgeries.
Before surgery:
- Arrange for a ride to and from the procedure.
- Arrange for help at home.
- Do not eat or drink anything after midnight, unless care team says differently.
Anesthesia
The type of anesthesia will depend on your comfort levels and overall health. Options include:
- Local anesthesia—a small area will be numbed.
- Moderate sedation—you will feel sleepy and pain-free. You will be able to respond.
- General anesthesia—you will be asleep.
Description of the Procedure
A machine can show images of the ureter and kidney. The doctor will use the images to help guide the stent to the right place.
A special scope is used. It is a small flexible tube that can be passed through the opening where urine passes out of the body. The scope is passed into the bladder. A tube is then passed through the scope into the ureter. The tube releases a contrast. It is a dye that will highlight areas of the ureter and kidney.
A wire will then be passed through the scope to the kidney. The stent will slide over the wire until one end is in the kidney. The bottom end of the stent will stay in the bladder. Once the stent is in place the wire is removed. The doctor will curl the ends of the stent to keep it in place. Images will be used to make sure the stent is in place. The scope is then removed.
A string may be attached to the stent. The string will be left hanging through the bladder and out of the body.
Immediately After Procedure
The care team in the intensive care unit (ICU) will track vital signs after surgery. They may also check for urine flow.
How Long Will It Take?
Less than 1 hour
How Much Will It Hurt?
You may feel some pressure during the surgery. Anesthesia will prevent pain. There can be soreness after the procedure. It can be managed with medicine.
Average Hospital Stay
Most will go home the same day. A hospital stay may be needed if there were complications.
Post-procedure Care
At the Hospital
Medicine may be given to prevent infection or blood clots. An x-ray may be done to check the stent placement.
At Home
Some activity will be limited during recovery. This may affect your job.
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 or in the doctor's office by pulling on the string that was attached. The doctor will let you know when this stent can be removed.
Long-term stents will need to be replaced within 3 to 6 months.
Call Your Doctor
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, generally feeling unwell
- Amount of blood in the urine increases, large blood clots form, or there is a problem passing urine
- Pain that doesn’t go away with the pain medicines 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 17, 2020.
Ureteral stenting and nephrostomy. Radiology Info—Radiological Society of North America website. Available at: https://www.radiologyinfo.org/en/info.cfm?pg=ureteralNephro. Accessed September 17, 2020.
What is extrinsic obstruction of the ureter? Urology Care Foundation website. Available at: http://www.urologyhealth.org/urologic-conditions/extrinsic-obstruction-of-the-ureter?article=127&display=1. Accessed September 17, 2020.
Last reviewed September 2020 by EBSCO Medical Review Board Adrienne Carmack, MD Last Updated: 1/5/2021