• Ureteral Stent Placement

    (Ureteral Stenting; Uretic Stent)

    Definition

    Ureteral stent placement is a surgery to place a soft flexible plastic tube called a stent in the ureter. The ureters are long tubes that allow urine to pass from the kidneys to the bladder. A ureteral stent keeps the ureter open if it is narrowed or blocked. It can also be used to continue urine flow if the ureter is damaged while the damaged ureter heals.
    Anatomy of the Urinary System
    The Urinary Tract
    Copyright © Nucleus Medical Media, Inc.

    Reasons for Procedure

    A narrowed or blocked ureter makes it difficult for urine to drain out of the kidney. This prevents the kidneys from working properly. A backup of urine in the kidney can lead to serious damage and illness.
    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

    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
    • 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

    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

    Special imaging tools may be used to help guide the stent to the appropriate location. A needle will be used to inject a special contrast material through the skin and into the kidneys. The contrast material will make the kidneys and ureter visible on image screen. This will help the doctor guide the stent to the appropriate place.
    A cystoscope is a small flexible tube that can pass through the opening where urine passes out of the body, into a tube called the urethra, and then into the bladder. The doctor can pass the stent through the cystoscope from the bladder to the ureter. The stent will be passed through the ureter 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 from slipping out of the ureter. Once the images show the stent is in the correct place the cystoscope will be removed. Sometimes a string will be attached to the stent and be left hanging through the bladder, down the urethra, and out of the body.

    Immediately After Procedure

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

    How Long Will It Take?

    Less than one hour

    How Much Will It Hurt?

    The movement of the tube and placement of the stent will cause a feeling of pressure but anesthesia will prevent pain during surgery. Pain and discomfort after the procedure can be managed with medications.

    Average Hospital Stay

    This is typically done in a hospital. If you have any problems, you may need to stay longer. In other cases, you may not have to stay overnight.

    Post-procedure Care

    At the Hospital
    Right after the procedure, you will be in a recovery room where your blood pressure, pulse, and breathing will be monitored. 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 urgency to urinate
    • Frequent urination
    • Burning sensation during urination
    • Discomfort in the back near the kidneys
    Certain activities may be restricted or limited during recovery.
    Some stents can be removed at home by pulling on the string that is left attached. The doctor will instruct when the stent can be removed. Most stents will need to be removed with a second procedure.
    Stents may be required for short or long periods of time. Long-term stents will need to be replaced at regular intervals, often within 3-6 months of placement. Removal or replacement can be done with similar procedures.

    Call Your Doctor

    It is important to monitor 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: http://www.urologyhealth.org/urologic-conditions/extrinsic-obstruction-of-the-ureter?article=127&display=1. Accessed September 7, 2017.

    Revision Information

    • Reviewer: EBSCO Medical Review Board Adrienne Carmack, MD
    • Review Date: 09/2017
    • Update Date: 09/07/2017
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