Ureteric Stents

Ureteric stents are hollow tubes which are inserted through the ureter between the kidney and bladder. The stents are made of a soft and flexible plastic and come in various lengths and widths.

Stent Insertion

Ureteric stents are inserted using a cystoscope, which is a telescope placed into the bladder through the urethra (water-pipe). Very rarely, stents can also be inserted into the ureter via a puncture in the skin through the kidney – a nephrostomy.

Stent Function

The function of a stent is to allow urine to flow freely from the kidney to the bladder. The ureter is a narrow tube which begins in the kidney and ends in the bladder.

Many things can cause blockage to the ureter such as stones, bruising, blood clots, scar tissue and tumours. When a ureter is blocked, the kidney swells (hydronephrosis) and does not function properly. When this blockage is sudden as occurs with a renal stone, severe pain called renal colic usually follows.

A ureteric stent will relieve blockage in the ureter thereby relieving the pain and allowing the kidney to function properly.

Stent Usage

Stents are frequently used to treat stones that have caused blockage to the ureter. A stent can be placed beside the stone to relieve the pain, or after a stone has been removed to stop the ureter getting blocked postoperatively from bruising and swelling.

A stent is nearly always inserted after ureteroscopy / ureteropyeloscopy as otherwise patients will experience severe pain due to blockage in the system. Stents may also be inserted into the ureter to stretch it in cases where the ureter is too narrow to allow the passage of an instrument i.e. stents gradually stretch the ureters.

After a week or two with a stent in the ureter, it is often easier to insert a ureteroscope in order to treat stones in the urinary tract.

Stent Side-Effects

Most patients will experience some side-effects from a ureteric stent. It is extremely safe but often irritates the bladder resulting in urinary frequency, visible blood in the urine and sometimes a burning sensation when passing urine. Patients can also experience discomfort or pain in the region of the kidney from a stent – this is usually short lasting at the time of bladder emptying and for a couple of minutes later. Many patients report that they feel as if they have a urinary tract infection when they have a stent in the ureter. Although it may feel like this, more often a urine test will reveal blood in the urine (which is normal with a stent) but no actual infection.

A stent is nearly always inserted after ureteroscopy / ureteropyeloscopy as otherwise patients will experience severe pain due to blockage in the system. Stents may also be inserted into the ureter to stretch it in cases where the ureter is too narrow to allow the passage of an instrument i.e. stents gradually stretch the ureters.

After a week or two with a stent in the ureter, it is often easier to insert a ureteroscope in order to treat stones in the urinary tract.

Treatment of Stent Symptoms

Symptoms from a ureteric stent are difficult to relieve. The best treatment is stent removal but this may need to be delayed depending on the particular clinical circumstances. Simple painkillers such as paracetamol (Panadol), Panadeine or Panadeine Forte may help, as can anti inflammatories such as Nurofen, Brufen, Voltarin and Indocid. More recently, a medicine usually used for prostate enlargement, tamsulosin (Flomaxtra) has been shown to help some patients with bothersome stent symptoms. This may be used in men and women.

Stent Removal

Stent removal requires a cystoscopy and is a very minor and safe procedure. The cystoscope is inserted through the urethra (water-pipe), into the bladder where the lower end of the stent is grasped with forceps and removed. It can be performed with local anaesthetic only although many patients prefer to have with as a day case under sedation.

Uncommonly, stents may be inserted with a string attached to the stent. This string is left hanging out of the body through the urethra into the underwear. Removal of the stent in this circumstance simply entails pulling on the string. However, many patients find the string uncomfortable and this is why it is rarely utilized.