Most people who have stone surgery leave hospital with a stent in place, and most of them were told about it briefly on the day. Then they get home, notice they are passing urine far more often and seeing traces of blood, and start to wonder whether something has gone wrong.
Usually nothing has. But knowing that in advance makes the following two weeks considerably easier.
What a stent is
A ureteric stent is a soft, hollow plastic tube, roughly the width of a thin noodle, that sits inside the ureter. One curled end rests in the kidney and the other in the bladder, and the curls are what hold it in place.
It is entirely internal. Nothing is visible from outside and there is no bag. Its job is to keep the ureter open and draining while swelling from the stone or the surgery settles.
Why it is needed
The ureter is a narrow, muscular tube. Passing a stone through it, or passing instruments up it, causes it to swell. A swollen ureter can block, and a blocked kidney after surgery is both painful and risky.
The stent guarantees drainage while that settles. It also gently dilates the ureter, which is useful when a second procedure is planned.
What it feels like
This is the part worth setting expectations on, because stent symptoms are common and normal, and they surprise people who were not warned.
Expect some or all of the following:
- Needing to pass urine more often, and more urgently
- A dull ache in the loin when you urinate, caused by urine tracking briefly back up the stent
- Blood in the urine, coming and going, often worse after activity
- Discomfort low in the bladder or at the tip
- A sense of not having emptied completely
These vary a great deal between people. Some barely notice a stent. Others find it genuinely wearing. Neither response means anything has gone wrong.
Making it easier
- Keep drinking well. Concentrated urine irritates the bladder and makes every symptom worse.
- Expect more blood on days you are active. Reducing heavy activity reduces it.
- Take the medication you were given. Drugs that relax the bladder help a great deal with urgency, and many people stop them too early.
- Empty your bladder before it becomes uncomfortably full, since a full bladder increases the loin ache.
- Plan around it. If your work involves long stretches without a bathroom, mention it before surgery.
What is not normal
Contact your urologist or go to hospital if you have:
- Fever or shivering, which may indicate infection in an obstructed system
- Pain that is severe and not controlled by the painkillers you were given
- Inability to pass urine at all
- Heavy bleeding with clots, or bleeding that does not settle with rest and fluids
Getting it removed
This is the question everyone asks, and the answer is that removal is quicker and easier than people expect.
Most stents come out through a short outpatient procedure using a fine flexible telescope under local anaesthetic. It takes a few minutes. Some stents are left with a thread attached, and those are removed by gently pulling the thread, which takes seconds.
Symptoms settle within a day or two afterwards. A little discomfort and some blood on the first urination after removal is usual.
The one thing that genuinely matters
Do not forget your stent.
A stent is designed to stay in for a defined period, usually a few weeks. Left in for many months it encrusts with mineral deposits, can block, and becomes considerably harder to remove, occasionally requiring major surgery to deal with.
This happens, and it almost always happens to people who felt fine, moved house, changed hospitals or simply lost track of the appointment.
Before you leave hospital, write down the date the stent is due out. Put it in your phone. If that date passes without an appointment, chase it rather than waiting to be called.
The short version
A stent is a small tube that keeps your kidney draining while it heals. Frequent urination, some blood and a loin ache when you pass urine are all expected. Fever or uncontrolled pain are not. And whatever else you take away from this, keep track of when it is due to come out.