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What is a Ureteric Stent?
A ureteric stent is a thin, hollow flexible plastic tube approximately 12 inches in length, which is inserted through your bladder using a telescope. It is inserted into the ureter between your kidney and your bladder. It is curled at both ends to keep the stent in place inside the kidney and inside your bladder Allowing the urine produced by your kidney to
pass easily into your bladder.
Why are stents inserted?
The most common factor for stent insertion into one or both of your ureters is a blockage. Stents can be inserted at the end of planned surgery involving your ureter or as an emergency to bypass an unexpected blockage. Blockages may be caused by: A kidney stone (or stone fragment), this can move into your ureter either by itself or after extracorporeal shockwave lithotripsy. A stricture (narrowing) of the ureter, this can occur anywhere in the ureter due to scarring, congenital narrowing, and tumour growth within or outside the ureter causing narrowing and obstruction. After surgery or instrumentation, when an instrument has been put into the ureter and kidney this is often temporary to protect the ureter from a blockage caused by swelling that occurs in the first few days after surgery. Your surgeon will inform you how long the stent will remain in place, as length of time can vary.
How is a stent inserted?
A stent is normally inserted under a general anaesthetic (where you are asleep) or a spinal anaesthetic (where you are awake but can feel nothing from the waist down). A small telescope (cystoscope) is passed through the urethra (waterpipe) into the bladder. The stent is then placed into the ureter and kidney through the opening of the ureter in the bladder; x-ray guidance is used to check the correct position of the stent.
How long does a stent remain in place?
The length of time a stent can remain in place is variable due to the cause of its insertion. In most patients, a stent is required for a short duration, at times days but usually weeks or months. In some circumstances a stent is required on a long-term basis.
What are the possible side effects associated with a stent?
It needs to be recognised that most patients suffer from some stent related symptoms that vary in intensity. Each person has a different tolerance level of pain or discomfort. Most people find that they have a slight discomfort when
passing urine. As your bladder decreases in size when you pass urine, the lower part of the stent can rub against the sensitive bladder wall lining.
The most common problems are:
• Increase frequency of urination
• Burning on urination and the feeling of cystitis
• The need to rush to the toilet to pass urine (urgency)
• Pain and discomfort in your kidney, bladder, urethra, and genitals particularly after physical exercise or immediately after you pass urine.
• Blood in urine this is common, and you should drink 2 litres (3 and half pints) of water each day to flush your system through
• In men pain at the tip of the penis
• A slight risk of episodes of urinary incontinence
• Occasionally a sensation of incomplete bladder emptying
• Urine infection, requiring antibiotic treatment
What can I do as the Patient?
1. Drink plenty to water to reduce the blood in your urine and to reduce the risk of infection
2. Report to your GP if there is an infection
3. Report to your GP if you feel the stent has stayed too long with no contact from the hospital
How is a stent removed?
Stent on a string:
In some incidences a stent only needs to stay in place for a short period 1-7 days and often the stent is attached to a string which hangs outside the urethra and is taped to your body. A nurse or a doctor will gently pull the string which is attached to the stent and it should slip out easily and this takes a few seconds. It can sometimes be uncomfortable but, you do not routinely need to take any medication or painkiller beforehand.
Appointment details for stent removal (See discharge summary sheet):
In most cases a stent will have to remain in place for longer than 7 days and the stent is removed by flexible cystoscopy under local anaesthetic. You will be awake and local anaesthetic gel is inserted into the urethra and then a flexible telescope is place into your urethra and into your bladder. Forceps are passed through the telescope and they grasp the stent, and this is removed with the telescope from your bladder. The procedure normally takes a few minutes to perform and you can go home straight after.
Having a stent in place with an underlying kidney problem makes you more susceptible to a urinary tract infection. You should suspect an infection if you have:
• A raised temperature
• Increasing pain in your kidney or bladder
• Difficultly emptying your bladder
• Increasing bleeding in your urine
• A burning sensation whilst passing urine; or
• A general sense of feeling unwell
If you do develop one or more of these symptoms, you should get medical advice without delay.
Can the side-effects interfere with daily life?
In general, for most patient’s stents should not cause disruption to your normal daily life but they can be frustrating. In a minority of cases there can be exceptions were a stent can be extremely problematic.
• Physical activity and sport:
You can continue with physical activity, provided the underlying kidney problem and your general health allows. You may get pain in your kidney and see blood in your urine after any sport or strenuous physical exercise. The side-effects can also make you feel more tired than usual and less keen to exercise.
You should be able to continue working normally with a stent in place. You may get some discomfort if your work involves a lot of physical activity, and you may feel more tired than usual. If your stent symptoms interfere with your work, we recommend you discuss adjustments to your workload with your manager.
• Social interaction:
This should not be affected however, if you do suffer from urinary frequency and urgency, you may need to make sure you have access to toilets. Some patients who experience pain and tiredness will need more help from family and colleagues.
• Travel and holidays:
If your general health and the underlying kidney condition permit, it is perfectly safe to travel with a stent in place. Side-effects can make travel and holidays less enjoyable, and there is a small chance that you may need additional medical assistance during this time.
• Sexual activity:
There are no restrictions on your sex life if you have a stent. Some patients experience discomfort during sexual activity and the side-effects may have an adverse effect on your sex drive. If you have a stent on a string through your urethra, sexual activity can be difficult. You should be careful not to dislodge the string and displace the stent. You may have to abstain from sexual activity until the stent is removed.
Are there any other possible complications?
If the stent is left in place too long, it may become encrusted with a “crystal” (stone-like) coating on its surface and this may worsen some urinary side-effects (especially pain and bleeding).
Displacement of the stent is very unusual but, if your stent does slip out of your urethra or even fall out altogether, you should contact your urology consultant’s co-ordinator/ or your GP.
When should I call for help?
You should get in touch with your GP or hospital if:
• You experience constant, unbearable pain associated with the stent
• You have symptoms of urinary tract infection (high temperature, fever, pain on passing urine, offensive smell and feeling generally unwell)
• Your stent gets dislodged or falls out
• You are passing excessive blood and clots in your urine
• Difficulty passing urine or you cannot pass any urine
If you have not heard anything about your stent removal, please contact your consultant’s co-ordinator for further information. Phone the hospital on 01908 660033.