From the Guidelines
After a ureteric stent insertion for kidney stones, patients typically experience several changes, including discomfort, bladder irritation, flank pain, urinary frequency, urgency, and blood in the urine, which are usually managed with over-the-counter medications and increased fluid intake, and the stent is removed in a brief outpatient procedure within 1-4 weeks. The stent allows urine to flow from the kidney to the bladder while the ureter heals or while waiting for stone passage or further treatment. Patients should increase fluid intake to 2-3 liters daily to help flush the urinary system and prevent infection, as recommended by general medical guidelines 1.
Common Symptoms and Management
- Discomfort, including bladder irritation, flank pain, urinary frequency, urgency, and blood in the urine, are normal and usually improve over time.
- Pain management typically involves over-the-counter medications like acetaminophen (500-1000mg every 6 hours) or ibuprofen (400-600mg every 6-8 hours) if not contraindicated, as suggested by previous studies 1.
- Alpha-blockers and anti-muscarinic therapy may be offered to reduce stent discomfort, as recommended by the American Urological Association/Endourological Society guideline 1.
- Activity restrictions are minimal, though strenuous exercise should be avoided for a few days.
Warning Signs and Complications
- Patients should watch for warning signs requiring immediate medical attention: severe pain unrelieved by medication, fever above 101°F, inability to urinate, or large blood clots.
- The stent is temporary and will be removed in a brief outpatient procedure, typically within 1-4 weeks depending on the specific situation, to minimize complications like encrustation or infection that can occur with prolonged stent placement, as noted in a recent study 1.
- Routine placement of a ureteral stent is not recommended preoperatively or postoperatively, unless there are clear indications such as ureteral injury, stricture, solitary kidney, renal insufficiency, or a large residual stone burden 1.
From the Research
Consequences of Ureteral Stent Insertion
The consequences of ureteral stent insertion for nephrolithiasis (kidney stones) can be significant. Some of the key consequences include:
- Irritative urinary symptoms, such as frequency, urgency, and dysuria 2, 3, 4
- Pain, which can be severe and debilitating 2, 3, 5
- Increased risk of urinary tract infections (UTIs) 2, 4
- Potential for stent-related complications, such as encrustation, migration, or breakage 4
- Impact on quality of life, including missed work days and decreased productivity 2, 5
Factors Influencing Consequences
Several factors can influence the consequences of ureteral stent insertion, including:
- Stent duration: shorter stent duration may be associated with fewer symptoms and less pain 5
- Stent material and design: newer stent materials and designs may be associated with fewer complications and improved patient comfort 3, 4
- Stone size and location: smaller stones and those located in the distal ureter may be more likely to pass spontaneously with a stent in place 6
- Patient factors: individual patient characteristics, such as age, sex, and medical history, may influence the consequences of ureteral stent insertion 2, 3, 4
Management of Consequences
Several strategies can be used to manage the consequences of ureteral stent insertion, including:
- Medications: alpha-blockers, anticholinergic medications, and pain medications may be used to manage symptoms and pain 3, 5
- Stent removal: removing the stent as soon as possible may help to reduce symptoms and improve quality of life 5
- Patient education: educating patients about the potential consequences of ureteral stent insertion and how to manage them may help to improve outcomes 2, 3, 4