What are the typical symptoms and sensations associated with having a ureteral stent?

Ureteral Stent Sensations and Symptoms

Having a ureteral stent typically causes bothersome lower urinary tract symptoms and pain that can temporarily alter quality of life in approximately 80% of patients. 1

Common Symptoms Associated with Ureteral Stents

Urinary Symptoms

• Urinary frequency and urgency are among the most common complaints, affecting the majority of patients with ureteral stents 1, 2
• Dysuria (painful urination) is frequently reported and can significantly impact daily activities 2, 3
• Hematuria may occur in some patients with indwelling stents 2

Pain Symptoms

• Flank pain, particularly during urination, is common and likely related to reflux of urine up to the renal pelvis 1, 4
• Suprapubic discomfort or bladder pain, especially during voiding or when the bladder is full 4
• Pain may worsen with physical activity or certain body positions 4

Mechanism of Stent Discomfort

The exact cause of stent-related symptoms remains incompletely understood but is likely multifactorial:

• Bladder irritation from the distal curl of the stent is a primary contributor to symptoms 1, 3
• Retrograde reflux of urine through the stent to the renal pelvis, especially during voiding, causing transmission of high bladder pressures 1
• Mucosal irritation along the ureter from the stent material 4
• Stent length that crosses the midline of the bladder significantly increases symptom frequency 3

Factors Affecting Stent Discomfort

• Stent positioning: Stents that are too long and cross the midline of the bladder cause more symptoms 3
• Duration of stenting: Longer indwelling times can lead to increased complications including encrustation, infection, and persistent symptoms 2
• Individual patient factors: Some patients experience more severe symptoms than others with similar stents 4

Management of Stent-Related Symptoms

Current evidence suggests that a multimodal approach is most effective for managing stent-related discomfort:

• Alpha-blockers have shown efficacy in reducing stent-related symptoms and should be considered as first-line treatment 1, 4, 3
• Anticholinergic medications can help reduce bladder irritability and urinary frequency 1, 4
• Anti-inflammatory medications and appropriate pain management can help address discomfort 1, 4
• Ensuring proper stent length and positioning can minimize symptoms 3

Emerging Solutions

• Complete intraureteral stents (CISs) that don't extend into the bladder have been shown to significantly decrease urinary symptoms and pain compared to conventional double-J stents 5
• Drug-eluting stents are in development and have demonstrated promising early results for reducing symptoms 1, 4
• Periureteral botulinum toxin A injections represent a novel treatment approach for stent-related pain 4

Important Considerations

• Stent-related symptoms are temporary and typically resolve completely after stent removal 1
• Long-term indwelling stents (beyond recommended duration) can lead to serious complications including encrustation, infection, and obstruction 2
• Patients should be informed about expected symptoms before stent placement to reduce anxiety 4
• Regular follow-up is important to ensure timely stent removal and prevent complications 2