Is ureteral stent removal painful?

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Last updated: January 27, 2026 • View editorial policy

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Is Ureteral Stent Removal Painful?

Yes, ureteral stent removal is painful or uncomfortable for the majority of patients, with approximately 80-95% experiencing some degree of discomfort during the procedure and 55-64% reporting symptoms afterward, though the pain is typically brief and self-limiting. 1, 2, 3, 4

Pain During the Removal Procedure

  • Almost all patients (approximately 82%) experience either pain or discomfort during the actual stent removal, but for most (approximately 66%), the pain is of short duration, lasting only seconds to minutes 2
  • The procedure itself involves cystoscopic visualization and grasping of the stent, which causes transient urethral and bladder discomfort 5
  • A single dose of an NSAID (such as rofecoxib 50 mg or equivalent) given before stent removal prevents severe pain in the 24 hours following removal, reducing the incidence from 55% to 0% in one randomized controlled trial 3

Post-Removal Symptoms

  • Approximately 64% of patients experience symptoms after stent removal, including pain, hematuria, urinary frequency, urgency, or fever 1
  • Among those with post-removal symptoms, 60% specifically experience pain or discomfort 1
  • Most post-removal symptoms resolve within 24 hours, though a minority of patients describe symptoms persisting for more than one day 2

Predictors of More Severe Pain

  • Patients who experienced discomfort while the stent was indwelling are significantly more likely to have pain after stent removal 1
  • Stone basketing procedures during the initial ureteroscopy correlate positively with increased post-removal pain 1
  • Conversely, anticholinergic use during the stent indwelling period and longer stent duration are associated with less pain after removal 1

Psychological Distress Component

  • Many patients (approximately 55%) describe significant anticipatory anxiety related to the removal procedure 2
  • Several patients (approximately 29%) report discomfort arising from lack of privacy or feeling exposed during the procedure 2
  • Provider interactions can either help put patients at ease or increase discomfort, highlighting the importance of clear communication 2

Pain Management Strategies

Pre-Removal Prophylaxis

  • Administer a single dose of an NSAID (such as ketorolac 30 mg IV/IM or ibuprofen 600-800 mg PO) 30-60 minutes before the procedure to prevent severe post-removal pain 3

Procedural Anesthesia Options

  • Intravenous analgesics alone result in significantly higher pain scores and lower satisfaction compared to sedation approaches 5
  • Moderate sedation with midazolam provides significantly less pain and higher satisfaction than analgesics alone 5
  • General anesthesia using propofol without muscle relaxation provides the least pain and highest satisfaction rates, with no patients requesting alternative treatment modalities in future procedures 5

Post-Removal Management

  • A multimodal approach combining alpha-blockers, anticholinergic medications, anti-inflammatory drugs, and narcotic pain medications as needed is most effective for managing post-removal symptoms 4
  • Patients should be counseled that lingering urinary symptoms (frequency, urgency, mild dysuria) may persist for 24-48 hours but typically resolve spontaneously 2

Critical Communication Points

  • Inform patients preoperatively that they will likely experience brief discomfort during removal but that it is typically short-lived 2
  • Explain the possibility of delayed pain or urinary symptoms in the 24 hours following removal to help patients adapt to discomfort 2
  • Set expectations that approximately two-thirds of patients experience some symptoms after removal, but these are usually self-limiting 1
  • Reassure patients that severe, prolonged pain is uncommon and should prompt contact with their urologist 2

Common Pitfalls to Avoid

  • Failing to provide prophylactic NSAIDs before removal, which can prevent severe pain in the majority of patients 3
  • Underestimating the psychological distress component and not addressing anticipatory anxiety through clear communication 2
  • Not offering sedation options for anxious patients or those with prior negative experiences with cystoscopy 5
  • Dismissing patient concerns about post-removal symptoms without providing specific guidance on expected duration and management 2

References

1
Research

Symptoms after removal of ureteral stents.

Journal of endourology, 2015

4
Research

Ureteral Stent Discomfort and Its Management.

Current urology reports, 2018

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Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.