Double J-stent placement

When is the double-J stent removed?

During an appointment in the hospital, your doctor will tell you when the double-J stent needs to be removed. This can be in several days or within a few weeks.

How is a stent removed?

Stents can be removed two different ways. Sometimes a string has been left attached to the end of the stent. This string is allowed to come out of the patient’s urethra (the tube that transports the urine from the bladder to the outside of the body). The string can be used to pull on the stent and remove it. If a string is not attached, numbing medication is usually administered, and a small camera called a cystoscope is inserted into the urethra. The cystoscope is advanced into the bladder along with a grasping instrument, which grasps and removes the stent.

When the stent was placed during a procedure for stone removal

If a stone is removed during the procedure, it is sent to the laboratory to determine its composition. This may take several weeks. Based on the laboratory results, along with blood and urine tests taken before treatment, your doctor can determine whether you are at high risk of forming new stones (recurrence).

The results will be discussed with you during an appointment in the hospital or with your doctor (the follow-up).

What if the doctor suspects that I have a high risk of forming new stones?

If the results show that you have a high risk of forming more stones, your doctor will do a metabolic evaluation. This is a series of blood and urine tests to determine the possible causes of your stone formation. Depending on the test results, your doctor will recommend preventive measures or further tests. Besides changes in your lifestyle, you may be advised to take medication that reduces the risk of stones recurring. Generally, the medication will cause few to no side effects.

Changes in your lifestyle

Even if you have a low risk of forming another stone, your doctor and nurse will advise you to make some lifestyle changes.

Lifestyle changes may include:

• Increasing fluid intake: Drink 2.5-3.0 litres per day to neutralise the pH of your urine
• Adopting a balanced diet with less meat and alcohol and more vegetables and fibre to have normal calcium levels and less intake of animal proteins
• Maintaining a healthy weight and adequate physical activity

What is a ureteral stent?
A ureteral stent is a soft, hollow tube placed temporarily into the ureter to help drain urine from the kidney into your bladder. A double-J stent is a ureteral stent with curving ends that prevent the stent slipping into the bladder or the kidney.
How is a ureteral stent placed?
Ureteral stent placement is a surgical procedure. A tube with a tiny optic camera is inserted through the urethra into your bladder. The bladder is inspected, and the ureteric opening is located. The stent is placed by sliding it over a flexible wire inserted into the ureter. The procedure is usually performed with the patient asleep (under general anaesthesia). Sometimes a local anaesthetic, with or without sedation, is administered.
How long will I have the stent?
From several days to a few weeks, depending on why it was placed. Your doctor will tell you when the double-J stent needs to be removed.
Should I take an antibiotic?
Your doctor may prescribe an antibiotic to treat or prevent an infection or to relieve your pain. Report any signs of infection – including severe pain, chills, or fever – to your doctor right away.
I’ve had pain with the urge to urinate since the stent was placed. Is that normal?
You may feel mild to moderate pain in your lower abdomen, and you may have a strong urge to urinate. These symptoms are usually caused by the inserted stent. Ask your doctor about medication to treat these symptoms. Call the hospital or your doctor if you experience a serious burning sensation (not mild) when urinating or if you continue to have severe pain despite use of pain medication.
I’ve had blood in my urine since the stent was placed. Is that normal?
Small amounts of blood may be present in the urine after stent placement and usually disappear in a few weeks. Call the hospital or your doctor if you see large amounts of blood in your urine and it does not go away with rest and hydration.
Will the stent move inside me?
Yes, the stent is flexible and will move with your body.
Can the stent fall out?
The curved ends of a double-J stent usually keep it in place. In rare cases, however, the stent may slip into the bladder or the kidney.
If the stent falls out, what should I do?
It is very rare for a stent to fall out of the body. If this happens, wash the stent and place it in a plastic bag. Contact your doctor and bring the stent with you to your appointment.
How is a stent removed?
Stents can be removed two different ways. Sometimes a string has been left attached to the end of the stent. This string is allowed to come out of the patient’s urethra. The string can be used to pull on the stent and remove it. If a string is not attached, numbing medication is usually administered, and a small camera called a cystoscope is inserted through a flexible tube into the urethra. The cystoscope is advanced into the bladder along with a grasping instrument, which grasps and removes the stent.
Will I be asleep when the stent is removed?
Removal is very quick. A local anaesthetic is usually administered to numb the area.
Will I be in pain after I have the stent pulled?
You may experience some mild discomfort immediately afterwards. Some patients have severe pain that is temporary and resolves within a few hours.
Should I take pain medication before the stent pull?
Taking an NSAID (for example, ibuprofen) prior to stent removal can help minimise pain afterward. Always ask your doctor about treatment steps and any special instructions before a procedure.
Why is there pain after the stent is removed?
A medical device was present in your urinary tract, so some mild discomfort is expected when it is removed. More severe pain may result if the ureter spasms or swells. These symptoms disappear in a few hours. Taking an NSAID (for example, ibuprofen) before stent removal can help minimise pain.