Ureteral Stents For Kidney Stones: All You Need To Know

Have you heard of ureteral stents? They are devices used in urological surgery. PubMed Central (Central European Journal of Urology) notes that its main objective is to allow passage of urine and minimise early or late complications associated with the urinary tract. Despite their widespread use, awareness of ureteral stents is still limited. Today, this article will explore the use in kidney stone patients. 

To get a complete picture on this topic, the editorial team of OnlyMyHealth reached out to Dr Shashank MS, Consultant - Urology and Renal Transplant, Aster CMI Hospital, Bengaluru and Dr Dilip M Babu, Senior Consultant Nephrologist and Transplant Physician, Yashoda Hospitals, Hyderabad. 

Can Ureteral Stents Help Pass Kidney Stones?

As per the Cleveland Clinic, ureteral stents open the ureter, which can help urine pass easily from the kidney to the bladder. Their report mentions that healthcare professionals generally use ureteral stents for kidney stone cases to:

• Allow urine to bypass a kidney stone that slows or obstructs urine flow.
• Prevent a new obstruction from developing after kidney stone treatment.
• Stop a blockage from postoperative swelling after kidney stone removal.

Now, let us see what our experts have to say about this. As per Dr Shashank,“A ureteral stent is a thin, soft tube placed inside the ureter, which is the pipe that carries urine from the kidney to the bladder. It is commonly used in people with kidney stones to help urine flow properly when the ureter is blocked or irritated. The main purpose of a ureteral stent is to relieve blockage, reduce pressure in the kidney, and allow the stone to pass or prepare the body for further treatment. It also helps prevent complications like infection or kidney damage.” 

Explaining this further, Dr Dilip shares, “When a stone obstructs the ureter, pressure builds up within the kidney, leading to severe pain, infection risk and potential kidney damage. The stent functions as an internal support system, allowing urine to bypass the blockage and flow normally, thereby protecting kidney function and relieving pressure.”

Ureteral Stents For Kidney Stones: What Is The Procedure?

Now that we knowwhatureteral stents are, let us understand their procedure. “The procedure is usually simple and done under local or general anaesthesia. A doctor inserts the stent using a thin instrument through the urinary tract without making any cuts. The stent stays inside the body, with one end in the kidney and the other in the bladder, allowing urine to bypass the blockage,” says Dr Shashank.

Shedding more light on this, Dr Dilip shares, “The insertion procedure is minimally invasive and usually performed under regional or general anaesthesia. A small endoscopic instrument is passed through the natural urinary passage to guide the stent into position, so no surgical incision is required. Most stents are designed with curled ends that help keep them securely in place within the kidney and bladder.”

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Risks And Benefits Of Ureteral Stents For Kidney Stones

As per a 2018 study, published in the Asian Journal of Urology, “Despite the obvious benefits of ureteral stents, they carry some risks as well. It noted that ureteral stents can cause patient discomfort and negatively affect the quality of life. The presence of an indwelling foreign body can also lead to biofilm formation, the report mentioned. This may cause UTIs or encrustations, complicating subsequent stent removal.

In a 2017 PubMed study published in the Journal of Urology, patients with ureteral stents seem to have remarkably more bladder and lower urinary tract symptoms than those without stents. However, it also noted that a subgroup of patients is likely to benefit from stenting. 

Elaborating more on the risks and benefits of ureteral stents, Dr Shashank lists down the following:

Benefits:

• There are many benefits of a ureteral stent. It quickly relieves pain caused by blockage, protects kidney function, and improves urine flow.
• It is also useful after procedures like stone removal to keep the ureter open during healing.

Risks:

• However, there are some risks and side effects. Patients may feel discomfort, a frequent urge to urinate, a burning sensation, or mild blood in urine.
• Some people may also experience lower abdominal pain or infection, but serious problems are rare. 

Sharing what causes these side effects from ureteral stents, Dr Dilip shares, “These symptoms occur due to irritation of the urinary tract and generally improve with hydration and prescribed medications. In rare cases, prolonged stent placement can lead to urinary infections, mineral deposits on the stent or device displacement.” Ureteral stent displacement (migration) is a common complication where the stent displaces from its intended position. This can cause pain, urinary symptoms, or obstruction, and needs medical intervention. 

But, is there someone who should avoid ureteral stents? As per experts, ureteral stents are usually safe devices, but they should be avoided or used with extreme caution in patients with active, untreated Urinary Tract Infections (UTIs), those prone to severe encrustation, such as patients with chronic kidney failure, metabolic abnormalities, or those unable to comply with scheduled, timely stent removal.

Recovery From Ureteral Stent Procedure

Last but not least, people often wonder what recovery from this procedure looks like. Explaining this, Dr Shashank says, “Recovery is usually quick, and most people can return to normal activities within a few days. Drinking plenty of water helps reduce discomfort and keeps the urine flowing. A kidney stone stent stays in for four days to four weeks after the procedure, depending on the condition. Overall, a ureteral stent is a safe and effective way to manage kidney stones and protect the kidneys.”

On this note, Dr Dilip mentions, “Most patients recover quickly and can resume normal daily activities within a few days. Since stents are temporary, timely removal and regular medical follow-up are essential for safe, effective care.”

What Is The Removal Process Of Ureteral Stents?

As per the Cleveland Clinic, to remove a stent, a urologist will do the following:

• Use a topical anaesthetic to numb the area.
• Insert a cystoscope via the urethra and into the bladder.
• Use minor clamps attached to the cystoscope to get hold of the stent.
• Finally, gently remove the stent.

Is the removal procedure painful?According to the Cleveland Clinic, the area will be numb during ureteral stent removal, so there will not be much pain. However, in some cases, many people experience moderate discomfort or pain after the topical anaesthetic wears off. However, it goes away after a few days.

Stent removal is performed in a clinic or hospital, but some people also do self-removal. In a 2018 PubMed study, published inthe Arab Journal of Urology, the use of a stent with a string after URS appears safe and effective. It noted that few patients had difficulty removing their stents, but the complication rates were similar in the groups with and without a string attached to their stents. Single-and double-arm-stringed stents showed similar complication rates.

When To Seek Urgent Help

After the completion of ureteral stent surgery, you need to seek help from a medical professional if you experience any of the following (as per the Cleveland Clinic):

• Clots of tissue in your urine.
• Dark, cloudy or foul-smelling urine.
• Trouble peeing or severe pain or burning when you pass urine.
• Kidney pain.
• Nausea and vomiting.
• Signs of an infection, including a fever or chills.

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The Final Word

A ureteral stent is a thin, soft tube which is placed inside the ureter. It is the pipe that carries urine from the kidney to the bladder. The primary benefit of ureteral stenting is the prevention of kidney damage while relieving pain and supporting recovery after stone treatment. While it has many benefits, it also has some mild side effects.