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Ureteric Stent Insertion

Also known as: ureteral stenting, insertion of a ureteral stent

Ureteric stent insertion is a procedure which ensures that urine flows from the kidneys to the bladder when blockages are present, allowing for proper urine drainage.

Urology
01442 331 900
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What is a ureteric stent?

A ureteric stent, also known as a ureteral stent or kidney stent, is a thin, flexible tube placed inside the ureter to keep the urine flowing from the kidney to the bladder. It’s used when a blockage or narrowing of the urethra is preventing normal urine flow.

The stent is designed with curled ends, one in the kidney and one in the bladder, to prevent it from dislodging and to ensure continuous drainage. Made of soft plastic, it acts as an internal support structure to bypass obstructions and reduce pressure in the urinary tract.

By keeping the ureter open, the stent prevents complications such as kidney damage or infection, allowing the urinary system to function normally while the underlying cause is being addressed.

Symptoms of blocked ureters

Recognising a blocked ureter early is key. One of the most common signs is severe pain, often in the lower back or abdomen, which can come on suddenly and be bad enough to stop you from doing your daily activities. This pain, known as renal colic, persists despite changes in position and is a sign that urine flow is blocked. Blood in the urine, or haematuria, is another common symptom and can be visible or only detected through testing. Other signs include changes in urination, such as increased frequency, difficulty passing urine, or recurring urinary tract infections (UTIs), which may be accompanied by fever or a burning sensation during urination. In severe cases, a blocked ureter can cause systemic symptoms, such as fever and chills, indicating a kidney infection that requires urgent medical attention. Early recognition and treatment of these symptoms can prevent long-term complications.

Causes and risk factors of ureteric blockage

A range of underlying conditions can cause ureteric blockages. Kidney stones are the most common cause, especially when they lodge at the junctions where the ureter meets the kidney or bladder. Even small stones can cause intense pain and obstruction, depending on their location and number. Tumours, both benign and malignant, can grow in or near the urinary tract, compressing the ureters and impeding urine flow. Scar tissue from prior surgeries, infections, or radiation therapy may also narrow the ureter. Congenital abnormalities, such as duplicated ureters or ureteropelvic junction obstruction, can predispose individuals to blockages from birth. In rare cases, retroperitoneal fibrosis, a condition characterised by the excessive growth of fibrous tissue in the abdomen, can entrap the ureters. Cancers of nearby organs, such as the prostate, bladder, or cervix, may also invade or press against the ureters. Individuals with a history of kidney stones or pelvic surgeries are at greater risk of developing such obstructions. Being aware of these risk factors helps in the early detection and management of these conditions.

Before surgery

Initial consultation

The process starts with an initial consultation with a urologist. During this visit, the surgeon will explain the procedure in detail, including its risks, benefits, and alternatives. This is the time to ask questions and address any concerns you may have. A physical examination will be performed, and your medical history, including any medications that affect blood clotting, will be reviewed. You may also be asked to have blood tests to check kidney function and clotting ability.

Preparing for surgery

You will be advised on fasting instructions during your consultation. Please inform your medical team of any known allergies and all medications you are currently taking, including blood thinners, as these may need to be discontinued or adjusted before surgery. Proper preparation helps ensure a smooth and safe procedure.

During surgery

Ureteric stent insertion is typically performed under general anaesthesia, meaning you will be asleep and free of pain throughout. Once you are anaesthetised, a cystoscope – a thin tube with a camera – is passed through the urethra into the bladder. Using real-time imaging, such as fluoroscopy or ultrasound, the urologist identifies the location of the blockage and advances a guide wire through the ureter. The stent is then placed over the guide wire, with one end curled into the kidney and the other into the bladder. These curled ends help secure the stent and prevent it from moving. The entire procedure usually takes between 15 and 30 minutes. Nursing staff will be present throughout to ensure your safety and comfort.

After surgery

Immediate post-surgery care

Following the procedure, you will be taken to a recovery area where your vital signs and overall condition will be monitored as you wake up from anaesthesia. It’s normal to feel a bit groggy or out of sorts at first – this usually wears off within a few hours. You may experience some discomfort in your bladder or lower abdomen, but pain relief will be available if needed. It’s also common to see a little blood in your urine or to feel the need to go more often, but these symptoms usually settle down within a few days. Drinking around 2 litres of water a day can help flush your system and ease any irritation. Try to take it easy for the first day or two – resting and avoiding heavy lifting will give your body the best chance to recover smoothly.

Long-term recovery

As you transition into the longer-term recovery phase, there are a few key considerations to be aware of. It’s common to feel like you need to urinate more often, or to notice some discomfort or a tugging sensation when you do – that’s just the stent doing its job. Some people are more prone to urinary tract infections while the stent is in place, so if you notice signs like fever, burning when you pee, or urine that smells unusual, it’s essential to let your doctor know right away. You’ll have follow-up appointments to check how the stent is working and to decide when it should be removed or replaced. Sometimes, imaging scans are needed to ensure your kidneys are functioning correctly and the original problem is resolving. Most people can return to their usual routines while the stent is in place; however, you may need to make a few minor adjustments if any symptoms are bothersome. Staying on top of any issues early helps make sure everything heals as smoothly as possible.

Appointment and Treatment Plan

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Initial Consultation

You’ll meet with a urologist to discuss your symptoms. Imaging tests, such as an ultrasound or CT scan, may be used to confirm a blockage. If conservative treatments haven’t worked, a stent may be recommended.

Pre-Surgery Preparations

Before surgery, you may need to discontinue certain medications, fast for a specified period, and undergo blood tests. Be sure to inform your doctor of any allergies and arrange a ride home.

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Day of Surgery

The procedure takes 15-30 minutes under general anaesthesia. A camera is used to guide the stent into the ureter, with one end in the kidney and the other in the bladder. Most patients go home the same day.

Immediately After Surgery

You’ll rest briefly in recovery, while the anaesthesia wears off, then go home with post-op instructions. Some pain, frequent urination, or blood in the urine is normal for a few days and can be managed with medication and fluids.

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Early Recovery at Home

You may feel mild discomfort or urinary urgency while the stent is in place. Staying hydrated helps reduce irritation. Avoid strenuous activity for the first 24 to 48 hours.

Follow-Up and Monitoring

A follow-up appointment will verify the stent’s position and confirm that the blockage is resolving. Imaging may be repeated, and your doctor will decide when to remove the stent.

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Stent Removal and Recovery

Stents are temporary and removed in a simple outpatient procedure. Most patients recover quickly and return to normal activities once the stent is out.

Experts

We are proud to provide patients with access to a wide range of clinicians, chosen specifically for their knowledge and reputation in their area of expertise. Our experts align with our values: putting you at the centre of your care and educating you on your options at each step of the journey. We encourage you to learn more about our clinicians and how they can help you below. As always, please contact our patient services team if you require any additional information.

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FAQs

A ureteric stent is a thin, flexible tube placed in the ureter to maintain its patency and facilitate urine passage from the kidney to the bladder. This device is crucial for preventing obstructions that could hinder urinary flow.

Blocked ureters can cause severe pain, haematuria, altered urine output, and recurrent urinary infections. It is crucial to seek medical attention if these symptoms arise.

Blocked ureters can be caused by factors such as kidney stones, cancers (including prostate and bladder cancer) and congenital abnormalities. Each of these conditions can obstruct the normal flow of urine from the kidneys to the bladder, leading to significant complications.

It is essential to fast for at least four hours before ureteric stent insertion surgery and to inform your healthcare team about any blood-thinning medications or allergies you may have. Discussing the procedure with your doctor during your consultation will ensure you are fully prepared.

It is crucial to contact your healthcare provider immediately if you experience severe pain following the procedure. Prompt communication can help address any potential complications effectively.

Ureteral stent insertion is generally considered a minimally invasive procedure rather than major surgery. The procedure involves placing a thin tube inside the ureter to ensure urine can flow freely from the kidney to the bladder, especially when there is a blockage. Because it does not require large incisions or extensive tissue removal, recovery time is usually shorter compared to major surgeries. However, patients may still experience discomfort, urinary symptoms, or mild pain after the procedure, which typically resolve with time.

The duration a ureteric stent remains in place varies depending on the underlying condition being treated. In most cases, the stent is temporary and remains in the body for a few days to several weeks or months. For example, after kidney stone removal or to relieve a temporary blockage, the stent might be removed once the ureter has healed, or the obstruction is resolved. In some cases, such as chronic conditions or cancer-related blockages, the stent may need to stay in place for an extended period. It may require regular replacement to prevent complications. Your healthcare provider will schedule follow-up appointments and imaging tests to monitor the stent’s position and function and determine the appropriate time for removal or replacement.