A ureteral stent is a thin, flexible tube temporarily placed inside the ureter, the duct connecting the kidney to the bladder. The stent ensures urine drains freely, typically after surgery or to bypass a blockage like a kidney stone. Although effective for protecting kidney function, the device often causes significant physical discomfort in a majority of patients. This article manages expectations and provides actionable information on coping with associated symptoms.
The Physiological Reasons for Discomfort
Discomfort from a ureteral stent results directly from its mechanical presence within the urinary tract. The lower end of the stent features a coil that rests inside the bladder, constantly irritating the bladder lining. This foreign object triggers the bladder muscle to contract more frequently than normal, leading to a persistent sensation of needing to urinate, known as urgency.
Another source of pain is vesicoureteral reflux, or the backflow of urine. Normally, the junction where the ureter enters the bladder acts as a one-way valve, closing when the bladder contracts during urination. The stent prevents this valve from closing completely, allowing pressurized urine to travel backward from the bladder up to the kidney.
This retrograde flow causes the kidney’s internal pressure to spike abruptly during voiding, resulting in sharp, localized pain. The stent is a rigid structure in a dynamic, muscular tube, and constant friction against the sensitive ureteral wall contributes to generalized aching. This friction is often exacerbated by physical activity or changes in body position, as the stent shifts within the tract.
Recognizing Common Stent Pain Symptoms
The pain caused by a ureteral stent manifests in several distinct ways and locations. The most recognizable symptom is flank pain, localized in the back or side near the kidney, which intensifies significantly when the patient urinates. This specific spike in pain is a hallmark of urine reflux back into the renal pelvis.
Patients commonly report lower abdominal and suprapubic pain, concentrated in the pelvic area above the pubic bone. This pain is often accompanied by a burning sensation during urination (dysuria) and intense bladder spasms. These spasms are involuntary contractions of the bladder muscle attempting to expel the foreign body. The mechanical irritation also results in urinary frequency and urgency, causing the patient to feel the need to urinate more often than usual.
It is also common to observe hematuria, or blood in the urine, which appears as a pink or light red tinge. This symptom is generally benign and results from the stent rubbing against the delicate lining of the urinary tract.
Practical Strategies for Pain Management
Managing stent-related discomfort requires a multimodal approach combining medication and lifestyle adjustments. Pharmacological relief often begins with over-the-counter pain relievers such as acetaminophen or non-steroidal anti-inflammatory drugs (NSAIDs). For targeted relief, physicians frequently prescribe alpha-blockers, such as tamsulosin.
Alpha-blockers relax the smooth muscle in the ureter and bladder neck, reducing spasms and easing stent pressure. Anticholinergic medications, like oxybutynin or solifenacin, treat urinary urgency and frequency by dampening the bladder’s signals to contract. Patients should discuss a combination drug regimen with their urologist to address their specific symptom profile.
Hydration is an effective strategy, as drinking water helps dilute the urine, making it less irritating to the urinary tract lining. However, avoid overhydration, which can increase urination frequency and potentially worsen reflux-related flank pain. Modifying daily activity levels is necessary, as strenuous exercise or heavy lifting can worsen stent friction and movement, intensifying the pain. Reducing these activities minimizes mechanical irritation during the stenting period.
Limiting intake of known bladder irritants, such as alcohol, caffeine, and highly acidic or spicy foods, can significantly reduce urinary urgency and bladder spasms.
The Stent Removal Process and Expectations
The final stage involves stent removal, typically a quick procedure that alleviates the primary source of discomfort. There are two common removal methods, depending on the type of stent placed. If the stent has an attached string, removal is often performed in a doctor’s office by simply pulling the string.
String removal is brief, lasting only a few seconds, and is described as a sharp, pulling sensation that resolves immediately. For stents without a string, removal is performed using a flexible cystoscope, a small, camera-equipped instrument inserted through the urethra and into the bladder. A numbing gel is applied to the urethra beforehand to minimize discomfort during the one-to-two-minute procedure.
Following stent removal, patients may experience lingering symptoms for a short period as the urinary tract adjusts. It is common to have mild frequency, urgency, or a slight burning sensation during urination for 24 to 48 hours. This is due to residual irritation of the ureter and bladder lining, but these symptoms quickly subside as the tissue heals.