A ureteral stent is a thin, flexible tube inserted into the ureter, the tube connecting the kidney to the bladder. Its primary function is to maintain an open passage, ensuring urine drains freely from the kidney, bypassing any obstruction. While effective for preventing damage to a blocked kidney, the stent’s presence causes a range of expected side effects.
Common Urinary Changes
The most frequently reported side effects involve changes to normal urination patterns and urine appearance. The stent is a foreign object, and its lower coil sits inside the bladder, causing irritation to the lining. This irritation often leads to a sudden, strong, and frequent need to urinate, known as urgency and frequency.
Urinary frequency and urgency can feel similar to symptoms of a urinary tract infection, as the bladder muscle contracts involuntarily in response to the stent. These involuntary contractions are referred to as bladder spasms, creating a sudden, intense urge to empty the bladder. The urine itself may also show signs of the stent’s presence, most commonly as hematuria, or blood in the urine.
Hematuria occurs because the stent constantly rubs against the lining of the ureter and bladder. A slight pink or reddish discoloration of the urine is normal and expected, but physical activities like walking or exercise can temporarily worsen this effect. Drinking plenty of water is important, as increased fluid intake helps dilute the urine, which may reduce irritation to the urinary tract.
Pain and Physical Discomfort
Many patients experience a combination of symptoms clinically referred to as “stent syndrome,” defined by pain, urinary urgency, and frequency. The pain often starts in the flank area, the side and back where the kidney is located. This flank or kidney pain is directly related to the mechanics of the stent during urination.
When the bladder contracts to push urine out, the pressure increases dramatically. Because the stent acts like a hollow bypass tube, this high pressure can force urine backward (reflux) up the stent and into the kidney. This sudden backflow distends the kidney’s collecting system, causing a sharp, cramp-like pain often described as worse during or immediately after urinating.
Pain can also radiate down the path of the ureter into the groin or genital area. This discomfort is caused by the stent irritating the ureter as it travels from the kidney to the bladder. Separately, the coiled end of the stent sitting in the bladder can cause a chronic, dull ache in the lower abdomen or pelvic region, distinct from the sharp pain of spasms.
For managing these common aches and pains, over-the-counter medications like acetaminophen or ibuprofen are the first line of defense. In some cases, a physician may prescribe specialized medications, such as alpha-blockers, to help relax the muscles in the ureter and bladder. This can reduce the severity of spasms and painful reflux.
Serious and Rare Complications
While most side effects are uncomfortable but manageable, a few serious complications require prompt attention. One concern is a urinary tract infection, which can progress to pyelonephritis, a severe kidney infection. Because the stent is a foreign body, bacteria can colonize its surface, increasing the risk of infection. Signs of an infection include a fever, chills, and severe burning pain when urinating.
Another serious issue is stent blockage or obstruction, which can prevent the kidney from draining effectively. If the stent becomes clogged with debris or stone fragments, this leads to an inability to urinate or severely reduced urine output. Severe, unremitting flank pain, sometimes worse than the original kidney stone pain, can indicate the stent is no longer functioning to relieve the blockage.
Stent migration is a less common complication where the tube moves out of its intended position. If the stent shifts, it can worsen symptoms or cause a new obstruction. Long-term complications, generally only a concern if the stent is left in place too long, include encrustation. Encrustation occurs when mineral deposits build up on the tube, making removal difficult and increasing the risk of infection.
When to Seek Medical Attention and Stent Removal
It is important to distinguish between expected discomfort and symptoms that signal a potential medical issue. Patients should contact their healthcare provider immediately if they develop a persistent high fever, generally considered above 101°F. Uncontrollable pain that does not improve after taking prescribed or over-the-counter medication is also a sign that the stent may be blocked or dislodged.
Any inability to urinate or a severe reduction in urine output requires immediate medical attention, as this suggests a critical obstruction. A sudden, significant increase in blood in the urine, especially if passing large clots, should also be reported without delay. These symptoms suggest the normal side effects have transitioned into a potentially dangerous complication.
Eventually, the stent must be removed once the underlying condition is resolved. This is generally a quick procedure done in a clinic or hospital setting. While some patients experience anxiety about the removal process, it is typically well-tolerated and results in immediate relief of the stent-related symptoms. It is normal to experience some temporary side effects after removal, such as a brief period of hematuria or bladder spasms, as the urinary tract adjusts.