A ureteral stent is a thin, flexible tube placed inside the ureter, the narrow duct that carries urine from the kidney to the bladder. This device is used to maintain the flow of urine, bypassing an obstruction or blockage. People commonly need a stent to manage kidney stones, to allow the ureter to heal after surgery, or when a mass is compressing the ureter.
Expected Side Effects of a Ureteral Stent
The presence of a ureteral stent often causes symptoms that patients should anticipate, which are generally not signs of an infection. A common experience is mild to moderate discomfort or pain in the flank or groin area. This pain often increases during or immediately after urination, sometimes referred to as “stent pain.” The pain occurs because the bladder contracts during voiding, causing the lower coiled end of the stent to rub against the bladder wall.
Patients frequently notice changes in their urinary habits, including increased urinary frequency and a sudden, strong urge to urinate. The stent can also disrupt the anti-reflux mechanism, allowing a small amount of urine to flow back toward the kidney during bladder contraction. Hematuria, or blood in the urine, is also common, typically appearing as a pink or reddish tint. This trace amount of blood may come and go, often worsening after physical activity, but is usually not a cause for concern unless the bleeding becomes heavy.
Signs of a Stent Infection
While some discomfort is normal, a ureteral stent infection presents with distinct indicators and can lead to urosepsis. The most significant systemic sign is the sudden onset of fever, particularly a temperature reading above 100.4°F (38°C). This fever is often accompanied by shaking chills or rigors.
Local signs of infection include severe flank pain that exceeds the expected stent discomfort. This pain, usually located just below the rib cage in the back, will not be managed by routine prescribed pain medication. The characteristics of the urine may also change, becoming cloudy, dark, or developing a foul odor. This change suggests a high concentration of bacteria and white blood cells, a condition known as pyuria.
Worsening pain or burning during urination, known as dysuria, may signal a developing urinary tract infection. A stent infection can also cause nausea and vomiting, especially if the infection has caused inflammation in the kidney. The presence of bacteria on the stent surface, forming a biofilm, makes the infection difficult to treat with standard oral antibiotics alone.
Immediate Action and Medical Intervention
If signs of infection appear, particularly a fever, chills, or severe pain, contact the urologist immediately or go to an emergency department. A delay in seeking treatment can quickly lead to a life-threatening condition. Medical professionals will typically perform a urine culture and blood tests to identify the specific bacteria causing the infection.
Initial intervention often involves the administration of intravenous (IV) antibiotics to control the bacterial spread. The stent itself, which acts as a foreign body covered in a bacterial biofilm, must often be addressed as part of the treatment. This may involve an urgent procedure to remove the infected stent and replace it with a new one to ensure continued drainage and eliminate the source of the bacteria. In less severe cases, a course of antibiotics may be prescribed while keeping the same stent.