Most ureteral stents are removed 3 to 7 days after uncomplicated kidney stone surgery, though some stay in for up to 6 weeks depending on the complexity of your procedure. The American Urological Association recommends a minimum of 5 days for patients who didn’t have a stent placed before surgery, since removing it earlier than that increases the chance of an emergency department visit from pain or swelling.
Standard Removal Timelines
For the most common kidney stone procedure, ureteroscopy, the AUA guideline panel recommends 3 to 7 days of stenting. In some uncomplicated cases, your surgeon may skip the stent entirely. Uncomplicated typically means you have two functioning kidneys with normal anatomy, the stone wasn’t impacted, there’s no suspicion of leftover fragments, and there was no injury or significant swelling during the procedure.
For percutaneous nephrolithotomy (a procedure used for larger stones, where a small incision is made through the back), stents may come out as early as the next day if a tethered string was placed, or up to a week later via an office visit. Some patients in this group keep their stent for longer, with reported durations ranging from 1 to 48 days depending on complications.
When the stent is placed for healing purposes after a more complex procedure, 4 to 6 weeks is the typical window. Pregnant women with stents require exchanges every 4 to 6 weeks because encrustation builds up faster during pregnancy.
What Determines Your Specific Timeline
Your surgeon decides based on several factors: how much swelling or injury occurred in the ureter during the procedure, whether stone fragments remain, the size and location of the original stone, and whether you had a stent placed before surgery. Pre-stented patients may tolerate shorter durations better than those receiving a stent for the first time.
Research from the Journal of Urology found that patients without a pre-existing stent who had theirs removed within 4 days were significantly more likely to visit the emergency department on the day of removal or the day after, compared to those who kept the stent for 5 or more days. The difference was especially pronounced for stents with extraction strings, where the predicted probability of an ER visit was statistically higher for each of days 1 through 4. By day 5, that risk leveled out. This is why many urologists now aim for at least 5 days of stent time.
How the Stent Gets Removed
There are two main approaches, and which one you’ll experience depends on how your stent was placed.
- String removal at home. Some stents have an extraction string that hangs outside the urethra. You or a nurse gently pulls it out, which lets you control the speed and reduces discomfort. This approach is more common when the surgeon expects a short stent duration or when there’s concern you might not make it back for a follow-up appointment. Pulling slowly and steadily is key.
- Office cystoscopy. If there’s no string, your urologist removes the stent by passing a thin, flexible scope through the urethra into the bladder and grasping the stent. This is a brief outpatient procedure, usually done without general anesthesia. For difficult cases, a ureteroscope may be used instead.
What the Stent Feels Like While It’s In
Stent-related symptoms affect over 80% of patients, so what you’re feeling is almost certainly normal. The most common complaints are a frequent, urgent need to urinate (affecting 50 to 60% of people), a sensation of incomplete bladder emptying (76%), burning during urination (40%), and blood in the urine (25%). Flank pain, especially during or right after urinating, occurs in roughly 19 to 32% of patients. Suprapubic discomfort, a pressure or ache just above the pubic bone, affects about 30%.
The urgency comes from the stent physically irritating the bladder wall. Flank pain happens because the stent allows urine to flow backward toward the kidney during urination, temporarily raising pressure inside the kidney. Blood in the urine can come from both the original surgery and from the stent rubbing against tissue.
If your symptoms are significantly affecting your sleep or daily life, your doctor may prescribe medication to help. Alpha-blockers like tamsulosin relax smooth muscle in the urinary tract and have been shown to reduce both pain scores and urinary symptoms. Medications that calm bladder spasms by blocking overactive muscle contractions can also help, particularly with urgency and frequency. Over-the-counter pain relievers fill in the gaps for milder discomfort.
Risks of Leaving a Stent In Too Long
A forgotten or delayed stent is a real problem, and the risks escalate with time. The rate of mineral buildup (encrustation) on the stent climbs sharply: 9.2% for stents left in under 6 weeks, 47.5% at 6 to 12 weeks, and 76.3% beyond 12 weeks. An encrusted stent is much harder to remove and can require additional procedures.
Infection is the most frequent complication of long-term stent retention. In one review of patients whose stents remained for an average of nearly 30 months, 62.5% developed infections. Chronic kidney disease patients, people prone to recurrent stones, and those with urinary tract infections are at higher risk for these complications.
If you’ve been told your stent should come out at a specific time, keep that appointment. The stent is a foreign body, and your urinary tract tolerates it less and less as weeks pass.
Warning Signs Before Removal Day
While discomfort is expected, certain symptoms suggest something more serious. Fever with chills, severe flank pain that’s noticeably worse than your baseline stent discomfort, vomiting, or feeling generally unwell can signal a urinary infection that has spread to the bloodstream. This is a medical emergency. One documented case showed a patient developing dangerously low blood pressure, a heart rate of 125, and a temperature near 103°F within two days of stent removal, requiring hospital admission for a blood infection originating in the urinary tract.
These severe reactions are uncommon, but they can happen both while the stent is in place and shortly after removal. If you develop a fever above 101°F, can’t keep fluids down, or notice your urine has stopped flowing, don’t wait for your scheduled appointment.