Ureteral stent placement

A ureteral stent is a thin, flexible tube inserted into the ureter to promote urine flow from the kidneys to the bladder. It treats or prevents ureter obstruction, which can be caused by kidney stones, tumors, scarring, or other medical conditions.

Indications for ureteral stent placement

Kidney stones: ureteral stents are often inserted after surgery to remove kidney stones to aid in urine drainage and prevent obstruction;
Ureteral surgery: After ureteral surgery, such as removing a tumor or correcting anatomical abnormalities, ureteral stents can be used to keep the ureter open during the healing process;
Ureteral stricture: If the ureter is narrowed due to scarring or other causes, ureteral stents can help keep the ureter open and ensure urine flow.

Preparation for ureteral stent placement

Medical evaluation: Your doctor will assess your condition and discuss the benefits and risks of a ureteral stent.
Diagnostic tests: You may need to undergo diagnostic tests, such as ultrasounds, X-rays, or computed tomography (CT) scans, to evaluate the ureter and plan for stent placement;
Physical preparation: In some cases, you may temporarily stop taking anticoagulant or antiplatelet medications before the procedure.

Procedure for Ureteral Stent Placement

Anesthesia: the procedure can be performed with general anesthesia or spinal anesthesia, depending on your needs and the complexity of the procedure;
Placement: Using specialized instruments, your doctor will guide the ureteral stent through the urethra to the ureter. The stent is placed so that one part is in the kidney and the other in the bladder, with one part in the ureteral tract connecting the two;
Radiographic check: During the placement procedure, X-ray images are often used to precisely guide the stent into the ureter and confirm its correct placement.

Post-procedural care

Monitoring: After stent placement, you may need to remain under medical observation for a short time to monitor for any complications or adverse reactions;
Medications: Your doctor may prescribe medication to relieve any symptoms, such as pain or burning when urinating, that may occur after the stent is placed.

Long-term monitoring

After the ureteral stent is placed, you may need regular follow-up visits with your doctor to monitor its status and assess any complications or the need to remove it. It is important to promptly report any symptoms or problems that may occur while the stent is in place to your doctor.

Possible complications

As with any medical procedure, ureteral stent placement may involve certain risks and complications, including infection, bleeding, stent obstruction, allergic reactions, or discomfort when urinating, and discussing the potential risks and benefits with your doctor before the procedure is essential.

Risks of not placing the ureteral stent

Failure to place the ureteral stent when indicated can result in different risks and complications depending on the patient's specific condition:

Ureteral obstruction: If a condition could potentially obstruct the ureter, such as a kidney stone or stenosis, not placing the ureteral stent could lead to further obstruction of the ureter. This can cause damage to the kidneys due to urine buildup, resulting in kidney failure;
Kidney infection: Obstruction of the ureter can lead to a urine buildup in the kidneys, creating a favorable environment for bacterial growth. This increases the risk of developing a kidney infection, also known as pyelonephritis, which can be severe and require intensive antibiotic treatment and, in some cases, hospitalization;
Hydronephrotic dilation: The accumulation of urine in the kidneys due to an obstruction can lead to dilation of the kidneys, known as hydronephrosis. This can cause abdominal pain, lower back pain, and, in some cases, permanent kidney damage if left untreated;
Kidney damage: Chronic obstruction of the ureter can lead to permanent damage to the kidneys due to increased pressure in the ureter and kidneys. This can affect kidney function in the long term and may require surgery or other more invasive procedures to repair the damage;
Complications during future surgery: If future surgery involving the ureter is planned, such as removing a tumor or correcting a stricture, not placing the ureteral stent before surgery can make the operation more complex and increase the risk of intraoperative complications.

When to see a doctor after ureteral stent placement

After placement of a ureteral stent, it is essential to be aware of the following symptoms that could indicate the presence of complications or problems that require immediate medical attention:

Pain or discomfort: If you experience increased pain or severe pain in the lower back, lower abdomen, or pelvic area, it may indicate a problem with the stent or irritation of the ureter. The doctor should evaluate pain that persists or worsens over time;
Bleeding: If you notice blood in your urine (hematuria) or if the color of your urine turns red or dark brown, it could indicate bleeding from the area where the stent is placed or trauma to the ureter. Modest bleeding that subsides with increased water intake is generally not a problem. However, significant bleeding requires immediate attention;
Fever: The appearance of a fever may indicate an infection. You may need antibiotic treatment to fight the disease if you have fever, chills, sweating, and general malaise. It is essential to seek medical attention if the fever persists or increases;
Urinary difficulties: If you have difficulty or pain when urinating, it could indicate an obstruction or irritation of the urethra or ureter. Painful or difficult urination may be a sign of infection or a problem with the stent;
Systemic symptoms: In some cases, you may develop systemic symptoms such as nausea, vomiting, general malaise, or loss of appetite, which may be signs of an infection or other complications related to the ureteral stent.

Ureteral stent placement is a standard and relatively safe procedure for treating various ureteral conditions. In general, ureteral stent placement is considered when it is necessary to maintain urine flow through the ureter to prevent or treat conditions that could impair kidney function or cause other complications. It is essential to discuss the risks and benefits of ureteral stent placement with your doctor and to follow the treatment plan directions carefully to ensure the best possible outcome for your kidney and overall health.