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A ureteral stent, also known as uretic stent, is inserted into the ureter to remove blockages and allow urine to pass freely. The stent is a thin, hollow and flexible tube that is placed between the kidney and the ureter.  The stent is inserted with the help of a cystoscope and can be coiled at one or both ends. This coiled stent is called a pigtail stent or double J stent.

The obstruction in the ureter can be due to multiple reasons but putting this stent in can help the patient pass urine properly and relieve the pain. For instance, a kidney stone might cause some damage and this stent could help prevent further damage. Other conditions that can block the uretera are tumours, blood clots, swellings or infections.

The insertion of the stent is usually a temporary measure. A stent is usually not left inside for more than 12 months as it could possibly cause more long term damage like scarring the kidney. Sometimes stents are coated with heparin which is believed to increase the life of a stent when inside a human urethra. Research is being carried out on what type of coating can prolong the life of stent.

The size of the stent can vary between 25 to 30 centimetres with different diameters depending on the patient.  The placement is done by putting the patient under anaesthesia. Sometimes a guide wire is used to place the stent. The stent also has a thread that extends outside the body.

The stent is removed easily by pulling this thread out. Often nurses remove the stent but patients can also administer the removal of the stent on their own. A sharp pull can help the stent come out in one fluid movement. You need to take some precaution for the remaining urine is likely to drip out once the stent is extracted.

Complication & Side-Effects

• There are different side effects and complications to having a ureteral stent in the body.
• Primary complications involve infection from keeping the stent in too long. There can also be further blockage and dislocation due to prolonged insertion.  
•  Symptoms of complications include increased urination, leaking urine, blood in the urine and pain in the kidneys or the groin.  
• Movement of the stent is quite common. Stents can penetrate the adjacent organs too like the bladder, the kidneys or sometimes even the lungs. To prevent this movement from happening, it helps to have the stent of an ideal length. Threads attached to the stent can often irritate the urethra as well. Stents should be replaced every 6 months or as soon as kidney stones form. There are procedures to deal with encrusting of stents as well but this procedure has to be done in a delicate manner to prevent additional damage to the kidney.
• In rare cases, the stent can fracture inside the body. In such cases, procedures like ureterorenoscopy are used to retrieve the pieces.
• Patients with stents can go about their daily routine but occasionally their sex lives can get affected. The thread tends to act as a deterrent.
• A fever and an irritated bladder are the most common signs that prelude stent complications.

Patients are asked to drink up to 3- 5 litres of water every day in order to keep the kidney functioning properly. Follow up care and preventive measures is the best way to keep the functioning of the stent to the optimal.

Reference:

1. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2931292/
2. Chen-Hsun Ho, Huai-Ching Tai, Hong-Chiang Chang, Fu-Chang Hu, Shyh-Chyan Chen, Yuan-Ju Lee, Jun Chen, Kuo-How Huang, Predictive Factors for Ureteral Double-J-Stent-Related Symptoms: A Prospective, Multivariate Analysis, Journal of the Formosan Medical Association, Volume 109, Issue 11, November 2010, Pages 848-856, ISSN 0929-6646, 10.1016/S0929-6646(10)60130-1.
3. Rocco Damiano, Riccardo Autorino, Marco De Sio, Francesco Cantiello, Giuseppe Quarto, Sisto Perdonà, Rosario Sacco, Massimo D’Armiento, Does the Size of Ureteral Stent Impact Urinary Symptoms and Quality of Life? A Prospective Randomized Study, European Urology, Volume 48, Issue 4, October 2005, Pages 673-678, ISSN 0302-2838, 10.1016/j.eururo.2005.06.006.

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