Having a ureteric stent: why it is placed, what it feels like and how it comes out

A stent holds the ureter open. Trust leaflets list the common reasons: a stone blocking the ureter, an infected blocked kidney that needs urgent drainage, swelling after a telescope operation, a narrowing, or pressure from a tumour or other mass. A hospital also explains that a stent may be inserted before shockwave treatment so that the fragments can drain.

In some situations a stent is a temporary rescue and a definite treatment follows later. In others, such as after ureteroscopy, it protects a swollen ureter while it heals. Not everyone having stone surgery needs one, and the surgeon usually decides during the operation.

The main alternative for a blocked kidney is a nephrostomy, a small tube passed through the skin of the back directly into the kidney, usually placed by a radiologist. It is used when a stent cannot be placed or when the kidney is infected. A stent sits entirely inside the body, which many people prefer, though it causes more bladder symptoms.

For minor obstruction or a small passing stone, watching with painkillers may be reasonable. Your team will explain why they recommend a stent in your situation.

A hospital page says fitting is normally done under a brief general anaesthetic using a telescope passed into the bladder. A guidewire is passed up the ureter into the kidney under X-ray screening, and the stent is slid over it, leaving a curl at each end, one in the kidney and one in the bladder, which helps keep it in place.

A trust page says the stent is usually made of flexible plastic and gives a length in centimetres; the exact size is chosen by the surgeon to suit you. The procedure itself is short, and you go home once you are awake and have passed urine, often the same day.

Most people notice something. Trust leaflets list needing to pass urine often and urgently, a feeling of not emptying the bladder, blood in the urine, an ache in the kidney or bladder area, and occasionally pain at the tip of the penis or in the groin. Symptoms are often worse after activity and may flare when you pass urine. Some women notice cystitis-like symptoms, and leakage is described as a slight risk, especially in women.

Drink plenty. One trust suggests two to three litres a day for the first few days and at least one and a half to two litres afterwards; another says at least two litres. Simple painkillers, warmth and rest help, and your doctor may offer a tablet for bladder spasm. Most people can keep working and carry on with normal activity, although strenuous exercise can increase pain and bleeding.

If a string is attached, a nurse can pull it out in the clinic, or you may be shown how, and it is quick. If there is no string, a flexible telescope is passed through the urethra under local anaesthetic, the stent is grasped and withdrawn. A hospital says the stent is usually left for 4 to 6 weeks if the ureter was too narrow; another trust says up to 12 months but prefers three months at most for stone disease.

The most important point is to know the date. A stent left in too long can become coated with crystals, block, or become hard to remove, and a forgotten stent is a recognised safety problem. Ask for the plan in writing before you leave hospital, and chase it if no appointment arrives.

Common problems are the bladder symptoms above and urine infection. Less often a stent can move, become blocked, or cause a lot of bleeding. Stents left for a long time can become encrusted. If a stent is needed for months, it will be changed on a schedule.

Leaflets do not agree on exact frequencies and we have not quoted any. Ask your team how long they expect this one to stay and what the plan is if symptoms are too troublesome.

Go to A&E, or call NHS 111 for advice, if you develop a fever, shivering, aching and feeling unwell, large blood clots that are hard to pass, severe burning or smelly urine, or you cannot pass urine. Trusts also advise help for unbearable pain, new leakage that suggests the stent has moved, or the stent falling out.

Questions to ask: When will it come out and who arranges that? Does it have a string? Is it covered by my follow-up? What can I take for the symptoms? NHS and private services handle stents in a similar way; the key difference is that private billing should specify removal and any later visit.