Why Stent is Used in Kidney Stone Treatment?

Introduction

Patients who’ve undergone a kidney stone treatment or are scheduled for one have heard of ureteral stents. Stents are small metal or plastic tubes that help manage obstruction in the ureters. The obstruction typically results from kidney stones or narrowing of the ureters due to scar tissue. Stent placement is a crucial part of kidney stone treatment for ensuring an uninterrupted flow after a kidney stone removal procedure. Read on to understand ureteral stents and why they are used in kidney stone treatment.

What Are Ureteral Stents?

Ureteral stents are tubes featuring a small, hollow, and flexible construction placed into the ureters to manage obstruction and ensure a seamless urinary flow. Ureters are tubes that connect the kidneys to the urinary bladder and are responsible for the transportation of urine. Sometimes, issues such as kidney stones, postoperative swelling in the ureters after surgery, blood clots, scar tissues, inflammatory bowel disease, and ureteral stones can cause either of the ureters to become obstructed. This obstruction typically accompanies discomforting symptoms such as pain, fever, and infection and may even lead to more serious complications such as loss of kidney function, sepsis, and even death.

Why is Stent Used in Kidney Stone Treatment?

A stent is typically used in a kidney stone removal procedure for several reasons. It aids in a seamless flow of urine and assists in managing the kidney stones present in the kidneys or the ureters. When placed in the ureters, a stent helps keep it open and allows urine to pass freely from the kidney to the bladder. By maintaining the flow of urine, the stent helps alleviate the symptoms associated with the blockage caused by the kidney stone.

In cases where the kidney stone is too large or difficult to pass, additional procedures may be necessary for stone removal. The presence of a stent can assist in these procedures by providing access to the stone. It can also serve as a guide for instruments used in stone fragmentation and removal for seamless surgical procedures.

In addition, a ureteral stent also creates a widened passage for kidney stones. It dilates the ureter,  providing a wider pathway for the stones to travel through and eventually flush out of the system. This can be very helpful in passing smaller stones and eliminates the need for further treatment. Placing a stent can also relieve the pain and discomfort brought along by kidney stones, primarily due to an obstruction in the ureters. By relieving the pressure exerted by the stone, the stent allows urine to bypass the blockage, thereby reducing the associated symptoms.

While a ureteral stent is generally placed during or after most kidney stone surgery procedures, the need for it is determined by the doctor after an assessment of the patient. 

How is a Stent Placed? 

A ureteral stent is placed in a few uncomplicated steps, typically before or after a kidney stone treatment procedure. The stent may also be placed in other conditions, and the procedure in both cases is more or less the same. 

The doctor will first run a couple of diagnostic tests, including blood tests and imaging tests, to check your kidney function and rule out other underlying issues. They may also advise you to discontinue certain medications, such as blood thinners, before the procedure. In addition, you may be asked to avoid eating for a few hours before the procedure. You must note that if the stenting procedure is being performed in conjunction with a kidney stone removal procedure, the steps for preparation will be the same as that of the surgery. 

Moving on, let us look at the stenting procedure: 

• The doctor will give you general anesthesia to sedate you for the procedure. In case of kidney stone surgery, you’ll already be sedated. 
• Using X-ray imaging, the doctor will insert a small device called a cystoscope to help locate the obstruction and thread the guide wire for the stent.
• The guidewire will be used to place the ureteral stent. The upper part of the stent has a coil that will remain within the kidney. The lower end will consist of a loop that will stay within the bladder. The purpose of the is to keep the stent in place after placement. 
• After placing the stent, the doctor will remove the guidewire, and the stent will remain in place.

Typically, you will be allowed to return home on the day of the stenting procedure. But, if the stent is placed as part of a kidney stone removal procedure, your hospital stay will depend on the type of procedure you’ve had. 

What are the Side Effects/Risks of Ureteral Stents?

A stent placed after kidney stone treatment typically doesn’t cause any complications and is safely extracted within some days of placement. But a stent isn’t completely free of side effects. It does accompany some side effects and complications that one must be aware of. These side effects may or may not occur. In addition, their intensity is also bound to vary for individuals. Some common side effects of stent placement after kidney stone treatment include: 

• Light pink to red colored blood in the urine.
• Burning sensation while urinating can be managed by improving fluid intake, eating the right foods, and taking medicines prescribed by the doctor (if any). 
• Increased urgency to urinate. 
• Increased frequency of urinating. The frequency can range from a few minutes to an hour, chiefly depending on the amount of fluid you consume in a day. 
• Cramping, resonating muscle cramp in the middle or lower abdomen. 
• Thick blood clots or tissue in the urine.
• Dark and bloody urine that does not get better with ample fluid intake. 
• Severe pain in the abdomen or flank area that does not subside with pain medication. 
• Persistent fever that does not subside. 

It is important for patients to reach out to their healthcare provider if they experience side effects that they are unable to manage on their own. In such cases, a doctor will check the stent, remove or replace it as necessary, and suggest additional solutions for the discomfort you’re experiencing. Prompt recognition of the side effects and timely treatment is necessary to prevent potential complications. 

When is a Stent Removed? 

A DJ stent is placed during or right after a kidney stone treatment procedure. The removal typically takes place after 6 weeks to 6 months of the surgery. The duration for which the stent will be kept in place, and the right time to remove it is highly subjective. The total duration for which the stent will be kept intact in the ureter will be decided by the doctor based on the specifics of the case and the patient’s overall health. 

Sometimes, a stent is removed when it expires, and replaced with a fresh one. A DJ stent can be removed with either of the following procedures: 

• Standard Removal Of DJ Stent: A rigid endoscope is used to perform this procedure. The extraction is performed with the patient lying in a lithotomy position and takes 10 minutes. The procedure can accompany mild discomfort and bearable pain. 
• Flexible Removal Of DJ stent: In this method, the DJ stent is removed with the help of a fiberoptic endoscope. The patient has to remain in a lying position throughout. It accompanies mild burning and discomfort, but it’s manageable. The procedure only takes 2 to 3 minutes. 

The doctor will discuss the duration of the stent placement and will give you a tentative date of removal after the placement procedure. 

To Summarize 

Stent placement after a kidney stone procedure helps the kidney stones pass seamlessly, drain the kidney effectively and prevent obstruction and accompanying complications. Ureteral stents are safe, do not interfere with kidney function, and cause no long-term problems. When performed with precision, using the right approach, ureteral stenting can benefit you immensely and prevent potential complications after a kidney stone treatment procedure. Pristyn Care is one of the country’s leading healthcare facilities, making top-notch kidney stone treatment available at cost-effective prices. Our urologists have extensive experience in performing advanced procedures to treat kidney stones. They perform DJ stent placement and removal procedures with utmost precision and ensure that the patient is safeguarded from complications. Book your appointment with our experienced urologists for kidney stone surgery. Call us today.