Ureteric Stents Part 2

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Ureteric Stents

In patients who have, or might have, an obstruction (blockage) of the kidney, an internal drainage tube called a ‘stent’ is commonly placed in the ureter, the tube between the kidney and the bladder. This is placed there in order to prevent or temporarily relieve the obstruction. Your urologist is planning to use such a stent for you.

This information is divided into two parts:
Part 1 explains about the urinary system, obstruction of the kidneys and treatment of this obstruction using ureteric stents.
Part 2 describes what to expect while the stent is in place and any possible side effects.

Part 2: Living with a ureteric stent

Introduction

Ureteric stents are designed to allow people to lead as normal a life as possible. However, they may not be without side effects. In placing a stent, there is a balance between its advantages in relieving the obstruction and any possible side effects. Most side effects are not a danger to your health or your kidneys, although they can be a nuisance. Below, we have described all the possible side effects associated with a ureteric stent.

Many patients do not experience problems with their stent. In the majority of the patients experiencing side effects they are minor and tolerable. However sometimes they can be moderate to severe in nature. The majority of patients with a stent in place will be aware of its presence most of the time.

Commonly noted side effects are:

Urinary symptoms:

• an increased frequency of passing urine
• the need to rush to pass urine (urgency)
• a small amount of blood in the urine. This is quite common and the situation can improve with increasing your fluid intake
• a sensation of incomplete emptying of the bladder
• very occasionally, particularly in women, there is a slight risk of episodes of incontinence

These effects are possibly due to the presence of the stent inside the bladder causing mechanical irritation and should disappear when the stent is removed.

Discomfort or pain

Stents can cause discomfort or pain, commonly in the bladder and kidney (loin) area, but sometimes in other areas such as the groin, urethra and genitals. The discomfort or pain may be more noticeable after physical activities and after passing urine.

Complete understanding of these side effects and their causes is not clear at present. It has also not been possible to predict, before placement of a stent, which patients are likely to experience side effects and what they will be.

Duration of side effects associated with a stent – can they improve?

There is some evidence that some of the symptoms, such as pain while passing urine and blood in the urine, may improve with time. However, this remains unpredictable. It has been reported that around 20-70% of patients with stents experience one or more of these side effects.

Can the side effects interfere with my day to day life?

A stent should not be expected to cause much disruption to your normal daily life. However, you may experience some side effects that can cause some problems, either directly or indirectly:

Physical activities and sports
You can carry on with various physical activities while the stent is in place provided the underlying kidney condition and your health allows you to do so. However, you may experience some discomfort in the kidney area and passing of blood in your urine, especially if sports and strenuous physical activities are involved.
Sometimes side effects associated with a stent can make you feel more tired than normal.

Work activities
You can continue to work normally with the stent inside your body. However, if the work involves lot of physical activities, you may experience more discomfort.
Occasionally side effects, such as urinary symptoms and pain associated with the stent, may make you feel tired. If the stent causes significant problems, you can discuss it with your manager and colleagues so that possible temporary adjustments can be made at your work place.

Social life and interactions
The presence of a stent should not affect this in a significant way. In case you get urinary symptoms such as, increased frequency and urgency, you may need to use the toilet more frequently. Occasionally you may need a little more help from family members or colleagues, because of any pain or tiredness you may feel.

Travel and holidays
It is possible to travel with a stent in place, provided the underlying kidney condition and your general health allows this. However, presence of significant side effects associated with the stent may make travel and holidays less enjoyable. Also there is a small possibility that you may require additional medical help while the stent is in place.

Sex
There are no restrictions on your sex life due to the presence of a stent. Few patients experience discomfort during sexual activities. Occasionally the side effects associated with the stent may have an effect on the sexual desire.
If you have a stent with a thread coming outside the body through the urethra, sexual activities may be difficult. Care will be required so as not to dislodge the thread, which could then in turn displace the stent.

Can a stent get displaced? What other complications are possible?

Occasionally a stent may develop a crystal coating on its surface although this is not a significant problem. Very occasionally a stent may get displaced, usually slipping towards the bladder, and it may even fall out. If this happens, you should contact us or your GP.

Is there a possibility of a urinary tract infection?

The presence of a stent, along with the underlying kidney problem, makes it more likely that you could get a urinary tract infection. Some of the symptoms that you may experience if you get a urinary tract infection are

• raised temperature
• increased pain or discomfort in the kidney or bladder area
• burning sensation while passing urine
• feeling unwell.

Urinary tract infections usually require treatment with antibiotics.

What care do I need to take?

It is essential that you drink at least 1½ to 2 litres (approximately four pints) of fluids, mainly water, a day. This will help to cut down the risk of getting an infection and will reduce the amount of blood in the urine. It will also help in the treatment of stones.

If you experience bothersome pain you can take painkillers for relief, on the advice of a doctor.

If you have got a stent with a thread coming down from the urethra outside the body, then care will be needed so as not to dislodge the thread.

If in any doubt please contact us, your GP or local hospital for more advice.

When should I call for help?

You should contact a doctor or a hospital if

• you experience a constant and unbearable pain associated with the stent
• you have symptoms of urinary tract infection as mentioned above (e.g. a raised temperature, pain during passing urine and feeling unwell)
• the stent gets dislodged or falls out
• if you notice a significant change in the amount of blood in your urine.