Ureteral Stent — What You Should Know

1. What is a ureteral stent?

A ureteral stent is a hollow tube made of polymer materials and is widely used in clinical practice.

Because both ends are curled like the letter “J,” it is also called a Double J (D-J) stent, and due to its shape, it is sometimes referred to as a “pigtail” stent.

The upper end is placed in the renal pelvis, the lower end in the bladder, with the tube passing through the ureter.

2. What is the function of a ureteral stent?

It is commonly used in procedures such as urinary stone surgery, urological tumors, and ureteral strictures. Its functions include:

• Draining urine from the kidney
• Relieving ureteral obstruction
• Promoting postoperative healing of the ureter

3. Considerations when selecting a ureteral stent

Material:

Stiffer stents may worsen symptoms such as difficulty urinating and lower back discomfort. Hydrophilic-coated silicone stents are preferred due to their softness and good biocompatibility.

Length:

The length should match the ureter. Excessive length inside the bladder increases friction against the bladder wall, leading to more irritation symptoms such as pain and urinary urgency.

Diameter:

A smaller diameter stent is more flexible and causes less pressure on the ureter.

Type:

Selection should be individualized, commonly including Single J and Double J stents.

4. Precautions during indwelling of a ureteral stent

1. Drink more than 2000 ml of water daily.
2. Avoid holding urine; urinate promptly to prevent reflux.
3. Avoid strenuous activities (e.g., running, jumping rope, basketball) to prevent stent displacement or bleeding. Light activities such as walking are acceptable.
4. Increase fluid intake (2000–3000 ml/day) to reduce the risk of infection and stone formation.
5. Reduce intake of high-calcium, high-oxalate, and high-purine foods (e.g., milk, spinach, animal organs).
6. Monitor urine color and condition. Seek medical attention if hematuria, cloudy urine, or unusual odor occurs.
7. Watch for urinary symptoms such as frequency, urgency, or pain, and inform your doctor if they occur.
8. Seek medical attention promptly if experiencing back pain or fever, as these may indicate complications.

5. Possible complications and prevention

Pain

Causes:

The distal curled end of the stent may cause suprapubic pain, especially during movement or position changes.

Vesicoureteral reflux during urination may increase renal pelvic pressure, leading to flank pain.

Management:

Drink plenty of water (over 2000 ml/day) and urinate frequently. Avoid holding urine or straining during urination, and maintain regular bowel movements.

Medication: Anticholinergic drugs or α1-blockers such as Solifenacin and Tamsulosin can significantly relieve symptoms, usually within 1–2 days.

Hematuria and Urinary Tract Infection (UTI) Related to Ureteral Stents

1. Hematuria

Description:

After stent placement, patients may experience varying degrees of gross hematuria, which usually clears within 12–24 hours.

Precautions:

• Avoid strenuous activity.
• Drink plenty of water.

In most cases, hematuria resolves spontaneously.

What to do if sudden heavy hematuria occurs after activity:

• Lie down immediately.
• Drink plenty of water.

Observe changes in urine color:

• If urine gradually clears, continue resting and hydrating.
• If there is no improvement, seek medical attention promptly.

2. Urinary Tract Infection (UTI)

Causes:

• Persistent ureteral obstruction after stent placement.
• Vesicoureteral reflux induced by the stent.
• Reduced ureteral peristalsis due to stent presence.
• Bacterial colonization on the stent surface.

Management:

When infection occurs, especially with persistent flank pain and fever on the affected side, the first step is to rule out obstruction or reflux.

If imaging shows hydronephrosis (especially worsened compared to preoperative levels) or stent displacement, the infection is likely caused by obstruction. In such cases, stent replacement or relieving the obstruction is recommended.

If symptoms such as flank pain and fever occur during urination, vesicoureteral reflux may be the cause. Temporary catheterization can help reduce reflux.

Note: obstruction and reflux may coexist.

Active anti-infective therapy should be administered as appropriate.

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2. The medical information provided here is for reference only and should not be used as a basis for clinical diagnosis or treatment.