Kidney stents are small tubes inserted into the ureter to help drain urine from the kidney to the bladder. They are often uncomfortable, causing pain and urinary symptoms. However, there are several ways to help make a kidney stent more tolerable.
Why are kidney stents uncomfortable?
Kidney stents are foreign bodies within the urinary tract, which can cause irritation and discomfort in a few key ways:
- The ends of the stent rub against the sensitive lining of the bladder and ureter, causing pain and urgency to urinate.
- The stent creates a constant urge to urinate, even when only small amounts of urine are present.
- When urinating, the urine passing over the stent can cause a burning sensation or bladder spasms.
- The stent can obstruct urine flow, leading to incomplete emptying of the bladder and a frequent need to urinate.
- Stent placement may cause some mild bleeding and inflammation of the urinary tract initially, adding to discomfort.
For these reasons, most patients experience at least some bothersome urinary symptoms after stent placement. However, the level of discomfort varies greatly between individuals.
Medications for stent discomfort
Several types of medications can help manage kidney stent pain and urinary symptoms:
Pain medications
Over-the-counter pain relievers like ibuprofen or acetaminophen can help reduce general discomfort and flank pain caused by the stent. For more severe pain, prescription medications like tramadol or hydrocodone may be prescribed for a short time after stent placement.
Anticholinergics
Medications like oxybutynin or tolterodine work by calming overactive bladder contractions. This can decrease urinary frequency and urgency caused by the stent irritation.
Alpha blockers
Alpha blockers like tamsulosin ease urination by relaxing the prostate and urinary sphincter. This can improve urine flow with the stent in place.
Anti-inflammatories
Steroids like prednisone, taken for a few days after stent insertion, can help reduce inflammation from the procedure. This may improve overall stent discomfort.
Urination habits to reduce discomfort
Making some adjustments to urinary habits can also minimize stent symptoms:
- Urinate frequently to avoid bladder overfilling.
- Avoid holding urine or delaying urination when the urge arises.
- Sit in a warm bath to promote urination and soothe bladder spasms.
- Drink plenty of fluids to dilute urine and avoid dehydration.
- Avoid caffeine and acidic foods/drinks, which can irritate the bladder.
Activity modifications
Certain activities may need to be avoided or adjusted while stented:
- Avoid intense exercise, which can cause pain and stent migration.
- Use care with heavy lifting, which increases pressure in the urinary tract.
- Limit prolonged sitting, which can worsen discomfort.
- Abstain from sexual activity during the initial stent healing phase.
- Carefully monitor and avoid becoming constipated, which can also increase urinary tract pressure.
Stent position
Proper stent positioning can help minimize irritation:
- Use imaging tests to ensure the stent is in ideal position after placement.
- For ureteral stents, the portion within the bladder should be relatively straight, avoiding curling.
- Make adjustments if the stent has migrated from the original position.
Stent characteristics
Certain stent features may increase comfort:
- Stent material – Silicone or polymer stents tend to be better tolerated than stiff plastic stents.
- Stent diameter – Maximizing the stent diameter that the ureter can accommodate creates better urine flow.
- Stent length – Keeping stents as short as possible prevents irritation while still bridging the obstructed area.
- Stent coatings – Hydrophilic or antibiotic coatings on stents can reduce urothelial irritation.
- Stent design – Specialized stent shapes or side holes may reduce discomfort in some cases.
Stent removal
Most stents are designed for short-term placement, often 1-2 weeks. Leaving a stent in longer than necessary increases irritation. Plan for prompt stent removal or exchange once the obstruction has resolved.
Tips to increase kidney stent comfort
Here are some key takeaways for minimizing kidney stent discomfort:
- Use medication to control pain and urinary symptoms.
- Adjust urination habits to reduce irritation.
- Modify activities to avoid putting pressure on the urinary tract.
- Ensure ideal stent position to prevent migration.
- Discuss stent characteristics with your urologist to maximize comfort.
- Plan for stent removal as soon as obstruction is relieved.
While stents are bothersome for most patients, these management tips can help improve tolerance. However, contact your urologist if problems persist, as stent repositioning, exchanging to a different type of stent, or early removal may be required. Short-term discomfort is expected with stents, but significant pain or inability to urinate should be promptly addressed.
Frequently asked questions
Why do I constantly feel like I have to pee with a stent in?
The stent irritates the bladder lining, causing increased urgency and frequency of urination. Trying to urinate fully and avoiding holding urine can help. Medications to calm bladder contractions may also improve this feeling.
Is blood in urine normal with a kidney stent?
A small amount of blood after stent placement or removal is common and not dangerous. However, recurrent or heavy bleeding should be evaluated for possible urinary tract infection or injury.
Can I exercise with a kidney stent?
Light exercise like walking is fine, but intense physical activity should be avoided. Contact sports, heavy lifting, and vigorous aerobic activity can displace the stent or increase urinary tract pressure.
How can I get more comfortable sleep with a stent?
Try sleeping propped up on pillows to reduce pressure on the bladder. Taking pain medication before bedtime can also improve sleep. Avoid caffeine and limit fluids in the evenings.
When can I return to work after kidney stent placement?
Most patients can return to desk work 1-2 days after stent insertion when any bleeding and acute pain has subsided. Labor-intensive jobs may require up to a week off for recovery.
How soon after stent removal will I feel back to normal?
Irritation usually resolves rapidly after the stent is removed. However, it may take a few days for the ureter to heal from the foreign body irritation. Any stent-related medications can also be discontinued once the stent is out.
Conclusion
Kidney stents provide important relief of urinary obstruction. However, they commonly cause bothersome urinary symptoms. With a combination of medication, activity modifications, optimized stent characteristics, and proper urinary habits, stent discomfort can be minimized. Planning for prompt stent removal once its purpose is served can also reduce unnecessary irritation. If problems persist, contact your urologist to re-evaluate the stent positioning, need for continued stenting, or options for exchanging to a different type of stent. With some patience and management, stents can be reasonably tolerated for the short periods they are required.
References
- Joshi HB, Stainthorpe A, MacDonagh RP, Keeley FX, Timoney AG, Barry MJ. Indwelling ureteral stents: Evaluation of symptoms, quality of life and utility. J Urol. 2003;169(3):1065‐9; discussion 1069.
- Seitz C, Liatsikos E, Porpiglia F, Tiselius HG, Zwergel U. Medical therapy to facilitate the passage of stones: What is the evidence?. Eur Urol. 2009;56(3):455‐471.
- Wang CJ, Huang SW, Chang CH. Effects of specific alpha-1A/1D blocker on lowering the ureteral stent related symptoms: a prospective study. Urol Res. 2009;37(1):33‐37.
- Deliveliotis C, Papatsoris A, Chrisofos M, Dellis A, Liakouras C, Delakas D. Tamsulosin treatment improves spontaneous passage of ureteral stones: A double-blinded placebo-controlled study. Urol Res. 2006;34(5):356‐359.
- Lamb AD, Vowler SL, Johnston R, Dunn N, Wiseman OJ. Meta-analysis showing the beneficial effect of α-blockers on ureteric stent discomfort. BJU Int. 2011;108(11):1894‐1902.
| Medication Class | Examples | Mechanism | Side Effects |
|---|---|---|---|
| NSAIDs | Ibuprofen, Naproxen | Pain relief, anti-inflammatory | GI upset, bleeding risk |
| Narcotics | Hydrocodone, Tramadol | Pain relief | Constipation, dependence |
| Anticholinergics | Oxybutynin, Tolterodine | Calm overactive bladder | Dry mouth, dizziness |
| Alpha blockers | Tamsulosin, Doxazosin | Relax urinary sphincter | Headache, orthostatic hypotension |
| Steroids | Prednisone | Reduce inflammation | Increased appetite, mood changes |