Urinary System & Ureteric Stents

WHAT ARE URETERIC STENTS?

Ureteric stents are also known as JJ stents. The majority of stents are made out of polyurethane. They are placed inside the ureter, the tube that connects the kidney and bladder. In doing so the stents facilitate the continued passage of urine from kidney to bladder.

WHAT ARE THE INDICATIONS FOR INSERTION OF URETERIC STENTS?

Possible reasons for inserting a JJ stent include:

Obstruction of the ureter due to stones or tumour growth
After completion of laser of stone procedure – to prevent stone fragments blocking the ureter
Strictures or narrowing of the ureter

HOW IS A URETERIC STENT INSERTED?

Insertion of a ureteric stent requires a general anesthetic. It is commonly done in combination or at the end of another procedure such as laser of stone.

With you completely asleep and under a general anesthetic, an instrument called a cystoscope is inserted via the urethra and into the bladder. Once inside the bladder x-ray dye is injected into the ureter to outline not only the ureter but also the part of the kidney that collects the urine, called the collecting system. A slippery wire is then inserted into the ureter and collecting system. Using the wire as a guide the JJ stent is inserted over the wire until it is in the correct position. Once the stent is in the correct position the guide wire is removed.

Once the procedure has been completed you are woken up and taken to the recovery area where you are kept under observation till you are fully awake. Once fully awake you may be discharged home the same day or kept in hospital overnight as needed.

WHAT CAN YOU EXPECT AFTER JJ STENT INSERTION?

It is common to experience the following after stent insertion:

Blood in urine
Discomfort in the back especially when passing urine
Frequent urination
Urgent urination

WHAT ARE THE POSSIBLE COMPLIACTIONS AFTER JJ STENT INSERTION?

Complications after JJ stent insertion are rare, however some complications include:

Urinary infection – If you feel feverish or unwell several days after insertion of JJ stent it may suggest a UTI. If this is the case then a formal urine test will be needed. If this confirms a UTI antibiotics will be needed to treat the UTI.
Encrustation of stent – This occurs when the JJ stent has been left inside for prolonged periods of time, usually many months. If this happens then calcium deposits form on the stent making it extremely difficult to remove the stent.

TIMING OF JJ STENT REMOVAL?

Majority of patients only need the stent for a couple of weeks. Dr Vasudevan will automatically make arrangements for removal of your stent for 2 weeks after the insertion has been done.

To avoid the risk of stent encrustation, it is important that you arrive for your stent removal as scheduled by Dr Vasudevan.

If for some reason your stent has been inside you for more than 4 weeks, please make contact with Dr Vasudevan’s office so that immediate stent removal can be organized.

If your stent needs to be left inside you for prolonged periods of time due to your specific medical condition, Dr Vasudevan will inform you of this requirement and he will make appropriate arrangements for your sent to be replaced at the appropriate time.

HOW IS THE JJ STENT REMOVED?

Removal of the JJ stent involves a very quick and simple procedure under a local anesthetic. It is performed as a day procedure.

A local anesthetic gel is inserted into the urethra. An Instrument called a cystoscope is inserted via the urethra and into the bladder. The end of the stent that sits in the bladder is grabbed with an instrument called a stent removal forceps and then removed completely.

You will be discharged home soon after the stent has been removed.