A ureteral stent , or ureteric stent , is a thin tube inserted into the ureter to prevent or treat urine flow obstruction from the kidneys. The stent length used in adult patients varies between 24 and 30 cm. In addition, the stents have different diameters or meters, to fit different ureteral sizes. Stents are usually inserted with the help of a cystoscope. One or both ends of the stent may be rolled to prevent it from exiting; this is called JJ stent , double J stent or pig-tail stent .
Video Ureteric stent
Stent placement
Urethral stents are used to ensure ureteral patency, which can be compromised, for example, by kidney stones or procedures. This method is sometimes used as a temporary measure, to prevent damage to clogged kidneys, until procedures for removal of stones can be performed. A duration of 12 months or longer is indicated to hold the ureter open, which is compressed by a tumor in the ureteral environment or by the ureteral tumor itself. In many cases the tumor is inoperable and the stent is used to ensure urine drainage through the ureter. If drainage is impaired for longer periods, the kidneys can be damaged.
Stents may also be placed in ureters that have been irritated or scratched during a ureteroscopy procedure involving stone removal, sometimes referred to as 'take basket procedures'. Stents placed for this reason are usually left for about a week. This stent ensures that the ureters do not spasm and collapse after the trauma of the procedure.
Maps Ureteric stent
Side effects and complications
The main complications with ureteral sten are dislocation, infection and blockage by encrustation. Recent stents with coatings, such as heparin, are approved to reduce infection and encrustation to reduce the amount of stent exchanges.
Other complications may include increased urge and frequency of urination, blood in the urine, leakage of urine, pain in the kidneys, bladder, or groin, and pain in the kidneys during, and for a short time after urination. These effects are generally temporary and are lost by stenting removal. Drugs used for the treatment of OAB (over active bladder) are sometimes given to reduce or eliminate the increased urgency and frequency of urination caused by the presence of the stent.
Stents often have threads, which are used to remove, which pass through the urethra and remain outside the body. This thread can cause irritation to the urethra. This can be increased for patients born with Hypospadias or other conditions requiring the same corrective surgery. Care should be taken to ensure that the yarn is not caught or withdrawn, which can issue a stent.
While the stent is in place, the patient can continue with the most normal activities; However, stents can cause discomfort during heavy physical activity. Work and other daily activities can continue as usual. Sexual activity is also possible with a stent, but a stent with a thread can significantly inhibit sex. Stents can also rest in the prostate gland in men, and with ejaculation/orgasm, the prostate may have uncomfortable movements for the patient, similar to severe cramping or irritation. Someone should approach sex differently from stent, be careful.
Deletion
Stents with threads can be removed in a matter of seconds by pulling the thread. This is often done by the nurse, but it can be done by the patient. When removing the stent, constant, steady strength must be applied, to avoid starting and stopping. Something should also be placed under the patient to capture leaky urine during removal. Stents without threads are removed by the doctor using a cystoscope. Stents are removed with cystoscopy, outpatient procedures. Cystoscopy involves placement of small flexible tubes through the urethra (a hole in which urine exits from the body). The procedure, which usually takes only a few minutes and causes a slight discomfort, is done in an outpatient clinic or an outpatient operation center. Most patients tolerate the removed stents using only topical anesthetics placed in the urethra. Immediately before the procedure, sterile lubrication containing local anesthesia (lidocaine) is implanted into the urethra. Since no intravenous ducts are inserted and there is no anesthesia, you should not be accompanied by others and you can eat normally before and after the procedure.
Urethral stents can also be taken without using a cystoscope using a magnetic dissipation system. The inserted stent has a rare earth magnet attached to the end of its free bladder inside the bladder. When stents need to be removed a small catheter with the same magnet inserted into the bladder and two magnets connected and the catheter and stent can be easily removed. This eliminates the need for expensive and invasive cystoscopy in adults and children.
References
J Urol Vol 168, 2023-2023, Nov 2002
AUA University Series, abstract PD37-11
Additional readings
- Ureteral stent- Materials; Endourological Updates: Mardis HK, Kroeger RM: Urological Clinics of North America, 1988, Vol. 15, No.3, 471-479.
- Urethral stents - indications, variations and complications: Saltzman B: Endourology Renewal: North American Urology Clinic, 1988, Vol.15, No.3, 481-491.
- Internal internal ureter seals: Use and complications: Mardis HK: AUA update series, 1997, Lesson 29, Volume XVI.
- External urinary redirection: pathological state and available technology. Macaluso JN Jr. J Endourol. 1993 April; 7 (2): 131-6. PMIDÃ, 8518825
- Have Ureteric Stent - What to Expect and How to Organize it. Author: Bpk. HB Joshi (Specialist in Urology, Cambridge, formerly the Research Bureau at Bristol Urological Institute), N. Newns (Staff Nurse), Mr. FX Keeley Jr. (Expert Consultant Urology), Tn. AG Timoney (Urological Expert Consultant), Bristol Urological Institute, Southmead Hospital, Westbury-on-trym, Bristol BS10 5NB
- Minimally invasive ureter stent takes. W.N. Taylor. In "Stenting the Urinary System" 2E: Yachia, 2004, ISBNÃ, 1-84184-387-3 Martin Dunitz
- Minimally Invasive Ureteric Stent RetrievalTaylor WN, McDougall IT J UrolVol 168,2020-2013, November 2002
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