Ureteral Stents

Introduction

A ureteral stent is a thin, flexible tube threaded into the ureter to help urine drain from the kidney to the bladder. These stents are used in a variety of urological procedures and can be temporary or permanent depending on the medical condition being treated.

A ureteral stent placed within the urinary system.

Indications

Ureteral stents are used in a variety of clinical scenarios. They are often used to ensure the unobstructed flow of urine from the kidneys to the bladder in cases of ureteral obstruction caused by conditions such as kidney stones, tumors, or ureteral strictures. They can also be used after surgeries on the ureter, such as ureteroscopy, to prevent postoperative swelling and ensure proper healing.

Types of Ureteral Stents

There are several types of ureteral stents, each with its own specific uses and characteristics. These include double-J stents, pigtail stents, and multi-length stents. The type of stent used often depends on the specific medical condition being treated and the patient's individual anatomy.

Double-J Stents

Double-J stents, also known as DJ stents or J stents, are the most commonly used type of ureteral stent. They are named for their distinctive shape, which resembles the letter "J" at both ends. This design helps to keep the stent in place within the ureter.

Pigtail Stents

Pigtail stents are another type of ureteral stent. They are named for their coiled ends, which resemble a pig's tail. These stents are often used in cases where a longer stent is needed, as they can be more comfortable for the patient.

Multi-Length Stents

Multi-length stents are a type of ureteral stent that can be adjusted to fit the specific length of the patient's ureter. These stents are often used in cases where the patient's ureter is longer or shorter than average.

Procedure

The procedure to place a ureteral stent is typically performed under local, regional, or general anesthesia. The stent is usually inserted using a thin, flexible instrument called a cystoscope. The cystoscope is inserted into the urethra and advanced into the bladder. From there, the stent is guided into the ureter and positioned appropriately. The procedure is usually performed as an outpatient procedure, meaning the patient can go home the same day.

Complications

While ureteral stents are generally safe, complications can occur. These can include infection, stent migration, hematuria (blood in the urine), bladder irritation, and pain. In rare cases, the stent can cause damage to the ureter or kidney. If a stent is left in place for too long, it can become encrusted with stone material, making removal difficult.

Removal

Ureteral stents are typically removed in a similar manner to their insertion. A cystoscope is used to visualize the stent, which is then grasped and removed. This procedure is typically performed under local or regional anesthesia. In some cases, a string may be left attached to the stent at the time of insertion, allowing for easier removal.