Why ureteral stent

Not all stents have a visible string. A ureteral stent is placed to allow urine to flow from the kidney to the bladder when the normal flow is blocked. It may also be placed to prevent blockage. Kidney stones are the most common reason for placing a ureteral stent. Other reasons include stricture abnormal narrowing of the ureter , and outside forces such as a tumor pushing on the ureter and causing a blockage. Inflamed, swollen, or damaged ureteral tubes in need of healing may have a stent placed to keep the kidney draining during the healing process.

Some symptoms are not normal with a stent in place, and you should see your doctor. These include:. Yes, you can continue your normal activities with a stent in place. Though there may be some physical discomfort, a stent will not physically limit you.

Lifting, or reaching your hands above your head repeatedly may cause bleeding, or worsening bleeding that may already be present. This is related to increased irritation of the stent on your bladder. The length of time the stent will remain inside your ureter depends on the reason it was placed. They should only be removed in the timeframe recommended by your physician, not any sooner or later.

If the string is visible outside the body, it can be simply removed in office without the use of any procedures or specialty equipment. This is used for short term stents needed for 1 week or less. A nurse practitioner can do this in the office within days of your surgery.

Ureteral stents that do not have a visible string, or were placed to allow a longer healing period, will require a minor in-office procedure. A small, flexible scope called a cystoscope is placed into the urethra that allows the doctor to visualize the stent from inside the bladder. Then, the doctor grasps the stent with tiny clamps attached to the scope and removes the stent.

The presence of ureteral stent is also a predisposing factor for urinary tract infection. In recent years, the use of ureteral stents has increased in urology practice in order to provide drainage of urine. Ureteral stents lead to the formation of foreign bodies such as biofilms. As the use of ureteral stent increased, the incidence of complicated urinary tract infection, which is one of the complications of ureteral stent, also increased. Update on biofilm infections in the urinary tract.

World J Urol. The aim of this study was to determine the frequency of infection and asymptomatic bacteriuria and comorbid factors associated with the development of urinary tract infection in the adult patients with ureteric stent. Between the dates August and January the patients who placed ureteral stent in our Urology Department were evaluated. Sixty patients aged 18 years and more and with sterile urine who agreed to participate in the study were asked to sign an informed consent form.

Patients with ureteral stents were recommended to come to the hospital immediately in case of dysuria, fever, and side pain throughout the follow-up period. The data collected were stored in SPSS Student t test and chi-square test were used. Sixty patients with ureteral stent were followed up prospectively during the study until ureteral stent was removed.

The main features of these patients are shown in Table 1. The main reason for placing ureteral stent was prophylactic before extracorporeal shockwave lithotripsy ESWL , followed by hydronephrosis due to nephrolithiasis and ureteral stenosis of unknown cause.

The most common risk factors for urinary infection were diabetes mellitus and chronic renal failure. The association of risk factors with urinary tract infection is shown in Table 2. Longer duration of ureteral stent in place, presence of diabetes mellitus, and presence of chronic renal failure were significantly associated with the development of urinary tract infection.

Out of the 11 patients who developed urinary tract infection six had their ureteral stent changed and were given antibiotics according to the susceptibility test results. The remaining five patients who developed urinary tract infection were treated with appropriate antibiotics, but the ureteral stents were left in place.

In five patients urinary tract infection relapsed after 24 days on average. Of those, three patients developed urinary tract infection in a period ranging from 14 to 45 days, average of 27 days. Overall, 22 microorganisms were recovered from urine cultures, 11 from the patients with urinary tract infection and 11 from patients with asymptomatic bacteriuria. The distribution of microorganisms isolated from urine cultures of patients with urinary tract infection or asymptomatic bacteriuria is shown in Table 3.

All of the 22 bacteria isolated from urine cultures were sensitive to ertapenem, meropenem, and imipenem. Extended-spectrum beta-lactamase ESBL was detected in 7 Ureteral stents have been widely used in urology practice in the last two decades in parallel with increasing number of endourologic initiatives. Ureteral stents may lead to bacterial colonization similarly to all inserted synthetic medical devices.

A catheter is a long, thin plastic tube that is considerably smaller than a "pencil lead. Ultrasound machines consist of a computer console, video monitor and an attached transducer. The transducer is a small hand-held device that resembles a microphone. Some exams may use different transducers with different capabilities during a single exam. The transducer sends out inaudible, high-frequency sound waves into the body and listens for the returning echoes. The same principles apply to sonar used by boats and submarines.

The technologist applies a small amount of gel to the area under examination and places the transducer there. The gel allows sound waves to travel back and forth between the transducer and the area under examination.

The ultrasound image is immediately visible on a video monitor. The computer creates the image based on the loudness amplitude , pitch frequency , and time it takes for the ultrasound signal to return to the transducer. This procedure may use other equipment, including an intravenous line IV , ultrasound machine and devices that monitor your heart beat and blood pressure.

Image-guided, minimally invasive procedures such as ureteral stenting and nephrostomy are most often performed by a specially trained interventional radiologist in an interventional radiology suite or occasionally in the operating room.

This procedure is often done on an outpatient basis. However, some patients may require admission following the procedure. Ask your doctor if you will need to be admitted. Prior to your procedure, your doctor may perform ultrasound , computed tomography CT , or magnetic resonance imaging MRI exams. Your doctor may provide medications to help prevent nausea and pain and antibiotics to help prevent infection.

The doctor or nurse may connect you to monitors that track your heart rate, blood pressure, oxygen level, and pulse. A nurse or technologist will insert an intravenous IV line into a vein in your hand or arm to administer a sedative. This procedure may use moderate sedation. It does not require a breathing tube.

However, some patients may require general anesthesia. If you receive moderate sedation, you will be asleep but have the ability to be awakened. The sedation will be administered and monitored by your physician and nursing staff. If you receive a general anesthetic , you will be unconscious for the entire procedure. An anesthesiologist will monitor your condition. If you receive conscious sedation, a nurse will administer medications to make you drowsy and comfortable and monitor you during the procedure.

The nurse will sterilize the area of your body where the catheter is to be inserted. They will sterilize and cover this area with a surgical drape. Your doctor will numb the area with a local anesthetic. This may briefly burn or sting before the area becomes numb. Contrast material will be injected through the needle. During ureteral stenting, you are positioned on your stomach.

Using a fluoroscope to see the ureter, a guide wire is inserted into the ureter. The stent is run over the guide wire and placed in its permanent position within the ureter. Once the stent has been placed, the guide wire may be removed, or a nephrostomy catheter may be left in place for a day or two and then removed. When the procedure is complete, the doctor will remove the catheter and apply pressure to stop any bleeding. Sometimes, your doctor may use a closure device to seal the small hole in the artery.

This will allow you to move around more quickly. No stitches are visible on the skin. The nurse will cover this tiny opening in the skin with a dressing.

During nephrostomy, you are positioned on your stomach. Using a fluoroscope to see the kidney, a guide wire is inserted into the kidney, followed by a catheter. This will be left in place until a ureteral stent can be placed or the ureteral blockage is resolved.

Most commonly, the nephrostomy catheter is connected to an external bag that collects urine. Prior to leaving the hospital, you will be instructed on how to empty and care for the drainage bag.