The placement of an internal ureteral stent (Double-J or Pigtail) is very commonly used in urology after certain procedures, to ensure unimpeded urinary flow from the kidney to the bladder.
The stent remains in place for a few days or weeks and is easily removed by the urologist, usually with a very quick cystoscopy that does not require anaesthesia.
The ureteral stent is a thin, flexible tube placed inside the ureter, following:
- Flexible or Semi-rigid ureteroscopy: Protects the ureter from possible swelling that may be caused by the procedure
- Percutaneous nephrolithotomy (PCNL): Helps with healing and the passage of any remaining stone fragments that could temporarily obstruct the ureter
- When the ureter is obstructed, the kidney cannot drain properly (hydronephrosis) and its function is at risk
- To bypass an obstruction (e.g. an impacted stone, a stricture, or pressure from an external mass)
- To immediately relieve the patient’s pain
- As a preventive measure before starting extracorporeal lithotripsy sessions, when there are very large stones or kidneys at risk of obstruction as fragments pass
- After a ureteral injury or after surgical repair, it keeps the ureter open so it can heal evenly and without forming scarring (stricture)
Removal of the Ureteral Stent
Removal of the ureteral stent (Pigtail) is a short, simple and relatively painless procedure. A local anaesthetic gel (lidocaine) is often used in the urethra to reduce any discomfort during instrument insertion. The urologist inserts a thin endoscope (flexible or rigid cystoscope) through the urethra into the bladder. Using the camera, the doctor locates the end of the stent inside the bladder. With the help of a special forceps passed through the endoscope, the doctor grasps the end of the stent and gently pulls it out.
The procedure usually takes only a few minutes.
After removal, it is normal to experience mild discomfort during urination for a few hours, or a slight presence of blood in the urine (haematuria) for the rest of the day. The urge to urinate or the pulling sensation in the kidney disappears immediately.
