We previously went over how to place a ureteral stent. In today’s post, we go over the steps of removing a stent. Ureteral stents are removed using two basic methods:
1) By pulling on a stent string, if the string was left in place.
2) Placing a camera into the bladder (cystoscopy) to directly see and grab the stent with a small grasping device.
Removing a stent with a string left in place:
In some cases, your urologist will leave a string attached to one end of a ureteral stent. The stent string is a long piece of thread that will start from the stent and drape out the urethra, where it is visible at the urethral meatus (where urine comes out). A diagram and photos of a stent with a string attached are shown below.
To remove the stent, the visible string is firmly held and steady continuous pulling is applied until the entire stent comes out. The curls at the end of ureteral stent are flexible, so the stent should uncurl and come out easily.
What’s the advantage of leaving a string?
- The stent can be removed without performing cystoscopy.
- Patients can remove their own stent without waiting for an appointment or having to come to the office.
- Stents can’t be “forgotten” when a string is attached. When no string is left attached, a patient may forget or not realize that a stent was left in place. Over time, these forgotten stents can form large stones on them, making removal very difficult.
What’s the disadvantage of a string?
- The string can get snagged on clothing or be pulled on accidentally, resulting in a ureteral stent being removed earlier than it was supposed to. This seems to more commonly occur with female patients.
- The string can be a minor annoyance.
- Some patients prefer not to have to remove their stents themselves at home using the string. They however can usually come to the office where the staff can perform this for them.
Removing a stent by performing cystoscopy (with video below):
When no string or only a portion of the string is left attached, your urologist will need to use a camera to enter your bladder through your urethra. He or she can then see the stent and use an instrument to securely grasp it and remove it. The process is usually quick and occurs in the clinic. It takes only a minute or so in most cases.
Steps in removing a ureteral stent with cystoscopy
- Use a cystoscope to enter the bladder. (A cystoscope is a camera that can be placed into the bladder).
- Identify the stent.
- Use a grasper to securely grab the stent.
- Remove the cystoscope, grasper, and the secured stent as one unit.
The video at the bottom of the page demonstrates all these steps.
How uncomfortable is stent removal using a cystoscope?
For the majority of patients, stent removal is not as uncomfortable as they expected. We often have patients react in surprise when they learn that the stent has been already been removed and the procedure is done.
Unfortunately, some patients do experience discomfort with stent removal, more commonly in men because of their longer urethra. This can be due to discomfort from the cystoscope itself or from the sensation of the stent being removed. While most patients do not feel the stent actually sliding when removed from the kidney, some do experience an uncomfortable sensation with this.
Is there anything that can be done to make it more comfortable?
- Lidocaine jelly placed into the urethra at the beginning of the procedure will help to numb the area but will not completely take away sensation.
- In men, and also occasionally in women, increased discomfort is related to tightening of the urethral sphincter as the scope is passed into the bladder. Trying to relax, take a deep breath, and not “clench” down during the cystoscopy process can sometimes make the process less uncomfortable.
- Anticipation and perception also seem to play a role: Researchers have found that patients who watch their own cystoscopy procedure on a video screen experienced less discomfort than those that did not.
Video of ureteral stent removal in a male patient.
Pain after stent removal:
In most patients, stent removal is a relief as their stent discomfort goes away. However, in some patients, severe pain may occur for several hours. This is thought to be due to spasms of the ureter or swelling and temporary blockage developing after the stent comes out.
Not enough is known about this phenomenon but one recent study suggests it may occur in as many as half of patients. In the study, patients given a single dose of rofecoxib did not experience this pain while those given placebo developed it in 55% of cases. Rofecoxib went by the brand name Vioxx and is no longer available in the U.S. as it was withdrawn by the manufacturer. The authors of the study report they now use naproxen as an alternative. You can read more about the study in our post “Severe pain after stent removal: How often does it occur and can anything prevent it?”
If you are thinking about trying naproxen, be sure to read the manufacturer’s warnings as some patients should not take the medication and check with your doctor first to make sure it’s okay in your situation.
I removed my stent this morning and it was so easy and painless. I was nervous at first but again – so easy and painless.
Hey Jerry, thanks for your post. I had a kidney stone removed Thursday. They placed a stent in and actually told me I could remove it myself today which is saturday august 25. I was very nervous about removing the stent by myself. I just grabbed the little string and kept constant pressure on it and before I knew it , the stent came right out with no pain at all. I did have a burning sensation for about 2-3 minutes after removing it, but nothing like the burning sensation I had when peeing with the stent in. It’s noon now and I feel like a new man. No pain at all. I did take two oxycodone pills about 1 hour before I removed it, so I would advise that before removing it. All I can say is when u start to pull, just keep constant pressure on it and it’s over before u know it. I wish everyone the best. Wasn’t bad at all.
Glad it went well for you too. I feel like a new man as well.
I have stents in each kidney as I became double impacted. Should I pull one string at a time when removing my stents?
Check with your urologist to make sure they want you to remove both stents at the same time. If so, pulling on one string at a time will probably be better to reduce the discomfort. However, you may notice that when you pull the first one out that it could “snag” the other one and you will end up removing both.
I had my stent removed yesterday afternoon, what a relief. I had been so uncomfortable for the last 4 weeks. Was nervous about the procedure, but in less than 2 minutes it was out. Did not experience any pain, just an odd feeling. For all of you worried about the removal process, it was far more uncomfortable having it in than taking it out. Glad it is over!!!!
Thanks for sharing that you feel much better without the stent. I’ve had mine for 6 1/2 weeks and will have removed on the 23/08. The pain that I have encountered has been beyond belief no real pain relief has worked. I miss feeling better and being my old self . I will be glad when all this will be over.
I’m also mine out tomorrow, 8/28, after having it in for 9 weeks. I am more than ready to see it go and would happily incinerate the thing after it comes out! Thanks everyone for the reassurances that it’s not so bad to get it out, I am still slightly terrified, but hopefully it goes smoothly!
I just had a stent removed this morning and I am in so much pain from the burning fire! Does anyone know when this goes away? This feeling is far more painful then when the stent was inside! Ug! I need relief!
I agree with you. I had mine removed yesterday and my urethra is on fire. I am in so much pain. I am in tears. I keep taking hot baths 5 times a day and now I have an icepack (the kind that they give you in the hospital after you have a baby) on it to see if that helps. The doctor gave me Uribel but in between pills I am doubled over again. The stent was painful but this is unbearable. Did yours ever stop hurting?
I was admitted to the hospital becuase the kidney stone i’ve been trying to pass for the last seven months blocked my right kidney and i became deathly ill from infection. I had a stent put in to drain the fluid and was on a heavy round of two different anti biotics and IV fluids for six days. I’m a little scared to have the stent removed this Wednesday, but hopefully it won’t be as bad as the pain i was in when i was admitted to the hospital.
I found out June 2 i had partial blockage of both kidneys. I had stents put in then. Next have, sock wave surgery fixed the left. Then major surgery for large stone in right??
kidney.Had surgery June 26 its now july 22 . Still in pain. Still have stents. See doc 25 hope he takes out stents. Still have blood in urine and tonite i have fever100.5
you need to be drinking at least 3 liters of water a day and a very low sodium diet to help clean up your stones.
i had a kidney stent fitted last xmas and then it was removed 2 weeks ago but i had to have another one fitted , i had the last stent removed today and was expecting to have a bit of pain, i was pleasantly suprised when the consultant didnt even use injections just an anasthetic gel , the whole process took 3 minutes and the most painful thing was actually the antibiotic injection in my thigh , so my advice to anyone having this procedure is dont worry about it at all, i was suprised just how painless this was ,
Will be havng stint removed at dr office in 2 weeks, after reading testimonies it makes sense to take pain meds prior to removal, or 3 stiff drinks, for its un predictable how much discomfort any patient may experience, considering the dr doesn’t feel any pain
I had a stent in a few weeks ago for kidney stones, it gives me so much pain and is very uncomfortable, i get really sharp pains when walking or not sat in the right position, still waiting for both the kidney stones and the stent to be removed, it seems to hurt more now the when it was put in two weeks ago, they are saying it will be four to six weeks, this seems to long to me, but i just have to wait!!
I had a stone removed via perc on Friday. Monday I was in the ER in horrible pain. Doc inserted a stent on Tues. and I’m still in pain today (Sunday)–can’t lift or even move w/o a feeling of stabbing pain. Does this get better? or can I expect to have this stabbing sensation in my back until the stent is out (3 weeks from date of insertion). I’m also worried about even MORE pain when the stent is removed. 🙁
I had to remove mine a week after surgery. I was told to wait 2 weeks after laser lithotripsy surgery. The pain was unbearable, especially when urinating. I would scream. It was like being stabbed in the back.
just had my stent removed 22 hours ago. I was so scared of the pain when removing it but let me just say, “Relief”. The jabbing pain in my right lower back was immediately gone. The spasms gone. I was finally going to get some sleep but one hour after the doc removed the stent, I was doubled over shouting for my husband to call doc. I was breathless due to pain. My pain was back 100%!! How could this be? The doc. told my hubby that it is not uncommon to feel pain after removal of stent so if I could bare pain for 24 hours I would feel better. I share this with you all so you are not surprised & so that you have pain meds ready. Good luck! I am still in pain:'(
stent removal with the cytoscope is the most painful thing I’ve ever lived through.. I had another one put it with the string so we’ll see if this is really any better. If I ever have to do it again, I will be knocked out.
Hey All..
For those of you thats going in for Kidney stone removal its not that bad!
I had mine removed yesterday – 28 June 2012 – I had that useless Catheter in – and have a stent from my right kidney downwards… Yes I agree there is a lot of pressure on the bladder and it hurts like hell to urinate,, Going for my stent removal on Wednesday – really not up for it and so scared! But if I can tolerate this Urination pain – then ill be able to tolerate the removing of the stent!
I have a urethral stint after kidney stone removal. My urologist is on vacation, so she scheduled my stint removal with one of the other doctors in her group. I was counting the hours to get this stint out (extremely uncomfortable)….went to the doctor’s office, filled out paperwork, and the nurse told me the doctor wouldn’t remove my stint because he didn’t feel “comfortable” doing it since he didn’t put it in. So…as things stand now, I still have the stint until July 18 when my surgeon returns. Was told to go to ER if it gets too bad. ER said they wouldn’t do it either without admitting me to hospital and if there wasn’t a “problem” with the stint I wouldn’t be admitted. I sure wish I could remove it myself — the doctor who isn’t comfortable doing it has been in practice for 42 years, and even if I did go to the ER, I could get the doctor who turned me away at the office….I just don’t understand, and am beside myself with the way I feel. I love the urologist who did my surgery and just can’t imagine that another doctor in her group wouldn’t take care of this. They didn’t even bother to tell me until I drove 20 miles to the office.
First of all I would have a huge problem with this so called doctor that I “Love” so much and drive 20 miles for. What kind of practice is she a part of that she leaves on vacation or where ever…and is not able to TRUST her partners to cover her, or take care of her patients…God forbide one would be in a serious condition in the ER and they called her office…I wonder what would be the response, ” The doctor is away and her partner is not Feeling comfortable, since this is not his PATIENT “. That is
OUTRAGEOUS and you should let your doctor know that this is unexceptable on every level!
Stent removal……medicate ahead of time. Wasn’t bad at all, pressure and uncontrolable feeling of urinating. Other than that no worries. Having the left side kidney stones removed next so now I know what to expect. The worst part of the entire procedure was post sugery fire in my penis when urinating….only for about 48 hours though.
@harry… i actually lol’ed when you said “The worst part of the entire procedure was post sugery fire in my penis when urinating….only for about 48 hours though” because as of july 25, i also had a stint removed; am also in complete utter fireeyyy pain when i urinate! i hope it only persists for another day!
I’ve had a stent since last week and my discharge instructions were to remove it myself this morning — they left the string for me to do so.
The actual removal was no problem, a bit of discomfort, but no worse than dealing with the string hanging out of me and dealing with things while the stent was in me. It was more of a psychological thing, I’m going to pull WHAT out of my what now? LOL
The fun started about an hour later. Flank pain, groin pain nausea, sometimes alternating, sometimes more than one pain at a time, all accompanied by sweating and shaking, and no way to get comfortable. I took one Tylenol-3, didn’t seem to help much and after about 60 minutes took a second one. That seemed to do the trick. In about 15 minutes after I downed the second pill, my pain went from a 7-8 to a 3 and I wound up napping for a couple of hours. Right now I’ve been up for about 90 minutes and it’s almost like I’m a new person. So my recommendation to anyone else would be to medicate first, not due to the pain from the removal itself, but due to the body having fits over being violated again. By the time the pain starts to hit, so will the meds and you should have an easier time than I did.
I had my stent removed on Friday, the 22nd, after ureteroscopy to remove a 6 mm stone the week prior. I was pretty nervous since I had been so sore all week & heard that they remove it in the doc’s office.
Honestly, don’t stress. It’s no big deal. I had to have a cystoscopy in order for my doc to remove it (my stent didn’t have a string), but it wasn’t any worse than a normal pap. I did have the sensation of “sliding” when doc had a handle on it & pulled, but it wasn’t painful—just a strange sensation & only lasted for a few seconds & it was out.
My body feels much better without the stent. For the week I had it in, I was just “aware” of this object in my body. It was sore, I felt pressure in my bladder all the time & I had a lot of burning toward the end of my stream while it was in. I feel so much better now that it’s out.
I didn’t have but 1 kidney colic spasm a few hours after the stent removal. I feel totally back to normal now, a day & a half later.
Seriously. Don’t stress yourself about the stent removal.
Thank you SO much for sharing your experience with removal of your stent. I’ve had mine for 1 week and having it removed tomorrow. I am so sore and the thought of having anything put into me has me in a state of anxiety. Glad to hear that it was tolerable for you. I think now I will be o.k.
Happy to have found this, having my first stent removed today! I have had numerous stones removed surgically over the last 40 yrs and had my first one lasered last week with the stent being put in am still a bit anxious, but reading your comments have helped have always did well with most procedures ( and have been through many over the years) so reading these comments have helped me immensely! I have pain meds, so will be prepared if needed!
Oh my goodness, this stent is driving me nuts, I cannot wait until Monday when it gets removed…painful or not! Being this uncomfortable is beyond words!
I had a 7 mm, a 6 mm, and a 3 mm stones in my right kidney that landed me in the ER becase the 3 mm was actually two stones together making a figure 8 and was stuck in the urethra. I had a failed uteroscopy and my kidney stones were pushed back into the kidney with the scope. The doctor put in a stent which was really uncomfortable. Four days later I had a Lithotripsy and the stoens that were formerly stuck were blasted. They then got stuck in the opening of the kidney and the stent could not be removed as previously planned. This past Thursday I was scheduled for another uteroscopy and laser treatment but the doctor tells me that when he went in and took the stent out, the stones got unstuck. I was released from the hospital in awful pain. Percocet every six hours was prescribed but did nothing and I was up all night in dire pain, as bad as the pain that landed me in the ER the first time. I was not told to strain my urine but did any way. Later on Friday, I passed a 3 mm, a 5 mm, and a 7 mm stones and Saturday passed two smaller ones, 1 mm and 2 mm. Today is Sunday and I am still uncomfortable. I was told to call if I vomited and had a fever. I have had neither but do have a backache and discomfit in my lower abdomen. I can’t imagine there are any more stones but am guessing that the stent opened up my ureter to allow the stones to pass which is totally amazing me. Hopefully I am done with this situation but now have to deal with finding how to avoid them in the future.
I had my kidney stone removal surgery on June 1st. Everything went well, and I had a stent put in afterwards. I didn’t want this thing in me, but the Urologist explained that it helps with the healing process. I had to keep it in for a week, and then this morning, I had it removed. I have no issue with general anesthesia. You close your eyes, and when you open them, everything is done. Well, I’ve been dreading this stent removal because there would be no anesthesia! When I showed up at the Urology Clinic, I explained to the nurse that I was afraid it was going to hurt. She was amazing. She walked me through everything before the Urologist came in. She got me ready with that numbing jelly stuff. Then when he came in, he was explaining what they were going to do, and then each step of the way, they said what they were going to do, and what I would feel. There was ZERO pain the entire time. The only thing that was uncomfortable was this pressure I felt when the camera/grasper tool thing went from the urethra into the bladder area (which they gave me the heads up on). I found that watching the tv monitor was helpful too. The entire process took 5min, and only because the Urologist was explaining things to me. It would have been much quicker if I didn’t ask questions.
So in my experience, I can honestly say I felt no pain, and the worst part was anticipating that there was going to be pain.
Hello,
I have been suffering with kidney stones for over 25 years. I just had another surgery on May 28th to insert the stent, and a second surgery following that one on June 1st. If I do not pass this stone, I am looking at another surgery in 2 days.( I believe this is my 4th stent. I find it very uncomfortable and painful when urinating. It does not hurt to remove the stent at all. It only takes a few minutes. Those of you who are nervous, don’t be.) Thank you. I felt as though I was the only one who found the stent painful and uncomfortable.)
4 weeks ago I had renal failure. Two very large kidney stones became lodged in my right and one in my left urtera. This required stents (no strings to my knowledge). Because my kidneys had to recoup and so did I, my appointment is with my urologist (surgeon) next week to discuss removeal of the stones and stents. I am frightened. I’m fairly certain this will be an in patient situation. The stone on the left is in a more difficult position. I want the stents out and the stones but can you tell me what to expect? Thank you!!!
Depending on the size and location of the stones, your urologist may recommend ureteroscopy, shockwave lithotripsy, or percutaneous surgery. Take a look at our post on comparing the three surgical options to get an idea of what is involved and what the expected recovery is for each:
https://www.kidneystoners.org/treatments/comparing-ureteroscopy-shockwave-lithotripsy-and-percutaneous-nephrolithotripsy/
Lisa,
You will be fine. You will be asleep so you won’t feel a thing. Having kidney stones are painful, but it gets better. The stent is there to help crush the stones and help you pass them. This is what my doctor told me.)
Thank you very much. My surgery is set for July 10th. I’ll be happy when it’s over.
Im a male and I recently just went into surgery I just got my kidney stones removed 6 days ago. They placed the stent inside afterwards. my question is when I go back to the doctor to get my stent removed if I request day surgery to be put under anesthesia will they grant my wish?
In the majority of cases, the risks of undergoing anesthesia for a simple stent removal do not justify being put under. While anesthesia has become a safe and routine procedure, serious complications can occur.
A stent removal procedure should only take 1-3 minutes in most patients and is usually advisable to have it done in the clinic. Most stents (we would estimate 99%) are removed in the clinic and not in the OR. Your doctor can go over your specific situation with you when you meet with him or her.
David,Before seeing my husband go thru so much pain,I would have thought theres no need to sedate to remove. This past Thursday am my husband had a kidney stone tapped and then the stent put in. Allll weekend he hurt Blood in urine,low fevers,chills and weak. Today he went in to have it removed. When he came out he was hobbling to the car & literalllly in tears(I’ve never seen him cry) I went in and told them what was going on and there response was to take him to the ER….it has been 4 hours and he’s still there. So,if I could rewind this whole ordeal…I would request sedation if possible. At first they said he would get an x-ray to make sure the stone was gone,and some light pain meds…Nothing. The NP did 1..2…and pulled. Bing Bam Boom..and now he’s in the ER. So,this is just one opinion but if you feel you prefer that,it never hurts to ask. I’m pretty upset over the whole thing. You always hate to see your loved one go thru such pain,and knowing it could have been averted. I wish you the best of luck.
For all of you worried about stent removal… Dont worry… I have had 4 stents now…2 were taken out under general anethesia, because i was having the next one put in… one was taken out in the drs office and i didnt even realize he had taken it out…took out my own today and no biggy.. If you can tolerate renal colic that is a 11/10…..then the stent will be no biggy…also the discomfort of having the stent in, is way worse than the removal… Good luck to you all
oh, dear, you’re starting to worry me. My stent is scheduled to be removed after a month from insertion. I hope it’s not that painful as it seems…
I just had my foot long ureteral stent removed this morning in surgeon’s office. No anesthetic or pain pills. It took about a minute, was uncomfortable with a couple minor painful twinges, but still better than putting up with the stent related bladder spasms for the past month. Right now, I have some internal bladder pain after I urinate, that last for a few minutes. I think it may just be residual irritation from the stent and/or its removal via the instruments. Six hours after the stent removal, I felt well enough to go for a bicycle ride, which I hadn’t been able to do for many weeks. That’s saying something about being free of pain. 🙂
I had my stent removed Monday morning (16 hours ago). While SLIGHTLY uncomfortable, this is truly NO BIG DEAL!!! The only (very momentary) actual pain I felt was due to the grabber actually touching the opening to the bladder. Please don’t be concerned over the removal. I know everyone is different, but relaxing makes all the difference in the world. The procedure literally takes SECONDS – come on, we can do anything for SECONDS:) My right kidney is very sore (akin to being kidney-punched, I would guess) and I still have that “full” feeling, although it has lessened measurably since the removal. If I have anything negative to say about the way my doctor handled the entire experience, I would say that he did not provide enough – or strong enough – pain management. Doctors – hydrocodone doesn’t even take the edge off the pain after surgery, and it takes more than a couple days of meds to help us through the pain. And this medication isn’t touching the kidney pain right now, even though I am taking 1 1/2 the dosage prescribed. Note to self: be very nice to friends who are willing to share the REAL painkillers:)
I agree with you regarding pain meds. If a doctor had a kidney stone, I’m sure they would have adequate pain control. Every patient is due appropriate pain control.
A few months back, I had rotator cuff surgery, and happened upon an awesome orthopedic doctor. One of his primary concerns is pain control, and he was the one doctor that made it a priority.
Pain control!! I must say that all Dr’s involved with me during this wonderful experience were very concerned about keeping my pain under control. Unfortunately the pills do very little to relive the pain. At one point I just couldn’t take it any more and was admitted into the hospital for 2 days so they could pump me full of the really good pain meds. I had a PCA pump and it was wonderful to finally get some really good relief. But then I had to leave the hospital and my new friend, the PCA pump, and now I am suffering again. Anyway – I’m getting my stent out tomorrow and since reading peoples experiences’ about the procedure – how easy it is – I am sort of looking forward to having it out. I’ve just had lots of side effects with it.
I’m really glad I found “kidneystoners”, reading about people who are unfortunately going through a similar ordeal. Done venting!
I had mine removed day before yesterday the anxiety and anticipation were worse than the actual procedure. There was a slight amount of pain when the lidocain lubricant was inserted. Then all was pretty ok until the stent was actually on the way out. I wouldn’t describe the sensation as pain exactly, but it was the most power feeling that I was going to pee all over the doctor that was most uncomfortable. That feeling like you are about to pee or are already in the process with no control over it was the most unusual and powerful feeling of the sort I think I’ve ever had.
I had my stent removed last week after having kidney stone surgery the week before, and while the procedure hurt like hell for a few seconds, once it was over it was pretty much over. It was painful to urinate that afternoon, and I felt the urge to urinate most of the next day, but two days later I was back to normal. I can’t recommend it, but it’s not that big of a deal.