Can a single pill prevent post stent removal pain? (Image from Office.com)
Many patients complain of some pain after having a ureteral stent is removed. This pain is usually mild and self-limited. However, the pain can sometimes be severe. Because patients may not have been warned about the possibility of significant pain beforehand, it can come as an unwelcome surprise, and patients may be left wondering whether something is wrong. Patients who are affected by this pain may describe it as being worse than their original stone pain. In some cases the pain can be bad enough to bring them back to the emergency room.
Up to now, there hasn’t been much research on this topic and it was not clear how often this phenomenon occurs or what might be done to prevent it. A recent publication in the journal BJU International now suggests that severe pain after stent removal may occur in as many as half (55%) of patients. In the study, performed by researchers at Oregon Health & Science University and the Portland Veterans Administration Medical Center, patients having their indwelling ureteral stents removed were either given a placebo pill or a single 50mg dose of the non-steroidal anti-inflammatory drug (NSAID) rofecoxib fifteen minutes before their stent removal procedure. Patients were asked to report their pain just before and 24 hours after their stent removal on a scale ranging from 1 to 10, with 7 or above being considered severe pain. Six of the eleven patients (55%) given placebo developed severe pain after their stent removal while none of the ten patients given rofecoxib developed severe pain.
The authors speculated that the mechanism by which the NSAID medicine may have provided such a dramatic reduction in severe pain occurrence might have been through reducing ureteral spasms or by decreasing pressure within the kidney. While the results of the study are very encouraging, further research will be needed to confirm the findings. For now though, the study is currently the only evidence we have on how often post stent removal severe pain occurs and what we might do to prevent it – take a single dose of a NSAID pain medication fifteen minutes before removing a stent.
Of note, the medication used in the study, rofecoxib (brand name Vioxx), was withdrawn from the US market in 2004 due to concerns about cardiovascular side effects and it is no longer available. The authors report in their paper that they now use a single 220mg dose of the NSAID naproxen with their patients. Naproxen is available over the counter (as a generic or under brand names such as Aleve) but you should check with your doctor about whether you should take it and make sure to read the warnings from the manufacturer as some patients with certain medical conditions shouldn’t take it.
While you might think that a single pill of naproxen can’t be very strong, other research actually supports its use for acute pain. In 15 randomized studies involving 1509 participants, naproxen was found to be effective for relieving moderate to severe pain in patients after surgery. Half of patients who were given a single dose of naproxen experienced at least half pain relief and the effects of the medicine lasted on average for up to nine hours. You can read more about naproxen for postoperative pain at the Cochrane Collaboration website.
REFERENCE: Tadros NN, Bland L, Legg E, Olyaei A, Conlin MJ. “A single dose of a non-steroidal anti-inflammatory drug (NSAID) prevents severe pain after ureteric stent removal: a prospective, randomised, double-blind, placebo-controlled trial. BJU International, 2012.
[…] out their own stents were more likely to report a severe episode of pain afterwards. There is some evidence that taking a tablet of an NSAID medication (naproxen) before removing your stent can help reduce […]
I only wish I would’ve stumbled on this site a few days ago.
I am a 30 year old female who has has several stones. My most recent is the first to require surgery. I had a 4mm stone removed via uretoscopy (yes small enough to pass but it just wouldn’t. After removal, the urologist placed a stent and told me
I could remove myself the next day. The stent itself was extremely uncomfortable. I couldn’t sit up or bend at the hip and urinating was beyond painful. I’d read that some people experience pain after roving their stent but was completely unprepared for what happened. About 45 mins after stent removal, I was in unbearable, excruciating pain. Nothing touched the pain, not even Vicodin. I was doubled over, in tears and it sounded like I was in labor. Almost ended up in the ER but decided to wait. Pain finally calmed down after 2 hrs, 4 ibu and a Vicodin. I wish I would’ve known this was all a possibility. I hate taking “big boy” pain meds, but I wish I would’ve taken Vicodin before removal. The pain was 10x worse than any kidney stone pain.
Hopefully this saves just one person from what I went through.
I had stone removed yesterday and removed my stent tonight. Removal wasn’t bad. But now pain in groin as bad as stone flare ups. My doctor wanted to do this before I went on vacation for fear stone would flare up. So glad I waited till I returned! Now I just hope I don’t have this pain much longer since holidays are next week!
I had my stent removed over a month ago and I am still experiencing pain and pressure in my urethra. The pain and pressure come and go and I have the constant urge to urinate. Once I do urinate, 5 or 10 minutes later I have the urge to urinate again. At times the pressure is very uncomfortable and bothersome. Please let me know if anyone else has experienced the same issue and what your doctors have done to help alleviate the discomfort.
My stunt removed on 26 December 2016. I have several pain after stunt remove in lower abdominal. Burning in stomach too. I m afread too much. Please help me. I have gone doctors office 5 times but couldn’t get solution. Please help me.
I had sever pain, worse than the stone itself after the removal of my stent. It lasted about 3 days with pain decreasing in intensity and duration each day until it stopped.
This is my actual pain level recordings:
9/9
Stint removal at 650 am
Pain at 810am level 10
Took 2 Vicodin and spasmatic
Pain at 3pm level 9
2 Vicodin and spasmatic
Pain at 1050 level 9
2 Vicodin and spasmatic
9/10
Pain at 10 level 8
1 Vicodin
Pain at 6 level 8
1 Vicodin
9/11
Pain at 7 level 7
Took 1 Vicodin
Pain at 415 for 10 mins level 5
No pain med
Pain at 5 for 15 mins pain level 3
No pain med
It has been about 1 1/2 months since my removal and I am experienceing painful pressure in my uretha. After I urinate it does seem to get better but the pain wakes me up at night. Have an appt soon but was wondering of anyone else has had this problem. Std free, no blood or mucus in urine, no fever or cramping. Not sure if I have an infection or not. Never felt this kind of pain before.
My stent is being removed tomorrow morning. Thanks for the heads up!!!!!!!!!! Hopefully, I am not one of those so highly affected from it, but with the way my luck goes I’m sure I will have some pain.
I am getting my stent out this afternoon. It has been in for over a month and I was very excited to be getting it out today but now am suddenly nervous about the 55% experiencing severe pain but either way it has to come out. Not sure how bad your stent has been but mine has been awful, have not had a good night sleep since they put it in, i feel it constantly. My doctor claims i should not even notice it and told me i am his first stent patient to complain of pain. anyway good luck.
I had my stint removed yesterday it was a simple procedure no big deal. Got home got some dinner didnt feel to bad. went to restroom a couple times and noticed I was passing some blood that had clotted and some mucus type stuff now that is when the pain started and I mean to say it was bad it hurt worse than a stone. pain pills would not touch it I tried a hot towel on my flank and groin,and after a few of them it made a very slight differance so I ran a bath as hot as I could take and sit in it and after about 30 mins. it started to ease up. I got out and cooled down and the pain returned even worse so I thought the only thing I can do is to either try to flush out what was in there or E.R so I started dring water and more water and more water and in about 3 – 4 hrs I think it must of flushed out what ever the stint removal had left behind that is what seemed worked for me well any how the sever pain has gone away
I had a large kidney stone laser out of me one week ago and a stent was put in place. All week I was in pain and discomfort from the stent and could hardly wait to remove it. I was told I could remove it myself – which I did. I followed tips from others – hot shower, full bladder and constant pull. the removal was not too bad and there was little blood. I thought to myself wow – this is great and I am so glad it is over!’
Ha! about 30 minutes after removal I was hit with the most excruciating pain I had experienced from the whole ordeal. I was in such pain I could not sit – just paced the floor with tears streaming down. I had already taken 2 Tylenol 3s and did not want to over do it. After 5 hours of suffering I phoned Emergency at hospital and they suggested I take 800mg of Advil along with my 2 T3s and that if that did not help to come in as I was in so much pain. One hour after taking the meds I was able to sleep. I am now monitoring my pain level- and it still hurts but not with quite the intensity as last night. I will continue to take meds as required . . . No one warned me that I may be in pain AFTER the stent removal so it was a bot of an unexpected shock . . . just make sure you have pain meds on hand IN CASE YOU NEED THEM!! Good luck!!
My now 96 year old mother had a stent put in 4 years a go & it was never removed, We did not know about & only descovered by another urologist lately. He said he may have a time removing it & she could lose a kidney. The original Dr was going through a marraige breakup & moved from Belleville Ont to Montreal * looks like he didn’t leave instructions or a follow up. We are pretty upset & are going to cause a stink. This is awful.
I just had my stent removed today (after having the stone retrieved 4 days ago) and was unprepared for the excruciating pain that followed about 2 hours later. I had the same procedure 3 years ago with very little pain. I took the advice of another post and took 2 Aleve after my pain medicine was not touching the pain at all. I’m also using a heating pad. I am getting some relief now. I have had 3 children, a appendectomy, 8 kidney stones, and 2 stents and today’s experience has been the worst!!! If you are suffering, try Aleeve and hang in there!
I had my kidney stones removed Jan. 20 and today Jan. 24 I removed the stents, (both kidneys done). I ended up in ER, taking Tylenol, (3) didn’t do anything, took pain meds. 5 mg. still not doing much. The absolute worst pain in my life. The Dr. said slight discomfort. I honestly don’t think I would have done this if I knew the nightmare with pain.
Here is my experience.
I am a female and had the stent removed via a cystoscopy on Tuesday. I had 10 seconds of stinging and discomfort, but definitely not as bad as I anticipated. Unfortunately I had very bad spasms and the intense feeling to pee about 1 hr after the procedure which lasted about 3 hrs. I then had the same the following evening, although not as intense. Just wish I had been warned to expect the pain after the event. I think the doctors do underplay the level of pain involved with regard to stents etc. which frustrates the person who is undergoing the procedure. Three days in and I still have flank and internal pain, but I was lucky not to pass any blood. Please be aware that you can experience intense pain after the procedure, and be ready with good pain meds. I was crying with the pain it was so bad. But also be aware that some people do not experience this. I’m only reporting this so people do not become alarmed and frightened. It may be an idea if the urologists who perform these procedures had first hand experience of the discomfort and pain involved (ie: had a stent inserted and then removed). I feel this may be the only way they can really empathese.
Had a 8mm stone removed via ureteroscopy a week ago. I found out about the stone 3 months ago and the Dr’s assumed I had passed it. After insisting the stone was still in me due to random pains I finally had it removed and a stent put in for a week. I was aware all week of the stent especially when going potty. I made sure I always had ibuprofen or Tylenol close by. There was significant blood inu urine a week. Getting the stent removed was a bit painful! My dr offered no pain meds. About 3 hrs after removal I was in the most excruciating pain of my life (and I have 3 kids!). Ended up with more pain meds and a prescription for Flomax. So far so good.
I had a stent placed after a 12 mm stone was removed. I had spasms the entire time it was in and had significant blood in my urine. I felt the stent every second it was in. it was very painful. The stent was in for two weeks. When I had it removed I took a Percocet 30 minutes before I had it removed. The discomfort was minimal and I had no pain after it was removed. I believe the Percocet played a huge role in relaxing me enough to make the procedure tolerable. I highly recommend if you can get someone to drive……medicate before the removal.
Well I feel some better after reading all the post, that my symptoms are common ones after having my stent removed yesterday morning. Certianly more pain after stent removal than passing the stone!!!
I had stent remove one week ago. As described by others I had pain about 1-1/2 hour after removal. My surgeon had warned me about the pain/cramps/spasms when he removed the stent. He said he warns everyone. I had Hydrocodon/Acetominophen left over from the surgery and took that when the pain reached the OH NO! level, then slept thru the night. I am tender on that side and the pinched nerve on the other side was still there. If my doctor hadn’t warned me that there would be pain as bad as the original attack I wouldn’t have been prepared and would have called him or have gone to ER. He warned about the blood clots too.
I am very pleased to report that I am improving every day. I went back to work after one day off. I took 2 Tylenol every 4 to 6 hours the first two days, then 1 after that, now one if needed. When I lie on that side I feel a dull internal ache and move off it sooner than later, cannot fall asleep on that side yet. I can see a slight bit of swelling on that side. It has diminished as well. I am a very physically active person, when I push myself I notice my urine is a little darker than usual (no blood clots) and back off. I had urine as dark as iced tea. The color now ranges from clear to barely noticeable ice tea and no clots. The pinched nerve on the opposite side has calmed down a lot. I am still favoring the hip joint affected when I walk up stairs, but realize it is mostly habit now, and I can start to push it soon.
I have a follow-up appointment for an ultrasound in a month. I expect that it will take at least that long for the swelling/aching to go away and the healing to be mostly complete. The ultrasound is to check for constrictions. I wish there had been more info from my doctor about what to expect EACH step of the way. So far I have had to call them once. I wouldn’t hesitate to call again. And thank God for this website. I have to work and need to know what to expect so I can inform my employer and family.
Acute pain might be mild and last just a moment, or it might be severe and last for weeks or months. In most cases, acute pain does not last longer than six months, and it disappears when the underlying cause of pain has been treated or has healed. Unrelieved acute pain, however, might lead to chronic pain.
[…] 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 […]
Has my stent removed this afternoon, I too experienced excruciating pain , an hour after returning home. Thank goodness for this site, as I had not been warned of this possibility. Called the dr. and asked about Aleve-Naproxin. Took it and am better ,but now know to expect that it will return sooner or later. Yes it was just like passing a stone again. Thought removal meant everything was done, They shud advise you of this possibility!
Pain came back this evening. Cant take more Aleve yet, took 2 at first the pain was so awful, only can take 1 more before tomorrow afternoon. Tried heat which has helped. How long will it last?
Hi guys,
I had stone.. i underwent cystoscopy..after few hrs of the surgery i experienced slight burning pain while passing urine..doctors said it’ll be like dat for 2 days..bt unfortunately the pain remained for 1 week and it was as horrible as you explained but later on my Urologist prescribed one tablet… Urotel XL 4 mg…it really worked for me..so if any of you guys are experiencing the same pain while urinating, please consult your urologist and check with him the tablet Urotel XL 4mg…if he says you can take, you can go for it… 🙂
After one week of suffering I had my stent removed today (03/29/2013). The whole thing was horrible. It has passed 5 hours and still feeling a severe pain and burning. I took the pyridium and vicodin and try to relax, but the pain doe not let me, the doctor said this will last probably 2 more days and next week all this ordeal will be history. I want desperately believe that.
I had a kidney stone removed on Dec. 20th.2012. Unknown to me a stent was put in for 1 week. Had it removed in the Dr.’s office so fast I didn’t have time to catch my breath. I have had more discomfort since it was removed. I have seen the Dr. Twice and he said all is well, it will just take time to heal. I have had deep massage, acupuncture twice, hot pads and some Advil. I am not a pill taker, so please give me a better solution to cut the pain. I have a big travel trip to India in April and I want to feel better. Thanks for hearing my deliemma.
My sudden onset of excruciating pain was four hours after removal. It lasted through the whole night, the only relief was hot baths, heating pad, and vomiting. Hope to never experience that agsin, if for some reason I do I will imply on having it removed in a same day surgery or ER setting. The only chance I would of had making it to ER would have been by ambulance.
Several years ago, my husband had a triple A by-pass (due to abdominal aorta aneurysm) in which a stent was implanted through the sides of his legs.
Right after the surgery he felt a horrible lower back pain, and that pain persists continually until this moment. He groans in pay and tears fall off his eyes. With me, his wife, a can’t endure watching my dear husband of 22 years suffering so much. I always wonder if there is a study done why is this happening, if his horrible pain right after the second he woke from the surgery could subside at last. If there’s hope for my suffering husband, please let us know. thank you
clara
Hi, I just had my stent removed, yesterday morning and I was surprised in the evening by a sever pain in my back (kidney area). It was for sure worse than stone passage. I took a NSAIDs and it stopped 100% and last for 9 hrs. Once the drug effect passed the pain came back. I think this is happening due to the kidney contraction to try to clean all the clotted blood that the stent did not allow to pass during the time I had it in. After a remove the stent I saw many clots in the urine.
hi bob, i am experiencing this at the moment and going out of my mind with pain, how long does it last for?
This afternoon I removed my stent and now i’m felling terrible pain. What do you think i should be taking other than advil?
Is it not rather barbaric that stent removal, in this century, is not done with mild conscious sedation? What possible benefit is there to increasing the risk of trauma …both physical and psychological.
YES! Seriously. It was TORTURE!!!! I did not have the one with the string, but doc had to do cystoscopy – go in and fish around for it then pull it out. IT WAS HORRRRRRRRIBLE!!!!!!!
I had a cystoscopy too R & L side stents removed 2 weeks ago, it was the worst pain and continued for hrs. I’m still sore 2 weeks later and wondering when it will subside plus I’m having hot sweats all night every night, I think that might be related to the anaesthetic…….
Three years ago when I had my stents removed, I had some discomfort with the actual removal. An hour later, quite unexpectedly, I was hit hard by extreme pain that had me back in the ER. I had no idea what was happening at the time. Today I will have stents removed again after my latest bout with stones in both kidneys. Now that I know what could possibly happen, I am afraid of a repeat, yes. But maybe I can fight through it with pain meds, heat, and just the knowledge that this is not abnormal….just excruciating.
Aren’t taking NSAIDs with kidney disease dangerous as they are harmful to the kidneys? Would someone with a chronic kidney disease be advised against it?
Yes, patients with certain kidney conditions which cause impaired kidney function (known as chronic kidney disease) should not to take NSAIDs. However, just having kidney stones does not necessarily mean that you have impaired kidney function. To make sure that NSAIDS are okay for you, we always recommend that you check with your doctor first.