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Of note, the medication used in the study, rofecoxib (brand name Vioxx), was withdrawn from the US market in 2004 due to concerns about cardiovascular side effects and it is no longer available.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.
13 years ago I had a staghorn kidney stone in my right kidney with sepsis. After a few procedures over the years I had another one last week to take out the last bit of resedule. A JJ stent was inserted. I had it for one week and it was removed today. I was surprised at the pain after a couple of hours. Oxycodone/acetaminophen and an ice pack helped. Hope it goes away and stays away soon.
hope so too!
Frequent flyer with JJ stent removal pain within hour or so of removal, and waves of pain about 6-8 hours apart, following ureteroscopic laser lithotripsy and basket removal 6 days ago (and 15+ similar procedures across last 26 years). Pain meds on board ahead of stent removal, always, and after, plus pyrridium (dayglow yellow dye), and for the men in the audience, Flomax/Tamsulosin (not sure what the female alpha-blocker medication equivalent is, but Flomax is a medication for prostate issues). The tamsulosin helps to relax the smooth muscles of the ureter and really helps with the spasms. Plus judicious use of heating pad and fluids intake. This combination of meds and heating pad use has kept me out of the ER for about 10 years for this renal colic pain. String stent removal, or the cystoscope path, both are weird in their own way and sting a bit with the passage past the prostate, and urethra, but it’s this colic that always has me worried if I can get the opiate pain meds, tamsulosin, pyrridium, and fluids combination and timing right. My urologist has cleared my right ureter and right kidney of about 3 small 5mm stones (ureter), 2 big 8mm stones (kidney) and 2 3mm small stones (kidney) this time around, but I know my left kidney has 2 8mm stones that aren’t coming out on their own…another time down the road for those. Ask your urologists about the alpha-blocker for the sympathetic nervous system affect and see if this combo might work for you. The side effects have been manageable in order to avoid more ER visits/costs for IV nausea & pain meds/fluids.
I had a large stone removed last Tuesday and the stent was removed on Thursday. I have never had such pain in my life when I woke up from surgery and felt like they had put a hot poker in my bladder. When I went to have the stent removed there was nothing for pain not even a numbing gel the nurse said just stand there and I will pull it out. She did, with me standing up, I felt like livestock. To me that was so barbaric and it was excruciating pain. I started hurting as soon as she took it out and have hurt ever since. I had the surgery a week ago today. I have bladder spasms, still peeing some blood, not every time though, and horrible bladder spasms. I currently have covid and every time I start coughing it sets off the spams and then I pee blood or tiny blood clots. This is as bad as the stone. My right side of my back is the side my stone was on is killing me right now and because I can’t take any aspirin products tylenol is just very minimal relief. I had to go to the ER the night she pulled the stent out. I was hurting so bad I thought I was passing another stone.
Unfortunately, this is much more common than they admit. It took me a month to feel better after my stent – I had all the same issues you do (minus the Covid). All I can say is, even though it might not feel like it today, you will get better – the blood will stop showing up in your pee, the spasms will eventually subside and the back pain will go away. The ONE thing that helped me the most was putting a heating pad on my lower back and my front (you can get a big wraparound one, but I just used two – one on my lower abdomen and one on my back) it helped calm the bladder spasms and also helped the horrible kidney pain. I really wish the doctors warned us so we could be ready for this. My poor husband was out at 2 in the morning driving out of town to a 24 hour Walmart to get me the heating pads because I was writhing in agony. It would have been nice if the doctor or nurse suggested having some heating pads and some massage oil ready BEFORE the surgery and stent instead of all of us being blindsided by the excruciating pain…
Thank you for your advice. Its been 3 weeks since my stent was removed and I still am having some major discomfort. I’ll try the heating pads. Again, thanks!
So I just had a second temp stent put in after second trip to ER. After my first stent removal I too had severe lower cramping/spasms but worst part is the vomiting non stop 36 hrs until stent was put back in and immediately vomiting stopped.. anyone else deal with vomiting?
I had kidney stone surgery 7 days ago and they put a stent in, it was miserable having it in, but I had it removed yesterday, some pain started by the time I got home. It continued to get worse throughout the evening. By the time I went to bed, I was in so much pain and so nauseous it was ridiculous. It’s now 8:30 am and I’ve basically been up all night. This pain and nausea is worse than waking up from the surgery.
Hi guys currently lying in hospital had my laseroprosy to remove kidney stone on Thursday (now on Monday ) and I can honestly say I’ve never experienced anything like this pain way’s horrendous and to top it off stone couldn’t be retrieved…had pain within 2 hours after procedure where they left a stent in and wallop the day I removed it was just so bad give me child birth anytime! Kept in hospital scan showed my kidney is enlarged prob from the procedure and things are very slowly starting to calm down with the aid of morphine and diclofenec sipositireis urine still very red but gallons of water later its starting to flush take care everyone and if you feel your pain is not normal seek medical advice
Hello everyone. I had a colorectal surgery which lasted 4 hours. Two weeks later I needed to have a stone removed. Had the stent for two weeks. Following the removal of the stent I started experiencing sharp pains/ spasms on my lower back and right side on my stomach towards my groin area. At times I can’t walk, sit, walk or turned around in bed without waking up. First surgeon said no related to the first surgery. Urologist said the same thing. Went to see a Neufrologist who said is related to the removal of the stent. I been to the ER three times after the removal. Everyone keep prescribing muscle relaxers, and morphine. I have miss so much work. Today I’m going to see a chiropractor. This is completely ridiculous that we need to suffer for so long, the way medicine is so advance. I really can’t take this pain anymore!!
I am so glad to have come across this forum. I am on day 14 after having my stent removed and I am still having pain. It is so frustrating! I guess it feels like spasms, but man are they uncomfortable. All I drink is water and changed up my diet some, but there has to be a better way. People should not be made to suffer through this for days, weeks and months at a time. It is hard to deal with mentally and even harder to function normally. And then they do tests and “everything is normal”. Living in pain or fear of pain is not normal! appreciate any tips for dealing with the pain. Hope everyone hangs in there and feels better soon.
Hely Leslie , did it go away ?
Hi Leslie how are things now for u
So, it’s 3pm and I had my stent removed at 8:45 this morning. I’ve been drinking water and urinating just fine. Then over a period of 10 minutes my pain went from 0 to 8. The pain is almost as bad as when I had the stone diagnosed in the first place.
I guess I’m now a member of the club! Removed stent at 7:30 this morning and just like clock work about an hour later WHAM!!’ I would rather give birth and I’ve had 4 kids.
I am wondering if the longer it’s left in the worse it gets? Tomorrow will be 1 month since this nightmare began.
Initially found 7 mm stone blocking ureter plus some in kidney. Placed stent in to let things “calm down”, a week later Eswl. I actually tolerated the stent (no string) pretty well until ESWL. After X-rays repeated for 2 weeks I was told the stones were stacked in my ureter and would need to do Laser. Did Laser Wednesday and new temp stent was put in. Was instructed to remove this morning and I am miserable! Severe pain. Took ibuprofen and oxybutin before removal. Ended up taking OxyContin from a previous surgery. It has let up some but I am currently sitting in a hot bath. That seems to help some also.
I was told I could have some “mild to moderate” pain after the removal. I agree with most that say this is worse that the stone. Sadly I have asymptomatic stones in my other kidney. I was hoping to get that taken care of this year seeing that my deductible is met but now I’m questioning it.
I know it’s not a matter of if but when the other side will start acting up but……
Hopefully this resolves soon. My son is getting married next weekend.
Update,
I now know why the pain occurred. Residual stones. Went to the restroom and had about 4 of them sitting in the bottom of the toilet. I’m still sore but the intense pain that I had this
Morning has subsided. My thought is when the stent was removed it stirred up residual stones.
I guess this will be a mini blog!
Update. Day 2 (stent removed yesterday)
I feel AMAZING! Just some soreness in my back. No more burning or pain. I drank tons of water yesterday. Just put the little water pitcher on the table next to me and hubby was nice and kept if full. I think I just needed a good flushing, (no pun intended). So far so good.
I’m going to leave it here, that is unless something happens such as pain returning etc. I hope this help someone. There is a light at the end of the tunnel. After a month it’s nice to not have that pain in the bladder and to pee like a normal person again. Good luck to everyone!
I’m so glad to read that you’re better. This horrible pain seems to be more common than the urologists are admitting. “May have some pain” really is a major understatement! I, myself, was in total AGONY for months after the stent came out. I agree, would rather give birth again that go through that misery. Thanks for posting, it’s a good reminder that we’re not alone.
You are so right! We are not alone. 😊
Boy your not kidding it was worse than passing a stone
Hello All
Got my stent removed 4 hours ago after the 10 days of kidney stone laser surgery . I almost passed out with pain in my hips and kidney . Took naproxen , hot pad but nothing is working .Pain is so bad that I can’t even able to breathe properly . I read all the comments but in the discussion no one told that if they felt any relief after days ? Please give me some advice or hope 🥲
It took me weeks to feel better. The pain was UNBEARABLE and nothing helped other that heating pads (but that just took the edge off). The spasms lasted over a month and it hurt to pee for a while for me. This seems more common than the doctors will admit. Just know, you will be okay and the pain does eventually subside.
Thank goodness you have said this, I had my Stent removed 2 weeks ago after having it in for 5 weeks and I have been up and down with pain !! One minute it’s fine the next it’s bad again, I was starting to think there was something wrong .
I am relieved to know I am not alone and that there are others out there that have experienced flank discomfort/pain and spasms in the Ureta/bladder for weeks after .
Victoria I’m going threw the same thing . I’m on 2 different antibiotics and pain meds . It feels like I have another stone but I don’t . I have never had this happen before. I have had stents before and never had a problem until now
I had my stent removed since December. I’m in stream pain all the time. I had it in for 3 months horrible pain. I don’t think there is stone because the pain is just severe on lower back not like when I had stones.
This, unfortunately, is not uncommon. It took me many months of horrible agonizing pain before it subsided. I am disappointed that the doctors don’t warn people of the possibility of this. All the people here who have experienced this, say they were not warned – which causes panic. Hope you feel better soon.
And how are you doing now ?
Hi There, did this ever go away for you? I am 5 day post stent removal and I am having pain in my ureter that comes and goes, like a burning or aching, sometimes going into the kidney. It’s not unbearable, but very annoying to deal with. Thank you!
It took me over 2 months to be completely pain free. The 2 weeks after the stent removal was pretty bad, but then it started to slowly improve. Once the pain finally did subside, I’ve been fine since.
Is it possible to have the surgery and not have to do the stents? I’ve been passing stones and dealing with this pain for over a month now. I had a CT scan done and it showed that both of kidneys are full of stones, Dr said he would do surgery if I wanted or I could keep trying to pass them on my own. I really didn’t want surgery, but after this past weekend being miserable I’m looking into the surgery options. After finding this forum, I really don’t want to have stents.
My stent was removed 2 weeks ago. I still feel kidney pain every now and then and constant pain in my urethra/urge to pee. Good to know that these symptoms are not that uncommon. I wonder how long until I’ll be fully recovered,
Hi Rose, any follow up ?
Mine are removed last week and I am in pain still
Hello, I removed the stent 5 weeks ago, the stent was in for 5 days . I have been seeing on and off flank area spasms and side abdomen pain that comes and goes since the removal. I had ct and mri taken recently, there is nothing wrong with the results. Total pain has slightly subsided , I don’t know when I will feel pain free.