What is a ureteric stent?
A ureteric stent is a thin, flexible tube-like device that is inserted into the ureter to facilitate the drainage of urine from the kidney to the bladder. The ureter is the narrow muscular tube that carries urine from the kidney to the bladder. Ureteric stents are typically made of biocompatible materials such as polyurethane, silicone, or Teflon and are designed to be temporary, removable devices.
Ureteric stents are commonly used in a variety of clinical scenarios, including:
- Kidney stone management: Stents can be placed to facilitate the passage of kidney stones or to provide temporary relief from obstruction caused by stones.
- Post-surgical ureteric management: Stents may be inserted after urological surgeries, such as kidney transplantation or pyeloplasty, to ensure proper healing and drainage.
- Ureteric strictures or obstructions: Stents can be used to maintain ureteric patency in cases of ureteric strictures, ureteric tumors, or other obstructive conditions.
- Urinary diversion: Stents may be used in patients with urinary diversions, such as ileal conduits, to ensure adequate drainage.
Why are ureteric stents used?
The primary purpose of a ureteric stent is to maintain the patency of the ureter, allowing for the unobstructed flow of urine from the kidney to the bladder. This is particularly important in situations where the ureter is narrowed, blocked, or compromised due to various medical conditions or surgical interventions.
By placing a ureteric stent, healthcare professionals can achieve the following objectives:
- Relieve ureteric obstruction: Stents can be used to bypass or dilate a ureteric obstruction, such as that caused by a kidney stone or a ureteric stricture, ensuring the continued drainage of urine.
- Facilitate healing: Stents can be placed after urological surgeries to maintain ureteric patency and promote proper healing of the surgical site.
- Prevent complications: Ureteric stents can help prevent complications such as hydronephrosis (swelling of the kidney due to urine backup) and urosepsis (a severe infection of the urinary tract) by maintaining urine flow.
- Provide temporary relief: In some cases, a ureteric stent may be used as a temporary measure to provide relief while a more definitive treatment is planned or implemented.
Ureteric stent placement and removal
The placement of a ureteric stent is typically performed by a urologist or an interventional radiologist. The procedure is usually carried out using cystoscopy, which involves the insertion of a small camera-equipped instrument through the urethra and into the bladder, allowing the healthcare provider to visualize the ureter and guide the stent into the desired position.
The specific steps involved in ureteric stent placement may vary, but generally include the following:
- Anesthesia: The patient may receive local, regional, or general anesthesia, depending on the complexity of the procedure and the individual’s needs.
- Stent insertion: The healthcare provider inserts the stent into the ureter, guiding it from the bladder up through the ureter and into the kidney.
- Confirmation: The position of the stent is confirmed using imaging techniques, such as fluoroscopy or ultrasound.
Ureteric stents are typically left in place for a specified duration, which can range from a few days to several months, depending on the underlying condition and the purpose of the stent. When it is time to remove the stent, the healthcare provider will typically perform a similar cystoscopic procedure to gently pull the stent out through the urethra.
In some cases, the stent may be designed to be self-removing, where a portion of the stent extends into the bladder and can be grasped and pulled out by the patient or a healthcare provider.
Potential complications of ureteric stents
While ureteric stents are generally well-tolerated, there are some potential complications associated with their use, including:
- Stent migration: The stent may move from its intended position, either upward toward the kidney or downward toward the bladder, which can lead to obstruction or pain.
- Stent encrustation: Over time, the stent may become coated with mineral deposits, which can lead to blockage and the need for more frequent stent changes.
- Infection: The presence of a foreign object in the urinary tract can increase the risk of urinary tract infections (UTIs).
- Discomfort and pain: Stents can cause irritation and discomfort, particularly in the bladder and kidney, which may result in pain, frequency, or urgency of urination.
- Hematuria (blood in the urine): Stents can sometimes cause bleeding from the ureter or bladder.
To minimize the risk of these complications, healthcare providers may recommend the use of prophylactic antibiotics, proper hydration, and regular stent changes when necessary.
Ureteric stent types and materials
There are several different types of ureteric stents available, each with its own specific design and characteristics. The choice of stent type and material depends on the individual patient’s needs and the clinical scenario.
Some common types of ureteric stents include:
- Double-J (DJ) stents: These are the most commonly used ureteric stents. They have a curved “J” shape at both ends, with one end in the kidney and the other in the bladder, to help prevent migration.
- Pigtail stents: These stents have a coiled or “pigtail” shape at one or both ends to help secure the stent in place and prevent migration.
- Externalized stents: These stents have one end that exits the body through the abdominal wall, allowing for easy access and removal.
- Biodegradable stents: These stents are made of biocompatible and biodegradable materials, such as polylactic acid or polyglycolic acid, and are designed to gradually dissolve over time, eliminating the need for a separate removal procedure.
The materials used in the manufacture of ureteric stents are also important considerations. Some common materials include:
- Polyurethane: A biocompatible and flexible material that is commonly used for ureteric stents.
- Silicone: A soft and flexible material that is also biocompatible and often used in ureteric stents.
- Teflon (polytetrafluoroethylene, PTFE): A smooth and slippery material that can help reduce the risk of encrustation and irritation.
- Hybrid materials: Stents may incorporate a combination of materials, such as polyurethane and silicone, to optimize their performance and biocompatibility.
The selection of the appropriate stent type and material is crucial and is typically based on the patient’s individual needs, the underlying condition, and the healthcare provider’s clinical experience.
Ureteric stent imaging and monitoring
Ureteric stents are often monitored using various imaging modalities to ensure proper placement, function, and identify any potential complications.
- Fluoroscopy: This real-time X-ray imaging technique is commonly used to guide the placement of the ureteric stent and to confirm its position.
- Ultrasound: Ultrasound imaging can be used to assess the position of the stent and monitor for any obstructions or complications, such as hydronephrosis.
- Plain radiography: Simple X-ray imaging can be used to visualize the stent and monitor for any changes in its position or evidence of encrustation.
- Computed tomography (CT): CT scans can provide high-resolution, cross-sectional images of the urinary tract, allowing for detailed assessment of the stent and any associated pathology.
Regular follow-up appointments and imaging studies are typically recommended to ensure the proper functioning of the ureteric stent and to monitor for any potential complications.
Ureteric stent management and patient education
Proper management of ureteric stents is essential for ensuring optimal outcomes and minimizing the risk of complications. Healthcare providers play a crucial role in educating patients about the care and maintenance of their ureteric stents.
Key aspects of ureteric stent management and patient education include:
- Hydration: Encouraging the patient to maintain adequate hydration and urine output can help prevent stent encrustation and obstruction.
- Pain management: Providing the patient with appropriate pain medication and strategies to manage any discomfort or irritation associated with the stent.
- Infection prevention: Educating the patient on the importance of good hygiene, proper handwashing, and the prompt recognition and reporting of any signs of urinary tract infection.
- Stent removal: Informing the patient about the planned stent removal procedure and ensuring they understand the process and any associated risks.
- Follow-up care: Emphasizing the importance of regular follow-up appointments and imaging studies to monitor the stent’s function and identify any potential complications.
By working closely with their healthcare providers and following the recommended management strategies, patients can play an active role in ensuring the successful and comfortable use of their ureteric stents.
Remember, if you have any concerns or questions about your ureteric stent or your urological health, please don’t hesitate to consult with the experienced team at Station Road Dental Aldergrove. We are dedicated to providing comprehensive and individualized care to help you maintain optimal urinary tract health.
