Introduction:
Ureteral stents are thin tubes made of bio-compatible material. The stents help in enlarging narrow tubes or openings in the body. Ureters are a part of the urinary system. They are the tubes that connect the kidneys to the urinary bladder. Their primary purpose is to facilitate the transportation of urine from the kidneys to the bladder. At times, these tubes may face obstruction from stones (renal calculi). This can make the passing of urine difficult. Hence, these ureteral stents help to treat urinary tract obstruction due to stones.
Ureteral stents are made of biocompatible silicone or polyurethane material. These tubes are quite long and extend from the kidneys to the bladder. The top part of the stent has a coil that sits in the kidneys. The stent's lower part has a loop attached to the bladder, which helps secure the stent's position.
What Are the Indications of Ureteral Stents?
In some cases, a blockage in the ureter prevents urine flow. When placed in the ureter, a stent can open the tube, leading to normal urine flow. The most common use of the stent is in kidney stones. A stone tends to narrow down the passage of the urine flow. When placed, a stent can open the ureter to its normal width, enabling urine flow. A stent could also be placed when the stones are fragmented to prevent them from blocking other parts of the ureter. Likewise, it is used in order to avoid post-operative swelling after removing a stone. Some of the other uses of renal stones include:
Narrowing due to the presence of a blood clot.
In the case of irritable bowel disease (IBS).
Uropelvic junction obstruction, an inherited condition wherein the ureters are constricted since birth.
In case of scar tissue buildup. This is more common in conditions like endometriosis.
It is for ease of functioning in case of tumors or growth.
What Are Kidney Stones?
Kidney stones are also known as nephrolithiasis or renal calculi. These are hard crystallized materials that lodge themselves in the urogenital region. This happens when the urine is high in salts. Smaller stones can pass through the urine by themselves. However, bigger stones may cause a lot of pain as it may block the urinary pathway. This may cause sharp pain in the lower back and side of the hips. The occurrence of renal stones is very common and affects one in every 10 people.
What Happens Before the Stenting Procedure?
Once the diagnosis of a kidney stone is made, the doctor will check if the patient requires stenting or if other procedures may be performed. If stenting is to be undertaken, the following steps will be undertaken by the physician.
A blood investigation to check for kidney functioning.
The doctor may prescribe certain supplements and medications (Such as antibiotics) that have to be taken before the stent placement.
The doctor may stop certain medications, such as aspirin. Aspirins are blood thinners. When continued during a procedure, it may cause excessive bleeding.
One may also be prescribed certain dietary restrictions or a specific diet a few days before the procedure.
What Happens During the Ureteral Stenting Procedure?
Ureteral stenting is, in most cases, a day-care procedure. The patient can return home on the same day of the procedure. A urologist, a specialist who deals with kidney conditions, performs this procedure. The following is the procedure undertaken for the placement of a stent.
The procedure may be performed under general anesthesia. Under general anesthesia, the patient may be completely asleep, and this is better for the procedure.
The procedure also utilizes specialized diagnostic procedures, such as X-ray fluoroscopy or a kidney ultrasound, to help locate the stone.
A specialized surgical device known as a cystoscope may be used to perform this procedure. This device is inserted through the urethra, the opening through which urine is passed, and then into the bladder.
The cystoscope is very thin and flexible. This aids in the movement of this device through a blocked ureter. The stent is threaded into the cystoscope. A guidewire helps place the stent in its desired location. A coiled part of the stent is placed in the kidney, and the loop is placed in the bladder.
The guidewire and the cystoscope are removed from the kidney from the urethra.
What Happens After the Ureteral Stenting Procedure?
After the stent placement procedure, the doctor may keep the patient under observation for a few hours. During this period, the anesthesia also wears off. In most cases, the patient would be able to go home the same day. The patient may experience some discomfort once the effect of anesthesia wears off. Some patients may also notice blood in the urine. However, most of these are normal side effects of the procedure. One should contact their physician immediately in case of any persistent discomfort.
What Are the Other Considerations?
Most ureteral stents are of a temporary nature. The doctor will remove the stent after the stone has been passed through the urine. However, certain other conditions, such as a tumor or scar tissue formation, may require stents for a longer period. The doctor may also consider replacing the stent once in a while to prevent any complications.
What Are Some of the Complications of Stents?
The following may be some of the complications of a ureteral stent:
1. Bladder spasms.
2. Urge to urinate frequently.
3. Pain while passing urine
4. Irritation of the bladder or the ureter.
5. Infections of the urogenital tract.
6. Bloody urine.
Conclusion:
Ureteral stenting is a minimally invasive method to help pass kidney stones. It is temporary and prevents the tube from narrowing. In some cases, the stents may be needed for a slightly longer duration. Some people can also experience discomfort after the procedure. Like every other procedure, this one, too, has certain side effects. The side effects of stent placement include infections, pain, and increased or painful urination. However, considering the effectiveness of this procedure, the complications can be dealt with without causing much harm.
