Stenting of Ureter
A stent is a hollow tube that is placed into the ureter from the renal pelvis to the bladder. It allow urine to flow from the kidney to the bladder.
Indications of ureteric stenting includes:
•Relieve ureteric obstruction from stones, cancer or scar tissue, by allowing urine to drain though the stent
•encourage healing of the ureter by providing an internal scaffold after surgery on the ureter
•Assist dilatation of the ureter to allow instrumentation of the ureter
The stent is left for one weeks following stone surgery. It is left for 4-6 weeks after ureteric surgery to promote healing. Some patients have a long-term stent, these stents need to be changed every 3-6 months to prevent stent encrustation with stones.It is vital to keep your appointment to have the stent removed or changed when planned by your doctor. Stents will begin to form stones over them over time in a process called stent encrustation. Eventually stent encrustation will accumulate and will make the stent very tricky to remove and can cause permanent kidney loss or damage.
•Blood in the urine – it is common for patients to have blood intermittently in the urine with the stent, usually it is the most severe in the first few days after surgery but it can persist for as long as the stent is still in position
•Frequency and urgency – the lower end of the stent is coiled in the bladder, this cause bladder irritation and lead to frequent urination and difficulties postponing urination
•Pain – it is common to have pains in the flank during urination because urine is refluxed back up into the kidney through the stent. A minority of patients have pain all the time due to inflammation and the irritation reason by the stent to the bladder and kidney.
Kidney stones can reason severe pain when it passes into the ureter. This pain is referred to by doctors as renal colic. Renal colic is reason by distension of the kidney because of the blockage of urine flow down the ureter. The pain can be very severe, and will come in waves. Discomfort will persist until the stone is passed into the bladder.
Symptoms may include:
•Severe pain on the back below the ribs on one side
•Pain may also happen over the lower abdomen, groin and during urination
•Pain that fluctuates in intensity
•Frequent urge to urinate
•Pink, brown or red urine that is cloudy or foul smelling
Your doctor will take a medical history and check Up you. A urine test is ordered to see if there is blood in the urine and also the see if there is any infection. Blood tests will be ordered to assess kidney function and signs of infection.
A CT scan is the best test for confirmation of renal colic, and estimate the size and location of the stone. Your doctor will also order an X-ray to see if the stones are visible on X-ray.You should contact your doctor immediately, or visit the emergency department if the pain is severe or if it is accompanied with fever, chills or vomiting.Treatment of renal colic depends on the size and location of the stone causing pain.Stones < 4 mm have a passage rate of 70% after 1-2 weeks. Bigger stones are less likely to pass spontaneously.Passing a stone can reason some discomfort. To relieve the pain, your doctor may recommend painkillers such as paracetamol and ibuprofen. NSAIDs are usually the most effective at controlling pain from renal colic.
Surgery is offered to patients with kidney stones that are too large to pass on their own or because they reason too much pain not controlled with medications. If there is kidney function failure, any signs of infection or a single kidney then emergency surgery to decompress the kidney is necessary.
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