Bilateral obstruction - an emergency situation
When the outflow is impaired on both sides, urine becomes scarce or disappears, creatinine rises quickly - the kidneys need to be unloaded within hours. Stenting of both ureters restores the outflow without external tubes and then allows the cause to be treated calmly. If it is impossible to insert a stent (tumor growth), a nephrostomy is installed on one or both sides. Two stents increase dysuric sensations, so alpha blockers are prescribed; replacement - every 3-6 months during prolonged standing.
When to install a stent
- ureteral stone with impaired urine outflow, renal colic, infection or solitary kidney - before the main treatment;
- after contact lithotripsy, ureteroscopy, PCNL, ESWL of large stones - for 1–3 weeks to protect the ureter;
- hydronephrosis due to ureteral stricture, tumor compression, retroperitoneal fibrosis;
- after reconstructive operations on the ureter and pelvis (pyeloplasty, ureterocystoneoanastomosis) - for 4–6 weeks;
- violation of urine outflow during pregnancy (stent before birth);
- preparation for surgery for staghorn stone or kidney infection.
How is stenting performed?
The procedure is performed in the cath lab under local anesthesia with sedation or spinal anesthesia. A cystoscope is inserted through the urethra, the doctor finds the mouth of the ureter and passes a thin guide through it to the renal pelvis under X-ray control. A stent with a diameter of 1.5–2 mm and a length of 24–28 cm is installed along the guidewire; after removing the conductor, its ends are curled into curls, fixing the stent in the pelvis and bladder. The correct position is confirmed by a photograph.
Replacing a stent during long-term standing proceeds in the same way: the old stent is grasped with forceps and removed, and a new one is installed along the guidewire. With unilateral installation, the procedure takes 15–20 minutes, with bilateral installation – up to 30–40. An outpatient option under local anesthesia is possible for most patients.
Feelings with a stent and how long it is worn
The stent is a foreign body, and 60–80% of patients feel it: increased urge, discomfort in the lower abdomen, nagging pain in the lower back when urinating, slight admixture of blood. These symptoms are reduced by alpha blockers and antispasmodics, drinking plenty of fluids, and avoiding heavy exercise. The duration of stay depends on the task: after operations - 1-3 weeks, for strictures and tumors - up to 3-6 months with planned replacement (modern stents - up to 12 months). An expired stent is covered with salts and encrusted, so it must be removed or replaced strictly on time.
Stent removal
The stent is removed on an outpatient basis during cystoscopy under local anesthesia in 5–10 minutes: the lower helix is grasped with forceps and the stent is removed. Some stents are equipped with a thread that extends outward, making removal even easier. After removal, mild discomfort may occur for 1–2 days. This procedure is described separately on the “Ureteral Stent Removal” page.
Ureteral stenting in Tashkent
In the clinics below, stenting is performed in the X-ray operating room, including urgently in case of renal colic with infection, as well as on an outpatient basis under local anesthesia. The price list indicates unilateral and bilateral installation, outpatient and inpatient options, stent replacement; Anesthesia is paid separately. The clinics are open 24 hours a day - if you have acute lower back pain with fever, please contact us immediately.
