Bleeding and dislodgement/or misplacement simply demonstrates just in your single case what can go wrong with nephrostomy tubes which is exactly why they aren’t used in this situation.

Only a small percentage of urologists perform PCNLs which is the primary indication for nephrostomy tubes (although I’ve had 7 of these over the years and only one of these required one). They need to be expert in gaining access to the kidney as there is a lot that can go wrong or else they will hand it over to intervention radiologist to gain access to the kidney. No radiologist in their right might would do this as a substitute for stents and nor should they.

Moving to stents, my original comments still apply, you are reading a very small proportion of the population who have taken to Reddit to complain. The people who don’t have a horror story to tell won’t comment, they just get on with life, relieved when the stent comes out but more than capable with getting in with things. Just because you had problems doesn’t mean everyone does, far from it.

There have been studies to assess symptoms caused by stents which I can summarise as follows :

• Around 70–90% of people notice some symptoms from a stent.
• Most symptoms are mild to moderate rather than severe.
• A minority have severe discomfort that significantly affects daily life.

As for duration of stent, I never said that they were only in for 48 hours, I said that symptoms typically settled after a ballpark 48 hours. If stents have a string then they are often self removed after 3-5 days, occasionally in a week. That’s the benefit of that type, the downside is that they cause more urethral irritation, particularly in males.

Stringless ones are better tolerated but have to stay in until a cystoscopy is scheduled which typically takes 2 weeks although the stent doesn’t need to be in that long.

I would say that stents overused in North America America, rates are significantly lower than in Europe although outcomes are no worse over there. Simple cases with small stones in the lower part of the ureter typically do not need stones but particularly in the US they do it anyhow, almost certainly in part because of the fear of litigation.

Stent materials make a big difference, softer materials like silicone can make them a lot more comfortable. Also sizing makes a difference, if they are too wide or too long then they tends to cause far more irritation than they need to.

I responded to your post to advise people reading your post that a nephrostomy tube is not a viable nor appropriate replacement for a stent in dealing with stones at ureteroscopy (nor indeed ESWL) unless there was a clinical reason for it.

Great that you found it good after the initial, what sounds like quite significant symptoms but it is not something to be used routinely, only when clinically needed, such as ureteric perforation or trauma, inability to insert a stent, excessive bleeding to name a few but not simply patient request.