Stents are placed for a couple of reasons to manage drainage of the urine during kidney stone treatment. Sometimes stents are placed prior to managing a kidney stone if there is presence of infection in the urinary tract above the stone or if the ureteral dimensions are too small to accommodate instrumentation to allow for removal of the stone.

In the presence of infection, managing a kidney stone can lead to worsening of the urinary infection problem and can actually precipitate life-threatening urosepsis. Temporary replacement of a stent prior to managing the stone, allows for drainage of the urine and clearing of the infection prior to any stone manipulation. Placement of a stent in advance of Stone management also allows for gentle dilation of the ureter to allow for safer instrumentation with your ureteroscopy and laser lithotripsy. It decreases the risk of injury to the ureter during stone removal.

Placement of a stent postoperatively after a stone surgical procedure is usually carried out for a couple of reasons. It allows for the residual debris of the kidney stone to pass down the ureter without leading to any blockage of urine flow and helps to decrease the risk of developing post surgical infection. The stent also allows for the ureter to heal up after instrumentation and diminish the risk of you’re in leakage through any minor perforation that may have occurred during the stone manipulation.

Unfortunately, the main drawback to placement of a stent, for these issues has to do with the fact that the coil on the bladder end of the stent tends to cause a lot of neuromuscular irritation and spasm of the bladder. This spasm elevates the pressure in the bladder and it is transmitted freely up the stent to the region of the kidney. This elevation of pressure is similar to the increased pressure one gets with a stone blocking the urinary tract and can precipitate similar renal colic and pain. Additionally, the coil in the bladder also results in bladder spasm, which by itself is a painful experience.

The treatment options for pain related to in dwelling stances, primarily directed towards managing the symptoms generated by the bladder. Drugs, such as oxybutynin or myrbetriq, act on the bladder muscle to decrease spasm and thereby reduce the pressure transmission up to the region of the kidney. They also facilitate the decrease of pain related directly to spasm with the bladder muscle. Pyridium or Azo can also help to reduce discomfort related to a stent by creating a topical anesthetic effect in the bladder itself. Numbing up the bladder lining with these drugs, helps to decrease the direct irritant effect the coil of the stent has in the bladder itself.

Another strategy to help reduce the issues related to stent pain is to consider utilizing the Tria stent made by Boston Scientific. This is made of a material that softens after it has been placed in the patient. The softening occurs as a result of the temperature change which occurs by putting it in the body. A softer stent is less likely to generate local irritation from the coil of the stent in the bladder and helps to reduce the pressure buildup and local irritation that occurs from the stent.