DJ stent pain is common after kidney stone surgery such as URSL, RIRS or PCNL. It may cause side pain, lower abdominal pain, burning urination, frequent urination, urgency and mild blood in urine. These symptoms usually happen because the stent irritates the ureter and bladder. Mild symptoms are expected, but fever, unbearable pain, worsening bleeding, inability to pass urine or a stent slipping out should not be ignored. BAUS advises urgent medical contact for constant unbearable pain, infection symptoms, significant increase in blood in urine or stent dislodgement.

What is a DJ stent?

A DJ stent, also called a double J stent or ureteric stent, is a thin hollow tube placed inside the ureter. The ureter is the pipe that carries urine from the kidney to the bladder.

The stent has a curl at both ends. One curl sits in the kidney and the other sits in the bladder. This shape helps the stent stay in position and keeps urine flowing from the kidney to the bladder while the ureter heals or swelling settles.

A urologist may place a DJ stent after:

• URSL for ureter stone.
• RIRS for kidney stone.
• PCNL for large kidney stone.
• Swelling of the ureter after stone surgery.
• Infection with urinary blockage.
• Ureter injury or narrowing.
• Stone fragments that may temporarily block urine flow.

The stent is useful, but it can be uncomfortable while it is inside.

Why does DJ stent pain happen?

DJ stent pain happens because the stent is a foreign body inside a sensitive urinary passage. The upper end may irritate the kidney side, while the lower end may irritate the bladder.

Pain may increase:

• While passing urine.
• At the end of urination.
• After walking.
• After climbing stairs.
• After long travel.
• After heavy activity.
• When the bladder is full.
• When urine is concentrated because of low water intake.

BAUS notes that ureteric stents can cause pain in the kidney area, groin, urethra or genitals, and symptoms may be worse after physical activity or just after passing urine.

Why does kidney pain happen while passing urine?

This is one of the most common complaints with a DJ stent.

During urination, the bladder squeezes to push urine out. Because the stent connects the bladder side to the kidney side, pressure can travel upward along the stent. This may cause a pulling, cramping or sharp pain in the side or back, especially near the end of urination.

This pain can feel worrying. But if it is mild to moderate, comes mainly during urination, and there is no fever, vomiting or worsening pain, it is often stent-related discomfort rather than a new emergency.

DJ stent pain symptoms

The Urology Care Foundation lists burning or pain while passing urine, lower back discomfort and blood in urine as common stent-related symptoms.

DJ stent pain: What is normal and what is not?

Mild symptoms can often be managed with prescribed medicines, fluids and activity adjustment. But infection, blockage, severe bleeding or stent displacement should not be watched at home. BAUS advises urgent medical contact if there is fever, increasing pain, difficulty emptying the bladder, increased bleeding or stent dislodgement.

DJ stent pain relief: What can help?

1. Drink water steadily

Drink fluids through the day unless your doctor has restricted fluids because of kidney, heart or other medical conditions.

For many patients with a stent, BAUS advises about 1.5 to 2 litres of fluid daily to reduce infection risk and blood in urine.

Do not suddenly drink a very large amount of water. A very full bladder may worsen urgency, frequency and bladder pain.

2. Take prescribed pain medicines correctly

Pain medicines can help, but the safest choice depends on your kidney function, acidity, bleeding risk, age and other medicines.

This is especially important after kidney stone surgery. Avoid repeated self-medication if pain is increasing, urine output is reducing, or you have fever or vomiting.

3. Ask about stent-symptom medicines

Some patients get relief with medicines that relax the ureter or bladder. EAU guideline material notes that alpha-blockers can reduce stent-related symptoms and colic episodes.

Research reviews also suggest that alpha-blockers can reduce ureteric stent-related urinary symptoms, pain and quality-of-life impact in selected patients, although benefit may vary between patients.

Other bladder-relaxing medicines may be considered in selected patients with severe urgency, frequency or bladder cramps. These medicines should be used only after medical advice, especially if you have low BP, dizziness, glaucoma, constipation, urinary retention risk or multiple ongoing medicines.

4. Reduce heavy activity for a few days

Light walking is usually fine if your surgery recovery allows it. But if pain or blood in urine increases after activity, reduce:

• Heavy lifting.
• Running.
• Cycling.
• Long stair climbing.
• Long bumpy travel.
• Intense gym workouts.
• Sudden jerky movements.

BAUS notes that sport or strenuous activity may increase kidney-area pain and blood in urine in some patients with a stent.

5. Avoid bladder irritants temporarily

Tea, coffee, cola, alcohol, very spicy food and dehydration can worsen urgency or burning in some patients.

You do not need a strict “stent diet.” But reducing bladder irritants for a few days may help if you are having severe burning, urgency or frequency.

6. Use heat carefully for muscle-type discomfort

A warm compress over the lower abdomen or back may help some patients with cramp-like discomfort. Avoid direct heat over fresh wounds, dressings or numb skin.

Do not use heat as a substitute for medical review if you have fever, vomiting, severe pain or worsening symptoms.

7. Do not pull the stent thread

Some DJ stents have a thread coming out through the urine passage. Do not pull it unless your urologist has specifically told you to remove it yourself.

If the thread moves, the stent slips out or the stent falls out, contact your urologist. BAUS advises patients to take care not to dislodge the thread during washing, urination or physical activity.

What should you not do for DJ stent pain?

Avoid these common mistakes:

• Do not ignore fever.
• Do not keep delaying stent removal.
• Do not take antibiotics without medical advice.
• Do not take repeated painkillers without checking kidney function.
• Do not do heavy exercise if bleeding increases.
• Do not pull the stent thread.
• Do not assume severe pain is always “normal stent pain.”
• Do not miss your follow-up after stone surgery.

A DJ stent is usually temporary. The most important safety step is knowing when it has to be removed or changed.

How long does DJ stent pain last?

DJ stent pain may continue until the stent is removed, but the intensity varies.

Some patients feel much better within two to three days. Others continue to have burning, urgency, frequency, blood in urine or side pain until stent removal.

The removal timing depends on why the stent was placed. Some stents are removed within a few days, while others may stay for a few weeks. BAUS advises patients to contact their urology department if they have not heard about stent removal within four to six weeks of insertion.

Do not forget the removal date. A forgotten stent can develop encrustation, where crystal or stone-like material forms on the stent and makes removal more difficult.

When should you call a urologist?

Call your urologist or seek urgent medical care if you have:

• Fever.
• Chills.
• Severe constant pain.
• Pain that keeps worsening.
• Vomiting with pain.
• Burning urination with fever.
• Difficulty passing urine.
• Inability to pass urine.
• Heavy blood in urine.
• Blood clots in urine.
• Stent slipping out.
• Stent thread pulled accidentally.
• Weakness, dizziness or feeling seriously unwell.

These symptoms may suggest infection, blockage, significant bleeding, stent displacement or another problem that needs examination.

What happens after DJ stent removal?

After DJ stent removal, mild burning, frequency, slight blood in urine or cramp-like pain may happen for a short time. Many patients feel much better once the stent is removed.

Fever, severe pain, heavy bleeding, vomiting or inability to pass urine after removal needs urgent medical care.

Consultation checklist

Bring these documents for DJ stent pain consultation:

• Surgery discharge summary.
• Date of DJ stent insertion.
• Planned stent removal date.
• USG KUB, X-ray KUB or CT KUB reports.
• Urine routine report.
• Urine culture report, if done.
• Serum creatinine report.
• List of current medicines.
• Details of fever, pain timing and urine colour.
• Photo of urine colour if bleeding comes and goes.

FAQs

Related reading

• URSL Surgery for Ureteric Stone: Procedure, DJ Stent and Recovery
• PCNL Surgery for Large Kidney Stone
• Pain After URSL Surgery: What Is Normal?
• Can I Work with a DJ Stent?
• Sex After Kidney Stone Surgery: When Is It Safe?
• Kidney Stone Treatment in Latur
• RIRS Surgery in Latur

References