DJ Stent Removal: When Is a DJ Stent Removed?
A DJ stent is usually removed within a few days to a few weeks after kidney stone surgery. After uncomplicated URSL or RIRS, many stents are removed in about 1–2 weeks. If there was infection, pus, ureter swelling, ureter injury, large stone burden or residual stone fragments, it may need to stay longer. The key rule is: every DJ stent should have a removal date or exchange plan. If you have a DJ stent and no removal date, contact your urologist. BAUS advises patients to contact their urology team if they have not heard about stent removal within 4–6 weeks.
What is a DJ stent?
A DJ stent, also called a double-J stent or JJ stent, is a thin plastic tube placed inside the ureter. The ureter is the tube that carries urine from the kidney to the urinary bladder.
The stent has two curled ends. One end stays in the kidney and the other stays in the bladder. These curls help keep the stent in position.
The main purpose of a DJ stent is to keep urine flowing while swelling settles or the ureter heals.
Why is a DJ stent placed after kidney stone surgery?
A DJ stent may be placed after:
- URSL for ureter stone.
- RIRS for kidney stone.
- PCNL for large kidney stone.
- Emergency drainage for infected obstructed kidney.
- Difficult stone surgery.
- Ureter swelling, narrowing or injury.
After ureteroscopy, a temporary stent may cause pain, kidney or bladder discomfort, urgency and frequent urination while it remains inside. NIDDK notes that a ureteral stent may be left for a few days to a week or more, and cystoscopy may be needed to remove it.
DJ stent removal timing after stone surgery
| Situation | Usual removal timing |
|---|---|
| Simple URSL for ureter stone | 5–14 days |
| RIRS for kidney stone | 1–3 weeks |
| PCNL for large kidney stone | 1–3 weeks, sometimes longer |
| Stent with thread/string | Usually less than 1 week, only as advised |
| Infection, pus or severe swelling | Several weeks may be needed |
| Ureter injury or narrowing | Longer planned stenting |
| Long-term obstruction | Planned stent exchange schedule |
These are general ranges. Your exact DJ stent removal date depends on your stone size, surgery findings, infection status, kidney swelling, ureter condition and whether another procedure is planned.
The 3 questions every patient with a DJ stent should know
Before leaving the hospital or at your first follow-up, ask your urologist:
1. Why was the stent placed?
Was it for swelling, infection, ureter healing, residual stone fragments, safety after stone surgery or long-term blockage?
2. When should it be removed?
Ask for a clear date or date range. Do not rely only on memory.
3. What if removal is delayed?
Ask whether you need removal, stent exchange, urine testing or repeat imaging if symptoms continue.
This simple habit helps prevent a forgotten DJ stent.
Not every patient needs a stent after ureteroscopy
Some patients ask, “Why did I need a stent when someone else did not?”
That can happen. In selected uncomplicated ureteroscopy cases, a stent may be avoided. AUA guidance allows stent omission in selected patients when criteria such as normal opposite kidney, normal kidney function, no ureter injury, no obstruction to stone fragment clearance and no planned second ureteroscopy are met.
But if there was swelling, bleeding, infection risk, large stone burden, ureter injury or concern about drainage, your urologist may place a DJ stent for safety.
Planned delay vs forgotten DJ stent
A DJ stent is usually temporary. It should be removed or changed as advised.
A planned delay is different from a forgotten stent.
| Planned delay | Forgotten stent |
|---|---|
| Your urologist knows about it | No one is tracking it |
| There is a reason | Patient is unsure why it is still there |
| There is a removal or exchange date | No clear date |
| Follow-up is planned | Follow-up is missed |
A planned delay can be safe. A forgotten stent can become risky.
Forgotten ureteral stents can migrate, encrust, fracture and may lead to serious infection or kidney-related complications. A 2024 systematic review found encrustation and urinary tract infection were common in forgotten stent cases.
What should you do if you do not know your stent removal date?
Do not wait silently.
Check your:
- Discharge summary.
- Stent card.
- Operation notes.
- Hospital message.
- Follow-up appointment slip.
If the date is not clear, call your urologist or hospital and ask:
“I have a DJ stent. When should it be removed or changed?”
This is especially important if the stent has already been inside for more than 4–6 weeks and no removal date has been given.
How is DJ stent removal done?
Most DJ stents are removed by cystoscopy.
In cystoscopy, a thin camera is passed through the urine passage into the bladder. The bladder end of the stent is seen, held with a small instrument and gently removed.
It is usually a short procedure. It may be done:
- In OPD or daycare setup.
- With local anaesthetic jelly.
- Under short anaesthesia in selected patients.
- With antibiotic precautions if infection risk is present.
Some stents have a thread or string coming out through the urine passage. These may sometimes be removed without another cystoscopy, but only if your urologist has clearly instructed you. Do not pull a stent string by yourself unless you have been told to do so.
Is DJ stent removal painful?
DJ stent removal is usually uncomfortable, not severely painful.
You may feel:
- Burning.
- A pulling sensation.
- Urgency to pass urine.
- Mild lower abdominal discomfort.
- Mild kidney-side pain.
Most discomfort settles quickly. Mild burning or frequent urination can continue for 24–48 hours.
What is normal after DJ stent removal?
After DJ stent removal, these symptoms can be normal for a short time:
- Mild burning urination.
- Slight pink urine.
- Mild flank pain.
- Frequent urination.
- Urgency.
- Mild bladder discomfort.
After cystoscopy or ureteroscopy, small amounts of blood in urine, burning, increased frequency and discomfort can occur, but these should gradually settle.
Red flags after DJ stent removal
Contact your urologist urgently or seek emergency care if you have:
- Fever or chills.
- Severe flank pain.
- Inability to pass urine.
- Bright red bleeding.
- Thick blood clots in urine.
- Vomiting with pain.
- Burning urination worsening after 48 hours.
- Severe weakness, dizziness or fainting.
- Pain not improving with prescribed medicines.
NIDDK advises medical care after cystoscopy or ureteroscopy if a patient cannot urinate, has fever, severe discomfort, bright red urine or blood clots.
Activity after DJ stent removal
Many patients can return to routine work the same day or next day if they feel comfortable.
You may need more rest if:
- Anaesthesia was used.
- There is pain or burning.
- You recently had fever or infection.
- Your work involves heavy lifting.
- You had complex stone surgery recently.
Avoid heavy exercise, cycling, long-distance travel and sexual activity until pain, bleeding and weakness settle. For many patients this is only a short pause, but it depends on the surgery, infection status and symptoms.
Tests before DJ stent removal
Not every patient needs tests before stent removal. Depending on your case, your urologist may advise:
- Urine routine/microscopy.
- Urine culture.
- Serum creatinine.
- X-ray KUB.
- Ultrasound KUB.
- CT KUB in selected cases.
Testing is more likely if you had fever, infection, large stone burden, residual fragments, persistent pain or kidney swelling.
Consultation checklist: what to bring
Bring these for your DJ stent removal visit:
- Discharge summary.
- Operation notes, if available.
- Stent card or stent insertion date.
- USG KUB / X-ray KUB / CT KUB reports.
- Urine routine report.
- Urine culture report, if done.
- Serum creatinine report.
- List of current medicines.
- Details of fever, burning, pain or blood in urine.
- Blood thinner details, if taking aspirin, clopidogrel, warfarin, apixaban or rivaroxaban.
FAQs about DJ stent removal
Is DJ stent removal compulsory?
Yes. Most DJ stents are temporary. They should be removed or changed as advised. A forgotten stent can cause infection, stone deposits and difficult removal.
How long can a DJ stent stay safely?
It depends on the stent type and reason for placement. Many short-term stents are removed within days to weeks. If your stent has been inside for 4–6 weeks and you have no removal date, contact your urologist.
Is DJ stent removal done under anaesthesia?
Many removals are done with local anaesthetic jelly using cystoscopy. Some patients may need short anaesthesia depending on pain tolerance, anxiety, age, anatomy or clinical situation.
Can I remove a DJ stent string at home?
Only if your urologist has clearly instructed you. Do not pull a stent string on your own without medical advice.
Is blood in urine normal after DJ stent removal?
Slight pink urine can happen for a short time. Bright red bleeding, clots or inability to pass urine needs urgent medical attention.
Will kidney pain stop after DJ stent removal?
Many stent-related symptoms improve after removal. Mild pain can continue for 24–48 hours. Severe or worsening flank pain needs medical review.
Can I travel after DJ stent removal?
Short travel is usually possible if you feel well. Avoid long travel if you have fever, severe pain, heavy bleeding, vomiting or recent complications.
What happens if DJ stent removal is delayed by a few days?
A short planned delay of a few days is usually not a problem. But repeated delay without urologist review is not safe. Always confirm the new removal date.
Can a DJ stent stay without symptoms?
Yes. Some patients have very mild symptoms. Lack of pain does not mean the stent can be ignored. The removal or exchange plan still matters.
Related reading
- RIRS Surgery for Kidney Stone
- URSL Surgery for Ureteric Stone: Procedure, DJ Stent and Recovery
- Can I Work with a DJ Stent?
- Pain After RIRS Surgery: What Is Normal?
- Sex After Kidney Stone Surgery: When Is It Safe?
- Kidney Stone Treatment in Latur.
References
- British Association of Urological Surgeons. Ureteric stent insertion/removal patient information https://www.baus.org.uk/_userfiles/pages/files/Patients/Leaflets/Ureteric%20stent%20insertion.pdf
- NIDDK. Cystoscopy and ureteroscopy https://www.niddk.nih.gov/health-information/diagnostic-tests/cystoscopy-ureteroscopy
- Hiller SC, et al. Appropriateness criteria for ureteral stent omission following ureteroscopy https://pmc.ncbi.nlm.nih.gov/articles/PMC9432824/
- Wang X, et al. Forgotten ureteral stents: a systematic review of literature. BMC Urology, 2024 https://pmc.ncbi.nlm.nih.gov/articles/PMC10913558/
- Healthcare Safety Investigation Branch. Unplanned delayed removal of ureteric stents https://www.hssib.org.uk/patient-safety-investigations/unplanned-delayed-removal-of-ureteric-stents/investigation-report/
- Alberta Health. Ureteral stent removal: what to expect at home https://myhealth.alberta.ca/Health/aftercareinformation/pages/conditions.aspx?hwid=abs2499