Pain After URSL Surgery: What Is Normal?
Pain after URSL surgery is common for a few days. Mild burning while passing urine, lower abdominal discomfort, kidney-side pain during urination, frequent urination and light blood in urine can be normal, especially if a DJ stent has been placed. These symptoms should gradually reduce. Severe pain, fever, chills, vomiting, inability to pass urine, heavy bleeding, clots or pain that is not controlled with prescribed medicines is not normal and needs urgent medical advice.
What is URSL surgery?
URSL stands for ureteroscopic lithotripsy. It is a minimally invasive procedure used to treat a stone in the ureter – the tube that carries urine from the kidney to the bladder.
During URSL, a thin telescope is passed through the urinary passage into the bladder and ureter. The stone is broken using laser or another stone-breaking method. Small pieces may be removed, while tiny fragments may pass naturally in urine.
After the procedure, your urologist may place a temporary ureteric stent. This helps urine drain from the kidney to the bladder while swelling or irritation settles. Guidelines support selective stenting after ureteroscopy rather than routine stenting in all uncomplicated cases.
Pain after URSL surgery: what is usually normal?
Some pain is expected because the ureter and bladder have been touched during the procedure. Pain is usually more noticeable when a DJ stent is present.
| Symptom | What it may feel like | Usually normal if |
|---|---|---|
| Burning urine | Mild burning or stinging while passing urine | It reduces over a few days |
| Light blood in urine | Pink, red or tea-coloured urine | It is light and not worsening |
| Kidney-side pain | Pain in the flank or back on the operated side | It is mild to moderate |
| Pain during urination | Kidney-side pain while passing urine | Common with a stent |
| Frequent urination | Going often, urgency, bladder pressure | No fever or severe pain |
| Tiredness | Low energy after anaesthesia and surgery | Improves with rest |
Mild discomfort can be part of recovery. But fever, worsening kidney pain, severe pain while passing urine, inability to pass urine or worsening bleeding should be checked urgently.
Why does pain happen after URSL?
Pain after URSL can happen because of:
- Swelling inside the ureter after stone treatment.
- Irritation caused by the telescope.
- Passage of tiny stone fragments.
- Bladder irritation after the procedure.
- DJ stent-related discomfort.
- Urine moving upward toward the kidney during urination when a stent is present.
The most important thing is the pattern. Pain that is mild, controlled and improving is usually part of recovery. Pain that is severe, increasing or associated with fever is not normal.
Normal pain vs warning pain after URSL surgery
| Situation | Usually normal | Needs urgent review |
|---|---|---|
| Pain severity | Mild to moderate | Severe or unbearable |
| Pain trend | Improving gradually | Getting worse day by day |
| Pain medicines | Pain controlled with prescribed medicines | Pain not controlled |
| Urine colour | Light pink/red urine | Heavy bleeding or clots |
| Urination | Burning and frequency | Unable to pass urine |
| Fever | No fever | Fever or chills |
| General condition | Mild tiredness | Vomiting, dizziness, weakness or feeling very unwell |
How long does pain last after URSL surgery?
Most patients feel better within a few days. If a DJ stent is placed, symptoms may continue until the stent is removed.
| Time after URSL | What you may notice |
|---|---|
| First 24-48 hours | Burning urine, blood in urine, flank pain, tiredness |
| Day 3-7 | Pain usually reduces; stent symptoms may continue |
| Until stent removal | Frequency, urgency, bladder pain or kidney-side pain |
| After stent removal | Mild cramps, burning or blood in urine for 24-48 hours in some patients |
| Few weeks | Occasional passage of tiny stone fragments |
Recovery depends on stone size, stone location, infection before surgery, ureter swelling, operative difficulty, residual fragments and whether a stent was placed.
DJ stent pain after URSL
A DJ stent is a temporary internal tube placed between the kidney and bladder. It is not visible from outside unless a thread has been left for planned removal.
A DJ stent can cause:
- Frequent urination.
- Urgency.
- Burning urine.
- Bladder pain or pressure.
- Blood in urine, especially after activity.
- Kidney-side pain during urination.
- Disturbed sleep due to repeated urination.
Stent-related symptoms are a common reason patients feel uncomfortable after ureteroscopy. A Cochrane review notes that ureteric stents are commonly used after ureteroscopy and may be indicated in situations such as infection, renal failure, ureteric injury or severe swelling.
Does every URSL surgery need a DJ stent?
No. A DJ stent is not always needed after uncomplicated ureteroscopy. NICE recommends not routinely offering post-treatment stenting to adults after ureteroscopy for ureteric stones less than 20 mm.
EAU guidance also states that routine stenting after uncomplicated ureteroscopy is not necessary. The AUA guideline similarly says clinicians may omit a postoperative ureteral stent after uncomplicated ureteroscopy in adult patients.
A stent may still be placed if there is ureteric swelling, infection risk, residual fragments, bleeding, ureteric injury risk, kidney swelling, a tight ureter or a planned second procedure.
What should you do if you have pain after URSL?
First, check three things:
- Is the pain controlled with prescribed medicines? If yes, it is more likely to be part of expected recovery.
- Is the pain improving or worsening? Gradually improving pain is reassuring. Worsening pain needs review.
- Is there fever, vomiting, heavy bleeding or inability to pass urine? These are warning signs and should not be managed at home.
Do not judge pain only by intensity. A patient with mild pain but fever may need urgent care. A patient with moderate stent discomfort but no fever, no vomiting and improving symptoms may only need routine follow-up.
What can you do at home for normal pain?
Follow your discharge instructions first.
Drink adequate water unless your doctor has restricted fluids. Do not force excessive water if it worsens pain or if you have kidney, heart or fluid-restriction issues.
Take only prescribed medicines. These may include pain medicines, antibiotics, urine symptom medicines or stent-related medicines. EAU guidance notes that alpha-blockers can reduce stent-related symptoms and colic episodes after ureteroscopy, but they should be taken only if prescribed for you.
Avoid heavy exercise, long bike rides, heavy lifting and strenuous travel for a few days, especially if bleeding increases after activity.
Light walking is usually fine.
Do not miss your DJ stent removal date. A forgotten stent can lead to infection, stone formation, blockage and more complicated treatment later.
What should you avoid after URSL?
Avoid these until your urologist clears you:
- Heavy gym workouts.
- Long-distance travel soon after surgery.
- Riding a bike or two-wheeler for long periods if stent pain increases.
- Taking leftover antibiotics without advice.
- Taking strong painkillers repeatedly without review.
- Missing your stent removal date.
- Assuming all pain is normal if it is worsening.
When should you call your urologist urgently?
Call your urologist or seek emergency care if you have:
- Fever or chills.
- Severe kidney-side pain.
- Pain not relieved by prescribed medicines.
- Vomiting or inability to drink fluids.
- Inability to pass urine.
- Heavy bleeding or clots.
- Burning urine with fever.
- Worsening weakness or dizziness.
- Severe pain after DJ stent removal.
These symptoms may suggest infection, blockage, significant bleeding, severe stent discomfort or another complication that needs evaluation. An obstructed kidney with signs of infection or no urine output is considered a urological emergency.
Return to work, travel, exercise and sex
You can return to desk work when pain, burning and tiredness are controlled. Many patients need a few days.
Short travel is usually possible once pain is controlled and there is no fever, vomiting or heavy bleeding. Long travel is better avoided until your follow-up and stent plan are clear.
Light walking is fine. Avoid heavy gym workouts until bleeding settles and your urologist clears you.
Sex can usually be resumed once pain and bleeding settle. If a stent thread is visible outside, ask your urologist before sexual activity.
Consultation checklist: what to bring
Bring these for your follow-up visit:
- URSL discharge summary.
- Operative notes, if available.
- Pre-operative CT KUB or USG report.
- X-ray KUB, USG KUB or CT report after surgery.
- Urine routine and urine culture reports.
- Serum creatinine report.
- List of current medicines.
- DJ stent removal date, if mentioned.
- Stone analysis report, if available.
- Photos of urine colour or clots, if bleeding is intermittent.
FAQs
Is pain after URSL surgery normal?
Yes. Mild to moderate pain after URSL surgery is common for a few days. It is more common if a DJ stent has been placed. The pain should gradually improve and remain controlled with prescribed medicines.
Why do I get kidney pain while passing urine after URSL?
This often happens because of a DJ stent. During urination, bladder pressure can cause discomfort that is felt in the kidney area. Severe or worsening pain should be checked.
How much blood in urine is normal after URSL?
Light pink or reddish urine can be normal after URSL, especially with a stent or after activity. Heavy bleeding, clots, inability to pass urine or worsening bleeding is not normal.
How long does DJ stent pain last after URSL?
DJ stent pain may continue until the stent is removed. Some patients feel only mild discomfort, while others have frequency, urgency, bladder pain or kidney-side pain.
Is severe pain after stent removal normal?
Mild cramps or burning can happen after stent removal. Severe pain, fever, vomiting or inability to pass urine after stent removal should be reviewed urgently.
Can I remove my DJ stent myself?
No, unless your urologist has specifically placed a stent with a string and given clear instructions. Most DJ stents are removed by a urologist in a planned procedure.
Can I go to work with a DJ stent after URSL?
Many patients can do desk work with a DJ stent if pain, bleeding and urgency are manageable. Heavy physical work may worsen pain or bleeding and should be discussed with your urologist.
Why does pain increase after walking?
Walking can sometimes increase stent irritation, bladder discomfort or blood in urine. Mild increase that settles with rest can happen. Severe pain, heavy bleeding or clots need review.
Related reading
- Kidney Stone: Symptoms, Causes and Treatment
- URSL Surgery for Ureteric Stone: Procedure, DJ Stent and Recovery
- DJ Stent Pain: Symptoms, Relief and When to Worry
- Burning Urination After DJ Stent: What Is Normal?
- Blood in Urine After Kidney Stone Surgery: What Is Normal?
- Kidney Stone Doctor in Latur
References
- European Association of Urology. Guidelines on Urolithiasis https://uroweb.org/guidelines/urolithiasis/chapter/guidelines
- NICE Guideline NG118. Renal and Ureteric Stones: Assessment and Management https://www.nice.org.uk/guidance/ng118/chapter/recommendations
- British Association of Urological Surgeons. Ureteroscopy for stones patient information https://www.baus.org.uk/patients/information_leaflets/185/ureteroscopy_for_stones
- American Urological Association. Surgical Management of Kidney and Ureteral Stones Guideline https://www.auanet.org/guidelines-and-quality/guidelines/surgical-management-of-kidney-and-ureteral-stones
- Ordonez M, et al. Ureteral stent versus no ureteral stent for ureteroscopy. Cochrane Review https://pmc.ncbi.nlm.nih.gov/articles/PMC6365118/