Patients who have lived with a double-J ureteral stent for days or weeks often approach removal day with a mix of relief and apprehension, unsure exactly what the appointment will involve. Double J stent removal is generally a brief outpatient procedure, and understanding the two common methods — string removal or cystoscopic removal — along with what sensations to expect can help ease uncertainty going into the visit. This article walks through what typically happens before, during, and after stent removal, based on generally established urologic practice.
Which Removal Method Will Be Used: String or Cystoscopy?
There are two commonly used approaches to double J stent removal, and which one applies depends on how the stent was originally placed. Some stents are placed with an external string, sometimes called a retrieval string, that runs from the bladder end of the stent out through the urethra and is taped to the patient. When a string is present, removal can often be performed by simply and steadily pulling the string in a clinic setting, without the need for a scope. Most stents, however, are placed without an external string, in which case removal requires a cystoscopy — a procedure where a physician passes a thin, flexible or rigid scope through the urethra into the bladder to visualize and grasp the coiled end of the stent before withdrawing it. The treating physician determines which method was used at placement and will explain the applicable removal approach ahead of the appointment.
What Happens During a Cystoscopic Stent Removal?
For a cystoscopic removal, the patient is typically positioned similarly to other outpatient urologic exams, and a topical anesthetic gel is commonly applied to the urethra before the scope is introduced to reduce discomfort during the procedure. The physician advances the cystoscope into the bladder, locates the curled end of the stent, and uses a small grasping instrument passed through the scope to secure the stent before withdrawing both the scope and stent together. The procedure is generally brief, often completed within several minutes, and is typically performed without sedation in an outpatient clinic setting, though practice can vary by provider and by patient-specific factors. Patients commonly report a sensation of pressure or a brief pulling feeling as the stent passes through the urethra, which typically resolves quickly once the stent is out.
What Does String Removal Feel Like by Comparison?
When a retrieval string is used, removal tends to be faster and is often described by patients as less involved than cystoscopy, since no scope is required. The physician or clinician grasps the external string and withdraws the stent with steady traction. Patients commonly report a brief pulling or cramping sensation during the moment of withdrawal, similar in character to what is reported with cystoscopic removal, though the overall appointment is often shorter. As with cystoscopic removal, individual experience varies, and any procedure-related questions should be directed to the physician performing the removal.
What Symptoms Are Common in the Hours and Days After Removal?
After either removal method, it is commonly reported that patients notice mild burning during urination, occasional light blood in the urine, and some urinary urgency or frequency for a short period following the procedure — symptoms generally attributed to irritation from the stent's presence and its removal rather than a new complication. These effects are typically described as improving over the following day or two. Symptoms that should prompt patients to seek immediate medical care include heavy or persistent bleeding, high fever, significant flank pain, or an inability to urinate. A qualified physician determines whether any post-removal symptom warrants further evaluation, and patients are generally encouraged to reach out to their urology provider with any concerns rather than waiting for a scheduled follow-up.
Stent Design Considerations Relevant to the Removal Experience
The stent product used can factor into the removal experience to some degree, since material flexibility and surface characteristics affect how the coiled end moves through the urethra. UroFlow Ureteral Stents, manufactured by INVAMED from polyurethane (PUR) with an optional phosphorylcholine (PC) surface treatment, are positioned by the manufacturer as designed with patient comfort in mind across the indwelling period, which can include the removal process. Additional detail is available on the UroFlow Ureteral Stents page, and readers can browse the broader urology and incontinence management category for related devices.
How soon can normal activity resume after stent removal?
Many patients resume typical daily activities within a day of removal, though this varies based on individual recovery and the reason the stent was originally placed. A treating physician can provide guidance specific to a patient's situation, including any activity restrictions tied to the underlying urologic condition.
Device availability and regulatory status vary by country. Please contact INVAMED or your authorized local distributor for current regulatory information applicable to your region.