Top 5 Worst Ureteric Stent Symptoms and Why Early Removal Surgery Matters

By Ivo Dukic, Consultant Urological Surgeon

Introduction: a necessary evil?

Ureteric stents are often called “double-J” or “DJ” stents are one of the most common devices used in urology. They are small plastic tubes placed inside the ureter (the tube that connects your kidney to your bladder) to keep urine flowing freely.

Stents are invaluable when a stone is blocking the kidney, after certain surgical procedures, or when swelling threatens to damage the kidney. Often they can be lifesavers. But living with a ureteric stent can be miserable. For many, the symptoms are far worse than expected. My philosophy is simple — we should always aim to make you stent-free as soon as safely possible, by treating the underlying problem and removing the stent.

Below, are five of the worst symptoms of stents, why they occur, and how we deal with them.

1. Severe Flank or Renal Colic Pain

What patients describe: sudden, intense waves of pain in the side or back, sometimes radiating to the groin. For some, it is a constant ache that flares when moving, passing urine, or even just lying still.

Why it matters: Pain is the most common reason patients come back to hospital after a stent insertion. When severe and unrelenting, pain is not just uncomfortable — it can occasionally mean the stent is blocked, kinked, or not functioning properly. However, this is very unlikely if the stent has been in for less than 3 months. Unrelieved obstruction risks kidney damage.

What we do: If pain is uncontrolled despite medication, we must reassess the stent and / or your current pain medication. Urologists often check the position of the stent with imaging tests such as an X-ray or ultrasound scan. In many cases, the definitive answer is to move forward with surgery — clearing the stone or repairing the ureter — so the stent can come out.

2. Irritative Bladder Symptoms: Frequency, Urgency, and Dysuria

What patients describe: needing to pass urine every 30–60 minutes, including throughout the night. A burning or stinging sensation (“dysuria”) may accompany it. Some patients leak urine when the urge hits, creating embarrassment and loss of confidence.

Why it matters: These symptoms are the single most common complaint in stented patients. The lower curl of the stent irritates the bladder wall, producing symptoms that mimic — and often exceed — those of a urinary infection. Sleep is disturbed, energy levels plummet, and day-to-day life is disrupted.

What we do: We may prescribe alpha-blockers (Tamsulosin) or anticholinergic tablets (Solifenacin) to take the edge off. Some patients find heat pads or lifestyle adjustments helpful. But the honest solution is simple: remove the stent as soon as it is safe to do so, after definitive treatment of the underlying condition.

3. Blood in the Urine (Hematuria)

What patients describe: urine that turns pink, red, or even dark cola-coloured. Sometimes this appears after exercise, lifting, or a busy day; sometimes it’s constant.

Why it matters: Bleeding is caused by the stent rubbing inside the urinary tract. While usually minor, it can be frightening. Heavy bleeding or passage of clots can block urine flow and may require hospital care, however, this is very rare. Persistent bleeding is very common with ureteric stents

What we do: We usually advise rest, hydration, and reassurance if the bleeding is mild. If it continues, we would sometimes request imaging and urine tests. Again, the cure is to remove the stent once it is no longer needed.

4. Recurrent Urinary Tract Infections (UTIs) and Sepsis

What patients describe: fever, chills, worsening bladder symptoms, and occasionally feeling generally unwell. In older patients, confusion can be the first sign.

Why it matters: The stent is a foreign body, and bacteria love to colonise it. While some patients remain infection-free, others experience repeated urinary infecctions. The most serious risk is sepsis — a potentially life-threatening infection that requires urgent hospital care.

What we do: Sending urine cultures and prompt antibiotics treatment is recommended. Urgent stent exchange or removal is sometimes considered as the antibiotics are only a stop gap solution and the bacteria will still be on the stent despite the antibiotics. Definitive treatment and stent removal is usually required.

5. Encrustation, Retained or “Forgotten” Stents

What patients describe: often very little at first — perhaps a return of pain or repeated infections. But when we attempt to remove the stent, we discover it has become encrusted with stone-like deposits.

Why it matters: This is by far the most dangerous long-term complication. The longer a stent remains inside, the higher the risk of mineral build-up. After several months, the stent may become heavily encrusted, fractured, or stuck. Removal can then require major surgery, sometimes in multiple stages. In the worst cases, kidneys can be lost.

What we do: The key is prevention: a clear removal plan at the time of insertion. If a stent has been forgotten or encrusted, we use advanced endourological techniques — ureteroscopy and laser fragmentation as well as percutaneous surgery — to safely remove it. These procedures are complex and avoidable with timely removal. There is a much higher chance of developing sepsis after kidney stone surgery the longer stents are left inside the body.

Why We Aim to Be “Stent-Free” Quickly

Stents serve a purpose: they protect your kidney drainage in a time of risk. However, for many patients they are associated with significant problems including:

• Up to 80% of patients report significant symptoms while a stent is in place.

• The longer a stent remains, the higher the chance of infection and encrustation of the stent.

• Forgotten stents are among the most challenging and high-risk cases in urology.

This is why, whenever possible, we plan surgery — such as ureteroscopy, percutaneous stone surgery, or ureteric repair — as soon as its safe, so the stent can be removed and the patient can return to normal life.

Practical Advice for Patients Awaiting Surgery

While waiting for surgery or stent removal:

• Report your symptoms to your urology team — especially severe pain, bleeding, or fevers.

• Take medications as prescribed; alpha-blockers and painkillers may help but are a temporary relief.

• Stay alert to red flags: fever, rigors, uncontrollable pain, blocked urine, or heavy bleeding — seek emergency care immediately.

• Know your removal date. Always confirm with your team when and how your stent will be taken out. If your stent has been left in for more than 6 months (and this in unplanned, or you are a kidney stone former) you should get in touch with your urologist.

Final Thoughts

As a urologist, I know that for many patients the hardest part of stone treatment is not the surgery — it’s the days or weeks living with a ureteric stent. These devices protect your kidney but at a significant cost in comfort and quality of life.

That is why my focus is always the same: to treat the problem, restore normal drainage, and remove the stent as soon as safely possible. Most of my patients typically have a ureteric stent for a few days following their surgery. These are usually pulled out using some strings which are attached to the stent and are outside the waterpipe in the days after surgery.

If you are struggling with stent symptoms, you are not alone — and you should not suffer in silence. Speak to your urologist about your symptoms and your timeline to become stent-free. The relief, for most, is immediate and dramatic.

Further reliable information regarding ureteric stents is available at:

The British Association of Urological Surgeons

Ivo Dukic is a leading Consultant Urological Surgeon who specialises in the treatment of kidney stones (shockwave lithotripsy, ureteroscopy and PCNL surgery). He is a high-volume stone surgeon who seeks the best possible outcomes of stone free rates and low complications for his patients. You can schedule an appointment with him for expert, bespoke advice through his Top Doctors profile or book an appointment through Harborne Hospital, HCA Healthcare, the Priory Hospital, Edgbaston, Circle Health Group or Droitwich Spa, Circle Health.