What you need to know about:

Ureteral Stenting (Double J Stent, JJ Stent)

Fast Fact

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Average Cost:

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Recovery Period:

Same day discharge

Permanence:

6 weeks - 6 months

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Time it takes:

3-4 minutes

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Anesthetize:

Local Anesthesia

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Overview of

Ureteral Stenting (Double J Stent, JJ Stent)

in Thailand

Ureteral stenting (also known as double J stent) is the procedure to place a thin, flexible plastic tube that is temporarily in the ureter to help urine drain from the kidney into the bladder in the case of a blockage. The ureters carry urine from the kidneys to the bladder. (Each kidney is connected to one ureter.) In rare cases, both ureters may be blocked, in which case bilateral ureteral stents are placed, one in each ureter. The stent may remain from days to weeks and even months, depending on the situation. A ureteral stent may also be placed during or after urinary tract surgery to provide a mold around which healing can occur, to divert urine away from areas of leakage, to manipulate kidney stones or prevent stones from moving prior to treatment, or to make the ureters more easily identifiable during surgical procedures.

Goals of

Ureteral Stenting (Double J Stent, JJ Stent)

Stents are used for various reasons in patients with kidney stones. They can be placed to help reduce sharp pain from a stone (renal colic) or to allow drainage when infection is present or when a stone prevents a kidney from working adequately. Stents are commonly placed after surgery for stones (for example, ureteroscopy) to allow healing and to ensure that swelling does not block the drainage of urine after the procedure.

Price of

Ureteral Stenting (Double J Stent, JJ Stent)

Average Cost

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Pros and cons of

Ureteral Stenting (Double J Stent, JJ Stent)

Pros

-Definitive approach to helping relieve obstruction and allow urine flow from the kidney

Cons

-Patients with stents seem to have significantly more pain and irritative voiding symptoms.

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How it works:

Ureteral Stenting (Double J Stent, JJ Stent)

The doctor will insert a cystoscope through the urethra and into the bladder, visualizing the opening to the ureter. A thin wire is then guided through the cystoscope, up the ureter, and into the kidney. The stent is inserted over the wire. A fluoroscope, a kind of x-ray machine, may be used to position the stent. The wire and cystoscope are then removed. When it is time to remove the stent, the same method is used. A cystoscope is inserted through the urethra and into the bladder and the stent is grasped with a small instrument and removed. You will be awake during this procedure and will only require a local anesthetic.

Preparation before

Ureteral Stenting (Double J Stent, JJ Stent)

Pre - treatment

Ureteral obstruction may be diagnosed with a cystoscopy, where a thin tube is inserted into the bladder to visualize it, ultrasound, computed tomography (CT) scan, and/or pyelography, where x-rays are taken of the urinary tract after a contrast dye has been injected. Placement of the stent is done using general anesthesia, so you will likely need to undergo a thorough health screening as well as blood tests, chest x-ray, and electrocardiogram (EKG). Please avoid all food and water for 6-8 hours before the procedure, or as recommended by the doctor. Please also let your doctor know about all medication that you are taking as some may need to be stopped before the procedure.

Recovery after

Ureteral Stenting (Double J Stent, JJ Stent)

Post - treatment

Some discomfort is normal while you have a stent. Certain movements may trigger pain or the need to urinate. You may also experience some soreness or pressure before or during urination. These symptoms usually disappear after the stent is removed. You may be prescribed medication for pain, infection, and/or bladder spasms. Make sure that you drink plenty of water to flush out the urinary tract. Blood in the urine is normal, caused by the irritation of the stent. It may occur on and off while you have the stent. During an appointment in the hospital, your doctor will tell you when the double-J stent needs to be removed. This can be in several days or within a few weeks.

Risks & side effects

·Bleeding ·Pain in the back, bladder, groin, and penis (in men) or urethra (in women) ·Urine leakage in some women ·Catheter migration or dislodgement ·Coiling of the stent within the ureter, causing abdominal pain during urination, urinary frequency, or blood in the urine ·Infection, or worsening of an existing one ·Penetration of adjacent organs ·Reaction to anesthesia

FAQs:

Ureteral Stenting (Double J Stent, JJ Stent)

What are the recommendations for travel for this procedure?

If you are taking any blood-thinning medication/anticoagulant, please let your doctor know as some may need to be stopped before you travel for the procedure. Travelers to Thailand should plan to stay in the country for at least two to five days after the procedure, depending on their condition after surgery, or for the entire duration of treatment. If you plan to return home after the procedure, please speak to your doctor before making travel arrangements. There are no restrictions for air travel. During your follow-up appointment your medical team will assess your health and your incision and you will receive documents detailing your medical and treatment history and your "Fit to Fly" certificate (if needed). "

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When is the double-J stent removed?

During an appointment in the hospital, your doctor will tell you when the double-J stent needs to be removed. This can be in several days or within a few weeks.

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How is the stent removed?

Stents can be removed two different ways. Sometimes a string has been left attached to the end of the stent. This string is allowed to come out of the patient’s urethra (the tube that transports the urine from the bladder to the outside of the body). The string can be used to pull on the stent and remove it. If a string is not attached, numbing medication is usually administered, and a small camera called a cystoscope is inserted into the urethra. The cystoscope is advanced into the bladder along with a grasping instrument, which grasps and removes the stent.

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What can I expect after removal of the stent?

You may have bloody urine, possibly with some small clots. You may also have “achy” pain due to ureteral spasms. This generally only last a few hours, but should resolve over the next 2-3 days. Sometimes, mild discomfort can last up to 2 weeks. You may also have burning with urination, with urinary frequency as well.

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What changes to my lifestyle do I need to make?

In order to prevent the occurrence of kidney stones, you will need to make some life style changes. These may include: -Increasing fluid intake: Drink 2.5-3.0 litres per day to neutralize the pH of your urine -Adopting a balanced diet with less meat and alcohol and more vegetables and fiber to have normal calcium levels and less intake of animal proteins -Maintaining a healthy weight and adequate physical activity

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