What Is a DJ Stent and How Long Does It Stay In? Living with a Stent

After kidney stone surgery, hearing “we have put a stent in” is new and confusing for many patients. A stent is a temporary aid that will be removed within a short time, but the person who has one needs to know a few things. In this article we explain what a DJ stent is for, everyday life with a stent and why a stent must never be forgotten.

What is a DJ stent?

A DJ stent (double-J stent) is a thin, soft and flexible tube placed in the tube that carries urine between the kidney and the bladder (the ureter). It takes its name from the J-shaped curls at each end: one end curls in the kidney and the other in the bladder, keeping the stent in place. The stent stays entirely inside the body; it cannot be seen from the outside and does not require a bag. Some stents, however, have a thin string that extends out through the opening of the urethra.

Why is a DJ stent fitted?

The main purpose of a stent is to allow urine to flow freely from the kidney to the bladder. It is most often fitted in the following situations:

• After stone surgery: After RIRS, ureteroscopy or PCNL, swelling can develop in the ureter and fragments of the broken-up stone can cause a temporary blockage. The stent protects the kidney during this period.
• Blockage and infection caused by a stone: When a stone blocks the urinary tract and an infection develops in the kidney, urine flow is first restored with a stent; the stone is treated later.
• Blockage in pregnancy: It can be used as a temporary solution for blockage caused by a stone or by pressure during pregnancy.
• Ureteric strictures and external pressure: It can be used long term when urine flow is impaired because of a stricture, a tumour or pressure from surrounding tissues.

The stent is usually placed during surgery, under anaesthetic and without any incision, using a thin camera passed up through the urethra. For stone treatment options, see the kidney stone treatment page.

Which symptoms are normal with a DJ stent?

A stent is a foreign body, and the end in the bladder in particular can cause irritation. Many people experience the following:

• Frequent urination and a sudden feeling of urgency
• Burning when passing urine or discomfort in the bladder area
• Pain in the side when passing urine: This is caused by urine flowing back up along the stent towards the kidney during urination.
• Slight blood in the urine: Pink urine, especially after movement and exercise
• Mild pain in the groin or side that gets worse with movement

These symptoms vary from person to person; some patients barely notice the stent, while others feel significant discomfort. Your doctor may recommend medicines that relax the bladder or the muscles of the urinary tract to ease the symptoms. Drinking plenty of fluids reduces both the bleeding and the burning.

What is everyday life like with a DJ stent?

• Work: Most people with desk jobs can return to work within a few days. For people doing heavy physical work, the timing is decided together with the doctor.
• Sport: Walking is fine. Running, heavy lifting and intense exercise can increase the blood in the urine and the pain.
• Fluid intake: Unless you have to restrict fluids because of heart or kidney disease, drink water regularly throughout the day so that your urine stays pale.
• Travel: You can travel by car and by plane with a stent. On long journeys, planning toilet stops makes things more comfortable.
• Sex: There is usually no problem; if it causes discomfort, you can take a break for a few days.
• Stent with a string: Take care that the string does not catch on clothing or get pulled. The string is usually taped to the skin of the penis or groin.
• Imaging: If you are going to have an MRI or another test, always mention that you have a stent.

What can be done to ease stent symptoms?

• Spread your fluids across the day: Rather than drinking a large amount at once, drink water at regular intervals throughout the day.
• Cut down on drinks that irritate the bladder: Coffee, tea, fizzy drinks and alcohol can make the feeling of urgency worse.
• Do not hold your urine for long: A full bladder and the backflow during urination can make side pain more noticeable.
• Take medicines as recommended: Take the painkillers and bladder-relaxing medicines you have been given at the prescribed dose and for the prescribed time; ask before adding any other medicine.
• Watch the colour of your urine after intense activity: If the pink colour does not clear with rest and fluids, let your doctor know.

How long does a DJ stent stay in?

The length of time depends on why the stent was fitted:

• After uncomplicated stone surgery: Usually between a few days and a few weeks
• If it was fitted urgently because of infection or blockage: Until the infection has been treated and the stone surgery has been done
• With long-term use (stricture, external pressure): Stents are changed at set intervals, usually every few months

You will be told when the stent is to be removed or changed when you are discharged. Make sure you write this date down.

How is a DJ stent removed?

• Stent with a string: It is removed in a few seconds in the clinic by gently pulling the string.
• Stent without a string: It is removed in a few minutes with a local anaesthetic gel, using a thin camera passed up through the urethra (cystoscopy).

In the first hours after the stent is removed, there may be brief pain in the side and slight blood in the urine; this usually settles on its own. Drinking plenty of fluids makes this period easier.

Why is a forgotten DJ stent dangerous?

A DJ stent is not designed to stay in permanently. A stent that stays in for much longer than planned, in other words a forgotten stent, can cause serious problems:

• Encrustation and stone formation: Minerals in the urine build up on the surface of the stent and form stones around it.
• Blockage: An encrusted stent can obstruct urine flow and block the kidney.
• Recurrent infections
• The stent breaking or fragmenting
• Loss of kidney function

Removing a stent that has been forgotten for a long time can sometimes require more than one operation instead of a simple cystoscopy. For this reason:

1. Save the stent removal or change date as a reminder on your phone.
2. Keep the stent information sheet you are given on discharge.
3. Book your appointment in advance as the date approaches.
4. If you have moved to another city or are seeing a different doctor, always tell them that you have a stent.

When should you seek help immediately with a DJ stent?

With the following symptoms, contact your doctor or go to the nearest emergency department without waiting:

• A fever of 38 °C or above, shivering
• Severe pain in the side that does not settle despite painkillers
• Being unable to pass urine at all, or a marked drop in the amount of urine
• Bleeding with clots, heavy bleeding or bleeding that is getting worse
• The stent coming out through the urethra, or the string of a stent with a string breaking
• Nausea and vomiting that will not stop

For other symptoms that need attention without waiting, see our article on urological emergencies, and to tell side pain apart, see our article on kidney pain.

When should you see a urologist?

See a urologist if your symptoms while the stent is in place are significantly affecting your daily life, if you do not know your stent removal date, or if the date has passed and your stent is still in place. Bringing your operation report and discharge documents with you makes the assessment easier.

Op. Dr. Mücahit Kabar sees patients in Bursa (Nilüfer), Turkey, at Özel Medicabil Nilüfer Hastanesi (weekdays 08:30–12:00, +90 444 8 112) and Özel Jimer Hastanesi (weekdays 13:00–17:00, +90 444 45 67). Appointments are booked through the hospitals’ online booking pages or appointment lines. Consultations are held in English or Turkish; the hospitals’ international patient departments can arrange interpreters for other languages. For questions or to share your operation report and discharge documents before your visit, you can send a WhatsApp message to +90 541 622 54 82. Further details are on the contact page.