Cystoscopic DJ Stent Placement

DJ stent placement cystoscopy

A Double J (DJ) stent is a small flexible tube that is inserted in the ureter to be able to sustain the flow of urine between the kidney and the bladder. The name is derived because the stent has the J-shaped curls at each end holding the stent in place. Placement is typically performed by cystoscopy which is a minimally invasive procedure.

DJ Stent Placement cystoscopically: Indications

A DJ stent may be required for:

• Ureteric stones (pre or post lithotripsy)
• Swelling, stricture, or tumor of the ureter.
• After surgery (drainage after ureteroscopy, pyeloplasty etc.)
• Anti-proliferative stenting in the context of preoperative abdominal/pelvic surgery.
• Obstructed infection (e.g., hydronephrosis with pyelonephritis)

Cystoscopy ureteral stent placement procedure

Ureteral stent placement is an operation where a small, flexible tube (generally a Double-J stent) is implanted within the ureter to contemplate the urine flow between the kidney and the bladder is preserved. The insertion of this stent is done with the help of cystoscopy which is a minimally invasive endoscopic procedure.

Preparation

• Fasting for a few hours
• Regular examinations: CBC, creatinine, urine test.
• Discontinue the use of blood thinners as recommended.
• Sedated or general anesthetized.

Procedure

• The patient is lying on the procedure table in a lithotomy position.
• The urethra is put in a local anaesthetic gel.
• A cystoscope (thin tube camera) is used by inserting it through the urethra to the bladder.
• The ureteric (opening of the ureter) is noted.
• A guidewire is inserted through the ureter into the kidney when directly seen with eyes or from a fluoroscopy.
• A guidewire is then passed over which a Double-J (DJ) ureteral stent is passed over.
• The stent has an upper coil that is located in the renal pelvis and lower one located in the bladder.
• This involves the removal of the guidewire and scope and retention of the stent.

Procedure Time:

• Usually 10–20 minutes.

After the Procedure

• Expected Symptoms

Mild, temporary symptoms:

• Burning while urinating
• Frequent urge to urinate
• Flank or bladder discomfort, mild.
• A small amount of blood in the urine (particularly following exercise).
• They normally resolve in a matter of days.
• Medications
• Pain relievers
• Antispasmodic drugs (to relieve stent pains)
• Antibiotics if needed

Recovery & precautions

• Take as much water as possible (2 -3 L/day except on limitation)
• Do not engage heavily in exercise, cycling or running.
• You are allowed to work and carry on with your daily activities.
• Sexual intercourse can bring about mild discomfort and can be tolerated unless the doctor recommends otherwise.

What is the Stent duration of stay?

• Typically between 2-6 weeks, and that depends on the reason why it was put there.
• Under certain circumstances it can last as long as 3 months.

DJ stent placement recovery time

Immediate Recovery

• Majority of them go home on the same day.
• The first stage of the recovery period includes 24-48 hours.
• Normal urination mild burning and a small part of blood in the urine persist on 1-3 days.

Full Symptom Adjustment

• A number of individuals experience stent related symptoms in several days:

Common symptoms:

• Urinary frequency
• Mild flank pain
• Bladder discomfort
• Urine is pinkish following activity.
• These tend to get better in 3-7 days.

When You Are ready to resume the activities?

• Office work: within 1–2 days
• Light exercise: after 2–3 days
• Strenuous physical / lifting: prohibit 1 week.
• Driving: typically the next day (no repercussions of sedation)

Stent Duration (Period of stay)

• DJ stents are normally maintained over 2-6 weeks depending on the clinical condition.

Best hospital for DJ stent placement India

• Artemis Hospital, Gurgaon
• Medanta-The Medicity, Gurgaon
• Fortis Memorial Research Institute, Gurgaon
• Max Hospital, Saket

Conclusion

Cystoscopy directed placement of DJ stents is a safe, rapid, and least invasive procedure to relieve obstruction of the ureters and guard the functioning of the kidneys. Majority of the patients are cured within 1-2 days and the symptoms they develop are mild urinary but they clear after a few days. The stent maintains urine flow until the underlying pathology, e.g. stones, swelling, or stricture, is cured. Follow-up must be regularly conducted as well, and within the recommended time 2-6 weeks, the stent should be removed to prevent complications. In general, it is a good and valid procedure to provide adequate drainage and avoid injury of kidneys.

Cystoscopic DJ stent placement India GetWellGo

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• Language Support
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FAQ

Is placing stent painful?

• No. The operation is done under local anaesthetic with sedation or without any anaesthetic, so you should not feel any pain. A little pain after the procedure is nothing to worry about. 

Is it possible to work or exercise with a stent?

• Yes. It will take 1-2 days to resume office. Try not to exercise hard, lift heavy things or travel long distances during a few days.

Can I have sex with a stent?

• Yes, unless your physician tells you not to. Bladder discomfort may cause some to develop discomfort.

Is blood in urine normal?

• Yes. Pink urine or slight blood streaks are frequent, particularly after the activity. Constant heavy bleeding is to be reported.

Which foods or beverages should I avoid?

• No strict restrictions. Keep hydrated unless otherwise. If the irritation worsens, avoid too much caffeine and alcohol. 

How is the stent removed?

• Removal is achieved by flexible cystoscopy which is a rapid (2-5 minutes) outpatient treatment. It is rarely painful or is mildly uncomfortable.

Can a stent move or slip?

• Very rarely. In case of migration, you might get more pain or trouble with urination. In case of acute exacerbation of the symptoms, contact your doctor.