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Forum Name: Urology Topics

Question: Pain/Bleeding after stent removal


 AlexThomas - Tue Oct 27, 2009 3:26 pm

As background info I'm a 30 year old male of average physical condition, in otherwise good health.

Several days ago I had three stones the largest being 8 mm treated by shockwave, a stent was left in for three days. For three days of recovery before removal of the stent I experienced what I consider to be fairly substantial pain and blood in my urine (colour of cranberry juice). After removal of the stent I have continued to experience some relief temporarily follwed by a sudden and extreme pain that lasted several hours during which time I was unable to pee. I was told by my surgeon/urologist that the removal of the stent may cause mild pain that wouldn't last more than 24 hours.

My concern is that it is now been 3 days since the stent has been removed and I am once again seeing blood in my urine and an increase in pain. Is it common or to be expected that symptoms similar to those that originally brought me to the emergency room would be happening now that the stones have been removed?

I'm not sure how to proceed, or what I should be expecting over the short term relating to recovery, (how much blood and pain is normally expected after stent removal).

Thanks for taking the time to respond.
 Dr.M.Aroon kamath - Sun Nov 01, 2009 1:08 am

User avatar Hi,
How much blood and pain is normally expected after stent removal is variable.
Stones in the urinary tract do not sit idle. They tend to produce local problems (such as local ulceration of the lining of the urinary tract by pressure or by their texture).These ulcers can bleed following stent removal (stent might have stopped the bleeding due to pressure- what we call 'tamponade' efect).
Also, stones sometimes get stuck to the wall of the urinary tract.When they get literally torn away from the urothelium during lithotripsy, they may cause bleeding.
Again, the stent itself can get stuck and cause bleeding on removal.
I have tried to explain how bleeding can occur and how it can differ from patient to patient.
Hopefully, your problem will get better in near future.
Best wishes!
 AlexThomas - Mon Apr 26, 2010 8:22 pm

First of all thank you Dr. Kameth for replying to my message, sorry it's been ages since I originally posted my question but I have finally come back to give some additional information about what was causing the pain, maybe some reader may find it helpful.

For two days after my initial post the pain continued and eventually escalated to the point of being unbearable, I decided to return to the emergency room. This time fortunately I met with a new doctor who was willing to help. He ran a few blood tests and discovered that the ciproflox wasn't working to prevent infection and that the infection itself was part of the reason the pain had continued, he prescribed macrobid, and kept me overnight for observation. The following day I gave a second urine sample and passed a stone and several blood clots right into the sample jar! Next the urologist had me take an ultrasound. The urologist was baffled becuase the ultrasound revealed a swollen but otherwise clear ureter, also there were no stones present in the kidney or the bladder. He felt that perhaps I had passed the stone just before the ultrasound and that as the stone was going through the ureter pressure had built up from hydro in my kidney that couldn't pass by the stone on the way to my bladder, this is why the ureter appeared swollen during the ultrasound. It also explains why there was so much pain the stone had completely restricted my urine flow, and my kidneys were full to the point of bursting.

Well I feel much better now that I've been through it, now I'll know what to expect next time. And just as an additional FYI the blood clots can actually be more painful than the stones for some people.
 Dr.M.Aroon kamath - Mon Jul 26, 2010 3:02 pm

User avatar Hi AlexThomas,
Thank you for updating us.I am glad to hear that you are finally feeling better.i do agree wit you that 'clot colics' can be more distressing than colics due to stones because of the pain+the apprehension caused by seeing the bloody urine. Macroscopic hematuria is not common in colics due to ureteric stones(although microscopic hematuria may be seen in some).
Good luck!

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