How Is a Ureteral Stent Placed for Hydronephrosis Treatment?

Understanding Hydronephrosis and the Role of Ureteral Stenting

Hydronephrosis, a condition characterized by the swelling of the kidney due to urine buildup, often requires prompt medical intervention. One of the most effective treatments involves placing a ureteral stent—a small, flexible tube designed to restore proper urine flow from the kidney to the bladder. This minimally invasive procedure plays a crucial role in relieving pressure on the kidney and preventing long-term damage.

The Procedure: Step-by-Step Overview

Ureteral stent placement is typically performed by a qualified urologist using a cystoscope, a thin instrument equipped with a camera and light. The entire process is carried out under sterile conditions to minimize the risk of infection and ensure patient safety.

Preparation and Patient Positioning

The patient lies flat on an examination table in the lithotomy position—legs elevated and supported in stirrups. After thorough disinfection of the genital area, sterile drapes are applied to maintain a clean surgical field. Local or general anesthesia may be used depending on the patient's condition and comfort level.

Cystoscopic Guidance and Access

A cystoscope is gently inserted through the urethra into the bladder. Once inside, sterile saline solution is introduced to expand the bladder, allowing the urologist to clearly visualize the internal structures. The openings of the ureters—the tubes connecting the kidneys to the bladder—are carefully examined to determine which side requires stenting.

Guidewire Insertion and Stent Placement

Using the working channel of the cystoscope, a specialized guidewire—commonly known as a "hydrophilic" or "Zebra" wire—is advanced through the targeted ureteral opening. The wire is carefully threaded upward through the ureter and into the renal pelvis, reaching approximately 25 cm in depth to ensure proper positioning.

With the guidewire securely in place, the ureteral stent is then slid over the wire and guided into position. The stent spans from the kidney down to the bladder, effectively bypassing any blockage and enabling continuous urine drainage. Once confirmed via imaging or direct visualization, the guidewire is removed, leaving the stent in place.

Completion and Recovery

After successful stent placement, the cystoscope is carefully withdrawn. Most patients can go home the same day, although mild discomfort, urinary urgency, or blood-tinged urine may occur temporarily. Follow-up appointments are essential to monitor healing and determine when the stent should be removed or replaced.

Why This Procedure Matters

Timely stent placement not only alleviates symptoms like flank pain and nausea but also protects kidney function. Left untreated, hydronephrosis can lead to permanent renal damage or even kidney failure. With modern urological techniques, however, outcomes are generally favorable, especially when intervention occurs early.

In summary, ureteral stenting for hydronephrosis is a safe, well-established procedure that restores urinary flow and prevents complications. Thanks to advancements in endoscopic technology and sterile technique, patients benefit from faster recovery times and improved quality of life.