How to Drain Kidney Hydronephrosis with a Ureteral Stent: Procedure, Benefits, and What to Expect

Hydronephrosis, or the swelling of a kidney due to a buildup of urine, often requires prompt medical intervention to prevent long-term damage. One of the most effective treatments involves inserting a ureteral stent—a thin, flexible tube—into the urinary tract to restore proper drainage from the kidney to the bladder. This minimally invasive procedure is commonly performed using a cystoscope or ureteroscope, allowing doctors to navigate the urinary system with precision.

Understanding the Ureteral Stenting Procedure

The process begins with the patient positioned in the lithotomy position—lying on their back with legs elevated—to allow optimal access to the urinary tract. A cystoscope or ureteroscope is gently inserted through the urethra and advanced into the bladder. Using real-time visualization, the physician locates the affected ureter—the tube connecting the kidney to the bladder—on the side experiencing blockage or obstruction.

Step-by-Step Guide to Stent Placement

Once the target ureter is identified, an ultra-slippery guidewire is carefully threaded through the scope and up the ureter, extending all the way into the renal pelvis of the kidney. This guidewire acts as a pathway for the stent. Following the wire's trajectory, a ureteral stent—typically around 30 centimeters in length—is then slid into place.

The stent spans the entire length of the ureter, with one end positioned in the kidney and the other coiled safely within the bladder. This strategic placement allows urine to bypass any blockages, draining directly from the kidney into the bladder, where it is naturally expelled during urination.

Anesthesia Options and Success Rates

The procedure can be performed under local anesthesia with sedation or general anesthesia, depending on the patient's condition and tolerance for discomfort. While local anesthesia may suffice for some individuals, general anesthesia significantly increases the likelihood of successful stent placement, particularly in cases involving anatomical complexity or heightened sensitivity.

Patients under local anesthesia may experience discomfort or involuntary muscle contractions, which can interfere with the precise navigation required. In contrast, general anesthesia ensures complete relaxation and immobility, minimizing procedural risks and enhancing overall success rates.

Recovery and Post-Procedure Care

After stent placement, most patients notice immediate relief from pressure and pain associated with hydronephrosis. However, some may experience mild urinary urgency, frequency, or discomfort during urination due to the presence of the foreign object in the bladder. These symptoms typically subside once the underlying cause of the obstruction is addressed and the stent is removed.

In many cases, the stent remains in place temporarily—ranging from a few days to several weeks—until further treatment, such as stone removal or surgery, resolves the root issue. Follow-up imaging, like ultrasound or CT scans, helps monitor kidney function and confirm proper drainage.

Why Early Intervention Matters

Timely stent placement not only alleviates symptoms but also protects kidney function. Prolonged urine retention can lead to infection, scarring, and irreversible damage to renal tissue. By restoring urine flow quickly, physicians help preserve long-term kidney health and reduce complications.

For patients diagnosed with hydronephrosis, understanding the stenting process empowers them to make informed decisions about their care. With advancements in endoscopic technology and anesthesia management, ureteral stent insertion has become a safe, reliable, and often life-saving solution.