How Long Should a Ureteral Stent Stay in Place After Kidney Stone Surgery?

Understanding Ureteral Stents After Stone Removal Procedures

Following most minimally invasive kidney or ureteral stone surgeries—such as ureteroscopy (URS), shockwave lithotripsy (SWL), or percutaneous nephrolithotomy (PCNL)—a double-J (DJ) ureteral stent is routinely placed. This flexible, coiled tube bridges the kidney and bladder to ensure unobstructed urine flow, reduce postoperative swelling, prevent stricture formation, and support healing of the ureteral lining.

Standard Stent Duration: What's Typical—and Why It Varies

While many patients can safely have their stent removed after 10–14 days, the optimal dwell time depends on several individualized factors—not just the surgical approach. Key considerations include:

• Patient-Specific Anatomy & Healing Response

Patients with healthy, non-dilated, non-scarred ureters—and no history of strictures, tumors, or chronic inflammation—often tolerate early stent removal (within 2 weeks). However, those with prior ureteral injury, radiation exposure, or underlying conditions like diabetes may require extended stenting (up to 4–6 weeks) to allow full mucosal recovery and minimize the risk of re-obstruction.

• Type of Surgical Procedure

Percutaneous nephrolithotomy (PCNL): Stents are often used temporarily to facilitate stone fragment passage and prevent "steinstrasse" (stone street obstruction). If imaging confirms complete stone clearance by day 10–14, early removal is appropriate—and commonly performed.

Laparoscopic or robotic-assisted ureterolithotomy: Because this open-style technique involves direct incision into the ureter, a longer healing window is needed. In these cases, clinicians typically recommend stent retention for approximately 4 weeks, followed by cystoscopic removal and post-removal imaging to confirm ureteral patency.

When Stent Exchange Is Necessary

In select cases—especially after complex PCNL, recurrent stones, or delayed healing—a two-stage stent strategy may be advised. This involves removing the initial stent at 3–4 weeks and replacing it with a new one for an additional 2–4 weeks. This approach helps maintain ureteral caliber while avoiding long-term complications like encrustation, infection, or stent fracture.

Practical Tips for Patients Living With a Ureteral Stent

While the stent is in place, adopting simple lifestyle adjustments significantly improves comfort and safety:

• Hydration is essential: Aim for at least 2–2.5 liters of water daily to flush the urinary tract and reduce irritation and infection risk.
• Avoid high-impact activity: Skip heavy lifting, intense running, or contact sports—these can dislodge the stent or trigger hematuria (blood in urine).
• Monitor symptoms closely: Persistent flank pain, fever, cloudy/foul-smelling urine, or visible blood warrants immediate urologic evaluation—these could signal infection, migration, or obstruction.
• Plan ahead for removal: Most stents are removed via outpatient cystoscopy under local anesthesia—a quick, low-risk procedure taking under 5 minutes.

Why Timing Matters: Balancing Benefits and Risks

Leaving a stent in too long increases risks—including biofilm formation, encrustation, and chronic discomfort. Removing it too soon may compromise healing or lead to acute urinary obstruction. That's why your urologist will base the removal schedule on personalized imaging (e.g., non-contrast CT or renal ultrasound), symptom assessment, and functional testing—not just a fixed calendar date.

Always follow up as scheduled and communicate openly about side effects like urgency, frequency, or dysuria. With smart timing and proactive care, stent management becomes a seamless part of your stone-free recovery journey.