DJ Stent Removal

What is a DJ Stent  (Double J Stent) ?

A double J stent (DJ Stent) is plastic wire that is placed from the kidney to the urinary bladder and helps in ensuring a flow of urine from the kidney to the urinary bladder via the urinary pipe.

Why is a Double J Stent placed?

A DJ stent is placed to bypass the flow of urine from the kidney to the urinary bladder. This helps to save the function of the kidney by relieving the obstruction. A double J stent is often placed after endoscopic stone procedures such as percutaneous nephrolithotomy and ureterorenoscopy. A Double J Stent may also be placed in cases where there is a blockage in the flow of urine from the kidney to the bladder because of an injury or obstruction in the ureter.

How long can the DJ Stent be placed?

The material and quality of the DJ stent guide the time for which it can be placed. Most commonly used DJ stent is the one which can be placed for a period of 3 months. Specially designed Stents can be placed for a duration of 6 months to 1 year. In cancer cases were long term stent is required silver metallic stent can also be placed which is usually changed annually.

Why does the DJ Stent have to be removed?

Based on the life of the material that the DJ stent is made up of there is a need to remove the stent. In case the stent is not removed within the specified time complications like formation of stone over the stand, breakage of the stent into small pieces and passing of those pieces in urine, blockage to the flow of urine from the kidney to the ureter, infections, bleeding and migration of the stent may take place. This will need ancillary surgical procedures to remove the stent.

How is the DJ stent removed?

The DJ stent is removed with the process called cystoscopy and DJ stent removal. In this procedure the patient is made to lie down on a table and a local anesthetic Jelly is placed in the urinary passage after which a scope is inserted and the DJ stent is visualized and extracted using an endoscopic forceps.

What is the duration of the procedure ?

In expert hands the process of DJ stent removal usually takes 10 to 20 seconds. The process of shifting to the theatre and shifting back to the private room may require 15 to 20 minutes.

Is the procedure painful ?

Most of our patients find the process of DJ stent removal to be extremely tolerable. We recommend doing these cases in local anesthesia. Since this is a short duration procedure the only pain patients may feel this that of a stinging sensation within the urinary passage when the jelly is inserted and a feeling of urgency to pass urine once the cystoscope is introduced into the bladder.

Anesthesia options?

The procedure of DJ stent removal can be performed in local anesthesia, regional or spinal anesthesia as well as in general anaesthesia. We recommend getting the procedure done under local anaesthesia as it offers many advantages. The biggest advantage of local anaesthesia over the other forms of anaesthesia is its safety. Local anaesthesia does not require any fasting, testing or prior preparations. It is possible to get discharged from the hospital within a few hours of the procedure. It is also possible to continue daily routine without much disruption. Regional and general anaesthesia score over local anaesthesia in terms of a nearly painless experience however in our opinion the pain of administration of anaesthesia is often more than the discomfort experienced during DJ stent removal under local anaesthesia.

What is the routine course in the hospital ? 

When you arrive to Urocentre on the designated day of your DJ stent removal you will be requested to report to the reception at least one hour before the procedure.

  • Once the reason for DJ stent removal is confirmed you will be allotted a private room to change into a gown.
  • An informed consent that clearly mentions the possible risks and complications of DJ stent removal will be discussed with you for you to sign.
  • An intramuscular antibiotic will be administered
  • You will be shifted to the operating room where you will be made to lie on the operating table
  • Your blood pressure and pulse rate will be measured
  • Local anesthesia will be administered
  • Stent will be removed and handed over to you / discarded
  • You will be shifted back to your room and discharge instructions will be explained

Pre -operative preparation & Investigations ?

Removal of double J stent does not require any particular investigations. Only a routine examination of urine and x-ray of the kidney region is required to ensure the location of the stent and sterility of urine. If the procedure of DJ stent removal is being done under local anaesthesia then the patient can come after having light breakfast. It is recommended that the pubic hair should be trimmed before coming to the hospital.

Complications ?

Mild burning in urine and the presence of blood in the urine are routine after removal of the DJ stent. In most patients burning and blood disappear after a couple of voids. The common complications after DJ stent removal include urinary infection, recurrence of pain due to residual calcifications around the stent and prolonged bleeding. Rare complications include trauma to the urinary passage, injury to the ureter and inability to locate and extract the stent.

Course after the procedure ?

After the stent has been removed, Dr. Raman will prescribe you some antibiotics, analgesics and antacids to prevent infection and make you feel comfortable. You will be advised to drink more fluids during the rest of the day.

Consumables list: Gloves 7.5, Lignocaine Jelly, IV set, 500 ml Normal Saline 0.9%