Antegrade ureteric stent insertion

What is an antegrade ureteric stent?

• An antegrade ureteric stent is a small flexible tube.
• It is placed from your kidney into your bladder. It helps urine drain normally when the ureter (the tube that carries urine from your kidney to your bladder) is blocked.

• "Antegrade" means the stent is inserted from the top downwards, through the kidney and ureter, rather than from the bladder up.

• It is often used if:

  • You have a blockage in your ureter (e.g., from a stone or scar)
  • Urine cannot drain from the kidney properly
  • You have already had a nephrostomy tube (a drain from the kidney to the outside) and are moving to internal drainage.

Why do you need this procedure?

• Your Doctor has recommended an antegrade ureteric stent because imaging tests have shown that your ureter is not letting urine pass normally.

• The stent allows urine to flow from the kidney into the bladder without needing a drain bag outside your body.

Before the procedure

Preparation

• You may be asked not to eat or drink for several hours before the procedure, depending on your appointment time.
• Please discuss with the Doctor whether you need to stop any medicines.
• If you take blood thinners (e.g., warfarin, apixaban), you may be asked to stop these before the procedure.
• Tell your medical team if you have allergies, especially to X-ray contrast dye, or if you are pregnant.
• You will be asked to sign a consent form after the risks and benefits have been explained.

Who you will see?

• A specially trained Interventional Radiologist and Radiology team will perform your procedure.
• They are experts in using imaging to guide minimally invasive treatments.

During the procedure

• You will change into a hospital gown and may have a cannula (small tube) placed in your arm to give medications.
• You will lie on the X-ray table, usually on your stomach.
• The skin over your kidney will be cleaned and numbed with local anaesthetic.
• You may already have a tube in the kidney (nephrostomy), which will be used to access the ureter. If not, we will insert a new nephrostomy.
• The stent is then placed over the wire so urine can bypass the blockage.
• In some cases, a temporary external nephrostomy tube may be left and removed later.

Will it hurt?

• The local anaesthetic can sting at first, but most people only feel pressure or pushing as the stent is positioned.
• The bladder will be inflated with contrast during the procedure which will also feel uncomfortable, and you will feel the need to urinate (pee).

Duration

• Expect to be in the Radiology department for around 1 hour, although times can vary.

After the procedure

• You will return to your ward and be monitored (pulse, blood pressure, comfort level).
• You may remain in bed for a few hours until you have recovered from sedation/local anaesthetic.

Risks and complications

• Antegrade ureteric stenting is usually safe, but possible complications include:

  • Failure to place the stent if the blockage cannot be passed. A nephrostomy may be reinserted and a second attempt planned.
  • Bleeding from the kidney and blood in the urine, usually minor but occasionally requiring further treatment.
  • Leakage of urine or a fluid collection inside the abdomen (stomach area) that may need draining.
  • Infection of the kidney or surrounding area, usually treatable with antibiotics.
  • Very rarely, damage to the ureter or bladder may occur.

Living with your stent

• The stent allows normal urine drainage, and you can usually carry on with daily activities.
• You may notice some bladder or kidney discomfort, or changes in urinary frequency.
• If your stent needs to stay in place long-term, it is typically replaced every 3 to 6 months as advised by your hospital team.
• This is performed under general anaesthetic by the urology team
• Contact your medical team if you experience severe pain, fever, the stent dislodging, or difficulty passing urine.

Contact our service

• If you have any questions about this procedure, your hospital team, Urologist, or Radiologist are available to discuss your care and answer your concerns before or after your appointment.

• For questions about your appointment at the Imaging Department please contact us on 020 7288 5888 (Monday to Friday from 9am to 3pm).