What is a Double J stent?
As it is known, our kidneys are organs located on both sides of our waist and produce urine by filtering the blood. Our urinary bladder is the organ located in the lower part of our navel, where urine accumulates and acts as a pump to discharge the urine. The hollow pipe-like structure with a diameter of approximately 5 mm and a length of 25-30 cm, which serves to carry the urine produced in the kidney to the urinary bladder, is called the ureter (Figure 1). The soft tube-shaped device with a straight middle part, which bends at both ends and forms a "J" or "O" shape, and is usually inserted after stone surgery and is inserted into the ureter with one end in the bladder and the other end in the kidney, is called a Double J stent. In short, it is called DJ stent. This name comes from the fact that its two ends are curved in a J shape.
When is a Double J stent inserted?
In cases where the urine produced in the kidney is prevented from being transmitted to the bladder for any reason, a DJ stent is inserted to ensure urine flow. Because if urine flow cannot be ensured, urine begins to accumulate in the kidney, causing the kidney to swell and lose function over time. At the same time, this obstruction is a condition that can lead to serious pain and sometimes infection. DJ stents are usually used in cases of kidney or ureteral stones. Especially in people who cannot undergo surgery immediately, it can be worn to prevent damage to the kidney during this period, and it can also be used before crushing operations with external shock waves to prevent the broken stones from blocking this channel and causing pain. However, today, it is most commonly used after stone surgery, to heal the damaged kidney or ureter, to prevent the remaining stone pieces from clogging the kidney, and to repair minor ureteral damages that occur during surgery.
Apart from these, it can also be worn during surgery to heal the duct that was cut and stitched during surgery in cases of renal duct stenosis. It is also used to heal this area in cases of stenosis occurring in the ureter due to various reasons, following the opening of this stenosis. In some cancer cases, in cases where the tumor compresses and narrows the ureter and does not allow the passage of urine, or in cases where the ureter narrows after radiation treatment (radiotherapy), kidney disease may also occur. Long-term stents may be placed to preserve their functions.
How long does the Double J stent stay in the body?
Leaving stents in the body for a long time may cause infection, stent hardening and many complaints. The duration of normal stents to remain in the body without causing any problems is around 2-3 months. However, these stents do not cause problems in everyone at the same time. While it does not cause any problems in some patients even if it stays for a very long time, in some patients it may petrify even within 20 days. For this reason, the length of stay of the stent may vary from patient to patient and this is decided by the relevant doctor. Specially made stents are designed to last for a long time without causing any problems in the body. These special stents are mostly used in cancer patients and are costly stents. DJ stents can be inserted for many reasons, as explained in the previous question. The length of stay of the stent is directly related to the reason for its insertion. It usually persists for 2-4 weeks after stone surgery. In open or laparoscopic canal stenosis surgeries, it is generally required to remain in the body for 6 weeks. In cancer surgeries, it is usually kept for 1 year and replaced with a new stent at the end of this period.
What kind of complaints does the Double J stent cause?
This situation varies widely. While it does not cause any complaints in some patients, some patients experience unbearable complaints and sometimes the stent needs to be removed in a shorter time than necessary. Common complaints are; Burning in urination, urinating less despite frequent urge to urinate, bleeding in the urine, pain under the navel, pain in the penis in men, pain in the kidney area (flank) where the stent is inserted during congestion or urination. These complaints are usually caused by the bent part of the stent that remains in the urinary bladder. It is also observed that in many patients, the complaints felt in the first days decrease as the body gets used to it in the following days. Less frequently; High fever due to stent-related infection, allergies to the structure of the stent, side pain due to the stent slipping out of place, or involuntary urinary incontinence may occur. Patients with severe complaints should consult a doctor and receive some measures to reduce or eliminate these complaints. The hungry can take it. All these complaints will disappear after the stent is removed. Otherwise, you need to consult a doctor again.
How to remove the Double J stent?
The most important issue is that regardless of the reason the DJ stent is placed, it should be removed when the time comes. The patient who has a stent should remember this and know that it must be removed. DJ stents are usually removed by endoscopic method. The stent is held and removed with camera devices inserted through the urinary tract. Since the urinary tract is very short, anesthesia is not required for this procedure in women, while it is appropriate to perform this procedure under anesthesia in men and children. For men, extraction with flexible instruments under local anesthesia is also an alternative. Usually the duration of the process is around 5 minutes. However, sometimes the lower end of the stent escapes upwards towards the kidney. In these cases, it may be necessary to enter the ureter with thin instruments and remove the stent from there, using different methods than classical methods. Very rarely, patients spontaneously drop the stent with contraction of the ureter and bladder or see one end coming out of the urinary tract. In this case, the most rational method is to consult a relevant doctor.
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