DJ Stent Removal: Procedure, Cost, Complications

DJ Stent Removal

Treatment Duration

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15 Minutes

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20 Minutes

Treatment Cost

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12,000

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20,000

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DJ Stent Removal

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Uro-surgeons use various medical tools to promote urine passage and avoid obstruction. However, these tools require regular updation through surgical means. One such technique employed is DJ stent removal, as it requires a replacement between 6 weeks to 6 months.

Are you wondering why the operation is required? It helps in preventing complexities like encrustation (deposition of minerals on the stent surface). In this blog, we will delve into the intricacies of the DJ stent removal procedure, exploring other reasons for placement and associated costs. Read on to find out.

Procedure Name

DJ Stent Removal

Alternative Name

Ureteral stent extraction or cystoscopy

Conditions Treated

Removal/replacement of a previously placed DJ (Double-J) stent

Benefits of Procedure

Alleviates discomfort, Improves urinary flow, Reduces the risk of complications

Treated By

Urologist 

You can check DJ Stent Removal Cost here.

What is DJ stent removal?

The DJ stent full form is "double-J stent," referring to the unique shape of the stent, resembling the letter "J". It is a medical device used in urology to address conditions related to the urinary system.

The stent is designed to be inserted into the ureter, the tube connecting the kidney to the bladder. The primary DJ stent use is to facilitate the urine drainage from the kidney to the bladder.

Some other reasons why the doctors would prefer this method are:

  1. Breaking kidney stones to stop obstruction.

  2. Preventing ureter blockage as a result of postoperative swelling.

  3. Treating blood clot-related ureteral complications.

  4. Controlling the accumulation of scar tissue from diseases such as endometriosis.

  5. Removing obstacles caused by inflammatory bowel disease (IBD).

Note: The DJ stent removal becomes necessary once it has served its purpose. Leaving it for an extended period may increase the risk of complications. Please get in touch with HexaHealth for detailed information. 

Anatomy and Physiology of Kidneys

The kidneys are vital organs in the human urinary system. They have a significant role in maintaining fluid balance, electrolyte levels, and waste elimination.

The kidneys are situated retroperitoneally (anatomical space located behind the abdominal cavity). Each kidney is supplied (blood supply) by the renal arteries. It filters the blood to produce urine and then funnels the urine into the ureters for transport to the bladder.

The DJ stent is often employed in cases where the natural flow of urine is hindered. This can be due to conditions like kidney stones or surgical procedures. It is designed to traverse the renal pelvis and ureter, facilitating the urine drainage.

Here's a brief exploration of the critical anatomical parts of the kidneys:

  1. Renal Cortex: It contains functional units called nephrons responsible for filtering blood and forming urine.

  2. Renal Pelvis: A funnel-shaped structure that collects urine produced by the nephrons. It serves as a transition point for urine as it moves toward the ureter for drainage.

  3. Ureters: They facilitate the urine flow from the kidneys to the bladder. DJ stent are often placed in the ureters to address various urinary tract conditions.

  4. Bladder: An organ that collectsurine until it is ready to be discharged from the body through the urethra. DJ stent, when placed, aid in the unobstructed passage of urine from the kidneys to the urinary bladder.

  5. Urethra: The tube-like organ which carries urine from the bladder to the external environment.

Conditions Treated with DJ Stent Removal

While the stents are necessary for managing specific urological issues, taking them out is equally significant. Here are some common conditions treated with DJ stent removal:

  1. Kidney Issues: The DJ stent may be removed once the stones are naturally passed or treated through interventions.

  2. Ureteral Obstruction: The stent is taken out to restore normal urine flow. 

  3. Post-Surgery Drainage: The DJ stent is extracted once the surgical site has healed.

Who needs a DJ stent removal?  

The decision to do a double J stent removal is made by a urologist based on the patient's condition. Generally, the procedure may be recommended for individuals in the following situations:

  1. People with kidney stones that have naturally passed or been treated surgically.

  2. Individuals whose ureteral obstructions have been addressed successfully.

  3. Anyone whose ureteral strictures have been adequately treated.

  4. A person having infections like bladder infection (cystitis), kidney infection (pyelonephritis) or other issues due to the DJ stent.

  5. Patients with healed sites following urological procedures.

Benefits of DJ Stent Removal

The doctor removes the stent after thoroughly assessing the patient's overall health. The advantages of DJ stent removal may vary based on the specific condition being treated. The few expected benefits are listed below.

  1. Reduced discomfort

  2. Improved urinary flow

  3. Decreased risk of infections, such as UTI

  4. Prevention of long-term complications

  5. Elimination of stent-related irritations

  6. Lowered risk of encrustation

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Before and on the Day of DJ Stent Removal

The complete pre-surgery and day-of-surgery preparations are essential for ensuring the patient's safety. They optimize surgical outcomes and facilitate a smooth recovery process.

Before Surgery

Before DJ stent removal, patients undergo thorough preoperative assessments, confirming readiness for the procedure. A detailed medical history is collected, and the surgery is scheduled. The surgical procedure is explained to the patient.

Parameters

Pre-requisites

Pre-op Assessment

Patient's urinary tract condition

Risk Evaluation

  1. Allergies

  2. Procedural risks and benefits

Anaesthesia Selection

Local anaesthesia

Fasting

Not needed

Drink 3-4 cups of water before the procedure

Medications

Stop taking medicines like blood-thinners

Note: Follow your urologist’s advice for a successful procedure. Please get in touch with HexaHealth for complete details.

On the Day of Surgery

On the day of kidney stent removal, healthcare providers guide the patients through the final preparatory steps. Initial paperwork is followed by patients changing into the procedural gown.The staff ensures the safekeeping of their valuables. The individual is then shifted to the OT room, where the surgical team prepares for the DJ stent removal.

Parameters

Pre-requisites

Consent

Mandatory

Surgical Preparation

  1. Hospital gown

  2. Briefing of the procedure

  3. Sterilisation process

Physical Evaluation

Vitals checkup (Heart rate, oxygen saturation, blood pressure, etc.)

IV Line

Not needed

Anaesthesia Administration

Local anaesthesia

DJ Stent Removal Procedure

This DJ stent removal is an outpatient procedure conducted by a urologist. It aims to conclude a patient's treatment journey successfully. Here are the critical steps on how to remove ureteral stents:

  1. Patient Positioning: The patient is told to lie on their back on the operating table, with legs slightly elevated and apart. This placement facilitates easy access to the urethra, ensuring a smoother procedure.

  2. IV Line Administration: An intravenous (IV) line is established to provide fluids and medications before the procedure.

  3. Anaesthesia: This is to ensure comfort and pain control during the procedure. It is generally performed under local anaesthesia (LA).

  4. Sterilisation of Surgical Site: The urethral opening is cleansed and sterilised to reduce the risk of infection. The drapes are then applied to maintain the aseptic conditions.

  5. Monitoring of Vitals: Continuous observation of heart rate, BP, and oxygen saturation.

  6. Urethral Access: The urologist inserts a cystoscope, a thin tube with a camera, into the urethra. The stent is gently grasped using specialised instruments and carefully pulled out. The whole process is guided by real-time imaging.

  7. Post-Removal Assessment: Once the DJ stent is successfully extracted, the urologist may inspect the urinary tract using the cystoscope. They check for complications, such as bleeding or injuries.

  8. Conclusion: The patient is closely monitored as they recover from anaesthesia. A follow-up appointment may be recommended to evaluate the patient's recovery.

After Surgery and Recovery

Following the stent removal procedure, patients typically experience a brief recovery period in the hospital. During this, they are monitored for any immediate postoperative issues. 

The Recovery Process in Hospital 

Patients receive attentive care in the immediate recovery phase within the healthcare facility. Here's what to expect:

  1. Vitals are checked, and the effects of anaesthesia are carefully tracked.

  2. Once stabilised, patients are discharged from the hospital.

  3. Emphasis is placed on pain management, infection prevention, and mobility, as needed.

Recovery Process/Expectation After Hospital Discharge 

After hospital discharge, patients may expect a progressive improvement in their overall well-being. They are advised to adhere to post-removal care instructions.

  1. Discomfort and transient urinary symptoms are common. They are expected to improve over the next few days.

  2. Urination is usually more frequent and causes moderate burning sensations.

  3. Individuals are advised to follow a balanced diet and stay hydrated.

  4. Strenuous activities should be limited initially to support the recovery process.

First Follow-Up Appointment

The initial appointment is pivotal for the healthcare provider to assess the patient's progress. Listed below is what one can expect:

  1. Evaluation of Recovery: The urologist will assess the healing progress, examining for any signs of complications.

  2. Additional Assessments: Tests may be prescribed to ensure complete resolution of the underlying condition.

  3. Prescription: The doctor might recommend medicines to manage and prevent DJ stent removal complications.

  4. Further Care Instructions: They will provide guidance on activity restrictions and any necessary lifestyle modifications.

Risks and Complications of DJ Stent Removal

The Double J stent removal is generally considered a routine and well-tolerated procedure. Still, there are potential risks involved. 

  1. Discomfort: After the removal of the DJ stent, patients may experience temporary mild pain. This is often managed effectively with prescribed medications.

  2. Loss of Blood: There is a risk of minor bleeding during or after the stent removal procedure. While this is usually self-limiting, the severity of this may require additional interventions.

  3. Infection: This is one of the potential DJ stent removal complications, especially if sterile techniques are not followed. Symptoms such as increased pain or changes in urine colour should be promptly reported.

  4. Ureteral Injury: Ureteral perforation may occur, leading to complications such as leakage or strictures.

  5. Urinary Leakage: If the ureteral walls have not entirely healed,  the urine can escape into the abdominal cavity. This requires prompt attention.

  6. Fistula Formation: It could develop between the ureter and nearby organs or tissues, potentially causing urinary and faecal matter to mix.

  7. Stenosis: The removal process or the healing afterwards may lead to the narrowing of the ureter. This can impede the normal flow of urine, causing discomfort.

  8. Obstruction of the Urinary Tract: This may result from blood clots, tissue swelling, or other factors, leading to impaired urine drainage.

When to consult a doctor?

Consult a doctor promptly if you experience any of the following after DJ stent removal or during the recovery period:

  1. Persistent or worsening pain

  2. Uncontrolled bleeding or significant blood in the urine

  3. Fever or signs of infection

  4. Difficulty urinating

  5. Changes in urine colour or odour

  6. Swelling or tenderness in the abdominal or pelvic region

  7. Inability to pass urine

Risks of Delaying DJ Stent Removal

Delaying the double J stent removal can pose several risks, potentially impacting a patient's urological health. Check the list below.

  1. Encrustation: Over time, mineral deposits can accumulate on the surface of the stent. This can make it more difficult to remove and increase the risk of complications.

  2. Increased Risk of Infections: The prolonged presence of a stent raises the possibility of getting a UTI. Bacteria can adhere to the material surface and ascend into the urinary system.

  3. Stent Migration: The material may move from its intended position. This can result in discomfort and urinary obstruction.

  4. Stone Formation: Urinary stasis and changes in urine composition can contribute to the formation of new kidney stones. This poses an additional risk to the patient's renal health.

Cost of DJ Stent Removal


The DJ stent removal cost can be impacted by a number of variables. Knowing these elements can help with the decision-making process. Here’s the estimated price range:

DJ Stent Removal

Cost 

Minimum

₹ 10,000

Maximum

₹ 18,000

Factors that may affect the DJ stent removal price include:

  1. Healthcare Facility: The choice of clinic or hospital can impact the overall cost. Hospitals often have higher overhead costs compared to specialised clinics.

  2. Geographic Location:  The expense of medical services varies significantly between different regions within India. Urban areas with higher living costs may charge more.

  3. Surgeon's Fees: Highly experienced or seasoned doctors may charge a higher price.

  4. Pre and Post-Surgery Tests: Additional costs may be associated with diagnostic evaluations and follow-up care.

  5. Health Insurance: This plays a crucial role in determining the out-of-pocket expenses for patients. The extent of coverage, deductibles, and co-payments will influence the final bill.

Takeaway

DJ stent removal is a crucial step in the management of various urological conditions. The benefits of removing the stent on time far outweigh any temporary inconveniences. Patients need to communicate openly with their healthcare providers and address any concerns.

At HexaHealth, we understand the importance of patient education and support throughout the DJ stent removal procedure. Our platform connects patients with reputable doctors, facilitating informed decision-making. Your health is our priority. Get in touch!

Frequently Asked Questions (FAQ)

A DJ stent, or double-J stent, is a flexible tube commonly used in urology to alleviate urinary obstruction. It is typically inserted into the ureter, facilitating the flow of urine from the kidney to the bladder.

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The term "Double J" refers to the unique design of the stent, resembling the letter "J" with curls at both ends. This design serves a functional purpose, with one curl positioned in the kidney and the other in the bladder. It anchors the stent in place and prevents migration within the urinary tract.

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A DJ stent is inserted to address various urological conditions. Common reasons for placement include managing ureteral obstructions. This can be caused by factors such as kidney stones, tumours, or scar tissue.

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A DJ stent is typically left in place for a temporary period, and the duration varies based on the patient's specific condition. Commonly, they are left in position for six weeks to six months.

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DJ stent removal is generally associated with mild discomfort rather than significant pain. Patients may experience a brief sensation of pulling or pressure as the stent is extracted. However, the procedure is typically well-tolerated, and any discomfort is transient.

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Identifying the signs indicating the need for DJ stent removal is crucial for maintaining optimal urological health. Here are factors that may suggest the necessity for the same:

  1. Successful resolution of the underlying condition

  2. Recurrent urinary tract infections

  3. Persistent or worsening lower abdominal pain

  4. Changes in urinary frequency or urgency

  5. Difficulty or pain during urination

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A DJ stent is typically removed through a minimally invasive outpatient procedure. Using a cystoscope, a thin tube with a camera, the urologist gently pulls out the stent through the urethra.

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The removal of a DJ stent is a brief procedure that typically takes only a few minutes. The process is usually conducted on an outpatient basis, allowing patients to return home shortly.

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The removal of a DJ stent is typically performed using local anaesthesia or sedation. General anaesthesia is not always necessary for this outpatient procedure. This ensures patient comfort while minimising the risks.

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While DJ stent removal is a routine procedure, it carries potential risks and complications like:

  1. Ureteral injury during the removal process

  2. Risk of urinary leakage

  3. Formation of fistulas

  4. Ureteral stenosis (narrowing) post-removal

  5. Obstruction of the urinary tract

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DJ stent removal is a medical procedure typically performed in a clinical setting by a urologist. Due to the need for specialised equipment and expertise, attempting this treatment at home is not safe or recommended.

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After DJ stent removal, you can expect some mild discomfort or a sensation of urgency during urination. These usually diminish within a day or two. Increased fluid intake is recommended to promote healing and minimise the risk of complications.

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Following DJ stent removal, patients can usually resume normal activities relatively quickly.  While some may experience mild discomfort or urgency, these symptoms typically subside.

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DJ stents are typically not intended to be left in the kidneys permanently. Prolonged presence can lead to complications such as encrustation, infections, and renal damage.

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The cost of DJ stent removal usually ranges from ₹ 10,000 to ₹ 18,000. The price varies due to a lot of factors, like locality, type of medical facility, and the specialist's experience and expertise, to name a few.

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A double J stent is typically made of soft, flexible materials such as silicone or polyurethane. These materials provide the stent with the necessary stretch to conform to the shape of the ureter.

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Yes, there is a single JJ stent, and it is designed with a unique curl at one end. This design helps anchor the stent in the kidney while ensuring proper drainage of urine.

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References

All the articles on HexaHealth are supported by verified medically-recognized sources such as; peer-reviewed academic research papers, research institutions, and medical journals. Our medical reviewers also check references of the articles to prioritize accuracy and relevance. Refer to our detailed editorial policy for more information.


  1. Al-Hajjaj M, Alam OA, Abu-Hussein B, Muhammad AL Husein HAL. Forgotten Double-J ureteral stent: An analysis of 25 cases in a tertiary hospital. Annals of Medicine & Surgery. 2022 Aug;80.link
  2. Ureteral Stents: What Are They, Procedure & Recovery [Internet]. Cleveland Clinic. link
  3. Dadkhah F, Yari H, Ali Asgari M, Fallahnezhad MH, Tavoosian A, Ghadian A. Benefits and Complications of Removing Ureteral Stent Based on the Elapsed Time After Renal Transplantation Surgery. Nephro-urology Monthly [Internet]. 2016 Mar 12 [cited 2024 Feb 1];8(2):e31108. link
  4. Nunes TF, Tibana TK, Santos RFT, Inchingolo R. Modified technique for double J stent removal. Radiologia Brasileira. 2021 Jun;54(3):204–5.link
  5. DJ Stent Removal Surgery [Internet]. Yashoda Hospitals. [cited 2024 Feb 1]. link
  6. Ureteral Stent Removal: What to Expect at Home [Internet]. myhealth.alberta.ca. [cited 2024 Feb 1]. link
  7. Lin TF, Lin WR, Chen M, Yang TY, Hsu JM, Chiu AW. The risk factors and complications of forgotten double-J stents. Journal of the Chinese Medical Association. 2019 Oct;82(10):767–71.link
  8. Frequently Asked Questions about Ureteral Stents What is a ureteral stent? [Internet]. link
  9. Kidneys: Anatomy, Function, Health & Conditions [Internet]. Cleveland Clinic. link
Disclaimer: The information provided here is for educational and learning purposes only. It doesn't cover every medical condition and might not be relevant to your personal situation. This information isn't medical advice, isn't meant for diagnosing any condition, and shouldn't replace talking to a certified medical or healthcare professional.

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Dr. Deepak Sharma

Dr. Deepak Sharma

MBBS, MS General Surgery, DNB Urology

15 Years Experience

Dr Deepak Sharma is a well-known Urologist currently associated with Sanar International Hospital. He has 15 years of experience in Urology and worked as an expert Urologist in different cities of India.

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Sangeeta Sharma

Sangeeta Sharma

BSc. Biochemistry I MSc. Biochemistry (Oxford College Bangalore)

6 Years Experience

She has extensive experience in content and regulatory writing with reputed organisations like Sun Pharmaceuticals and Innodata. Skilled in SEO and passionate about creating informative and engaging medical conten...View More

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