Laser lithotripsy is a technique used to break a kidney or ureter stone into smaller pieces, usually during ureteroscopy. A thin telescope called a ureteroscope is passed through the urinary tract to reach the stone, and laser energy can fragment it so that the pieces can be removed or pass through the urine.

After the procedure, the doctor may place a ureteral stent, commonly called a double-J or DJ stent, inside the ureter.

The stent is a small flexible tube that helps urine drain from the kidney into the bladder. It may be used when the ureter needs temporary support after stone treatment, when swelling could interfere with urine flow, or when stone fragments or blood could potentially obstruct drainage.

A stent is not the same as the stone itself and does not permanently remain in the urinary tract. It is generally a temporary part of treatment when the treating specialist considers it necessary.

At Prabhakar Bhurke Clinic, Dr. Sandip Prabhakar Bhurke, super specialist nephrologist and transplant physician, provides kidney-focused evaluation and management for patients with kidney stones, obstruction and associated kidney-function concerns.

Why Is a Stent Sometimes Needed After Laser Lithotripsy?

A stent is not automatically required after every laser stone procedure.

The decision depends on factors such as:

• Stone size

• Stone location

• Number of stones

• Condition of the ureter

• Degree of ureteral swelling

• Amount of stone fragmentation

• Presence of obstruction

• Infection history

• Whether the procedure was straightforward or complex

• Need to maintain reliable urine drainage

After ureteroscopy, a stent may help keep the ureter open while temporary swelling settles and urine continues to flow from the kidney to the bladder.

How Does Laser Lithotripsy Work?

Laser lithotripsy is generally performed through a ureteroscope rather than through an incision in the skin.

A simplified sequence is:

1. The patient receives appropriate anesthesia.

2. The ureteroscope is introduced through the urinary passage.

3. The surgeon identifies the stone using the camera.

4. A laser fiber is used to fragment the stone.

5. Larger fragments may be retrieved with a small basket.

6. Smaller fragments may be left to pass naturally when appropriate.

7. A temporary ureteral stent may be placed if required.

The exact technique depends on the stone's size, location, composition and the patient's urinary anatomy.

What Does a Ureteral Stent Do?

A ureteral stent provides a temporary pathway for urine to travel from the kidney to the bladder.

It can be useful when:

• The ureter is swollen after instrumentation.

• There is concern about temporary obstruction.

• Stone fragments could interfere with urine drainage.

• The ureter needs time to recover.

• A previous obstruction needs continued drainage.

• The doctor wants to protect urine flow after a difficult procedure.

The Urology Care Foundation describes ureteral stents as flexible tubes that help the kidney drain urine and may prevent stone pieces or blood from blocking the urinary tract after stone surgery.

Does Everyone Need a Stent After Laser Stone Removal?

No.

Some patients may not require a stent after an uncomplicated ureteroscopy.

Others may benefit from one because of the circumstances of the procedure or the risk of impaired drainage.

Therefore, seeing a stent after laser lithotripsy does not necessarily mean that something went wrong. In many situations, it is a planned temporary measure.

The decision should be made by the treating urologist based on the individual procedure and urinary tract condition.

What Does a Stent Feel Like After Laser Lithotripsy?

A ureteral stent can cause temporary urinary symptoms.

Some patients experience:

• Frequent urination

• Sudden urinary urgency

• Burning while passing urine

• Blood in the urine

• Bladder discomfort

• Lower abdominal discomfort

• Pain or pressure in the side or back, especially during urination

• A sensation of incomplete bladder emptying

These symptoms are recognized effects of ureteral stents and often improve after the stent is removed.

The severity varies considerably between patients.

Is Pain Normal With a Stent?

Some discomfort can occur while a stent is in place.

A patient may feel pain in the:

• Side

• Lower back

• Lower abdomen

• Bladder region

• Groin

Pain can sometimes become more noticeable during or shortly after urination.

However, severe or worsening pain should not automatically be assumed to be a normal stent symptom. Infection, obstruction or another complication may need to be excluded.

Contact the treating medical team if pain is severe, persistent or not controlled by the prescribed treatment.

Is Blood in the Urine Normal After Laser Lithotripsy?

A small amount of blood in the urine can occur after ureteroscopy and while a stent is present.

This can result from irritation of the urinary tract during the procedure or from the stent itself.

However, heavy bleeding, worsening blood loss, blood clots or difficulty passing urine should be medically assessed.

The amount and duration of bleeding should be discussed with the treating doctor if there is concern.

How Long Does a Stent Stay After Laser Lithotripsy?

There is no single duration that applies to every patient.

The stent may be removed after a relatively short period when the ureter has recovered and adequate drainage is established. In other situations, the treating doctor may recommend a longer period based on the stone burden, swelling, obstruction or complexity of the procedure.

The exact removal date should be clearly documented.

Do not forget or postpone planned stent removal. A stent that remains in place longer than intended can become encrusted and may cause infection, obstruction or other complications.

How Is a Stent Removed?

The removal method depends on the type of stent used.

Some stents have a string that allows removal according to the treating doctor's instructions.

Others are removed by a healthcare professional using a small procedure, often with a flexible instrument called a cystoscope.

The patient should never attempt to remove a stent unless the treating doctor has specifically instructed them to do so.

What Happens After Stent Removal?

After removal, temporary urinary symptoms generally begin to settle.

Some people may notice:

• Mild burning

• Increased urinary frequency

• Mild blood in urine

• Temporary bladder discomfort

• Mild flank discomfort

These symptoms should improve according to the individual recovery process.

Persistent severe pain, fever, inability to urinate or worsening symptoms require medical assessment.

Can You Work With a Stent After Laser Lithotripsy?

Many people can gradually return to normal activities while a stent is present, depending on their symptoms and the type of procedure performed.

However, recovery recommendations vary.

Your doctor may advise temporary restrictions on:

• Heavy lifting

• Vigorous exercise

• Long periods of strenuous activity

The appropriate timeline depends on the procedure, stone burden, stent symptoms and general health.

Ureteroscopy is often performed as a minimally invasive procedure, and some patients can return to routine activities relatively quickly, but individual recovery varies.

Can You Drink Water With a Ureteral Stent?

Fluid intake after laser lithotripsy should follow the treating doctor's instructions.

Adequate hydration may be appropriate for many patients, but drinking excessive amounts of water is not automatically beneficial.

Fluid requirements may need to be individualized if the patient has:

• Reduced kidney function

• Heart failure

• Fluid restrictions

• Significant obstruction

• Other medical conditions

Do not force large quantities of water simply because a stent has been placed.

What Medicines May Be Used for Stent Discomfort?

Depending on the patient's health and symptoms, a doctor may prescribe medicines to control pain, bladder symptoms or ureteral discomfort.

Some patients may receive medicines that relax the ureter or bladder.

However, medication choice must take kidney function and other medical conditions into account.

For example, some commonly used pain medicines may not be suitable for patients with kidney disease, dehydration or other risk factors.

Do not self-medicate for stent pain.

Can a Stent Become Infected?

Yes.

A ureteral stent is a foreign object inside the urinary tract and can be associated with urinary infection in some patients.

Warning signs may include:

• Fever

• Chills

• Worsening urinary burning

• Cloudy or foul-smelling urine

• Increasing flank pain

• Vomiting

• Feeling significantly unwell

Fever and chills after stone treatment should not be dismissed as routine stent discomfort.

Prompt medical assessment is particularly important when there is a history of urinary obstruction or infection.

When Is a Stent-Related Problem an Emergency?

Seek urgent medical attention if you develop:

• High fever or chills

• Severe uncontrolled pain

• Inability to pass urine

• Persistent vomiting with inability to keep fluids down

• Rapidly worsening weakness

• Severe flank pain with fever

• Significant bleeding or blood clots

• Sudden deterioration in general health

The Urology Care Foundation specifically advises contacting a doctor for fever with chills, severe pain not relieved by medication, inability to urinate or persistent vomiting while a stent is in place.

What If the Stone Was Not Completely Removed?

Laser lithotripsy does not guarantee that every patient will have complete stone clearance in one session.

The likelihood of complete treatment depends on:

• Stone size

• Number of stones

• Location

• Stone density or composition

• Anatomy

• Access to the stone

• Previous procedures

Some patients may require another procedure or follow-up treatment.

Ureteroscopy has a high success rate for many stones, but outcomes vary according to stone characteristics and patient factors.

Laser Lithotripsy Versus Other Stone Treatments

Laser lithotripsy is one of several approaches used for kidney and ureteral stones.

Depending on the case, treatment may include:

Ureteroscopy With Laser

A scope reaches the stone through the natural urinary tract and laser energy fragments it.

Shock Wave Lithotripsy

Externally generated shock waves are used to break selected stones into smaller pieces.

Percutaneous Nephrolithotomy

For larger or more complex renal stones, a small access tract through the skin may be used to reach and remove the stone.

The appropriate procedure depends on stone size, location, anatomy, density, obstruction, infection and patient factors.

What Tests Are Needed Before Laser Lithotripsy?

Before stone treatment, the medical team may review:

• Ultrasound or CT findings

• Stone size

• Stone location

• Number of stones

• Kidney function

• Urinalysis

• Urine culture when indicated

• Blood tests

• Current medications

• Previous stone procedures

• Other medical conditions

A suspected urinary infection should be appropriately evaluated before definitive stone removal.

If infection is present together with urinary obstruction, urgent drainage may take priority over definitive stone fragmentation.

Can Laser Lithotripsy Damage the Kidney?

Ureteroscopy and laser lithotripsy are established minimally invasive stone-treatment techniques, but—as with any procedure—complications are possible.

Potential complications include:

• Urinary infection

• Bleeding

• Ureteral irritation or injury

• Ureteral narrowing or stricture

• Residual stone fragments

• Stent-related symptoms

• Need for another procedure

Serious ureteral injuries are uncommon, but they can require additional treatment.

How Can Future Stones Be Prevented?

Removing a stone treats the existing stone but does not necessarily eliminate the reason it formed.

After treatment, prevention may involve:

• Stone analysis when possible

• Appropriate fluid intake

• Limiting excessive dietary sodium

• Maintaining an appropriate dietary pattern

• Reviewing metabolic risk factors

• Treating recurrent urinary infections when relevant

• Follow-up urine or blood testing in selected patients

• Preventive medicines when specifically prescribed

The prevention plan should be individualized according to stone composition, kidney function and recurrence risk.

Kidney Stone and Laser Treatment Evaluation at Prabhakar Bhurke Clinic

At Prabhakar Bhurke Clinic, Dr. Sandip Prabhakar Bhurke, super specialist nephrologist and transplant physician, provides kidney-focused assessment for patients with kidney stones, obstruction and related kidney-function concerns.

Depending on the clinical situation, evaluation may include:

• Review of kidney-function tests

• Assessment of creatinine and eGFR

• Review of ultrasound or CT reports

• Assessment of obstruction

• Evaluation of urinary infection

• Review of previous stone treatment

• Assessment of recurrent stone risk

• Medical management of kidney-related complications

• Coordination with appropriate urological specialists for stone procedures

• Follow-up kidney care after stone removal

Laser lithotripsy and ureteral stent decisions should be individualized according to the patient's stone characteristics and overall health.

Frequently Asked Questions

Why is a stent placed after laser lithotripsy?

A stent may be placed to maintain urine drainage while temporary ureteral swelling settles or when stone fragments or blood could interfere with urine flow.

Is a stent always required after laser lithotripsy?

No. Some uncomplicated procedures may not require a stent, while others do. The decision depends on the procedure and condition of the ureter.

How long does a stent stay after laser lithotripsy?

The duration varies. The treating doctor will decide when it should be removed based on the procedure, ureteral condition and stone-related factors.

Does a kidney stent hurt?

A stent can cause side or bladder discomfort, urinary urgency, frequency and blood in urine. Severe or worsening pain should be assessed by the treating team.

Can I urinate normally with a ureteral stent?

Yes. The stent is designed to allow urine to flow from the kidney to the bladder. Temporary urinary frequency, urgency or discomfort can occur.

Is blood in urine normal with a stent?

Small amounts of blood can occur after stone treatment and while a stent is present. Significant bleeding, clots or difficulty passing urine require medical evaluation.

What happens if a stent is not removed?

A stent that is left in place beyond the planned period can become encrusted and may contribute to infection, obstruction or kidney complications. Follow the scheduled removal plan.

Can laser lithotripsy remove a large kidney stone?

Laser treatment can be used for many kidney and ureteral stones, but the best procedure depends on size, location, anatomy and stone burden. Larger or complex renal stones may be better suited to PCNL or staged treatment.

Conclusion

Laser lithotripsy and a ureteral stent are often discussed together because a temporary stent may be used after endoscopic stone treatment to support urine drainage. Laser lithotripsy breaks the stone into smaller pieces, while the stent provides a temporary pathway for urine through the treated ureter.

A stent is not required in every case, and its duration varies according to the patient's procedure and urinary tract condition. Temporary urgency, frequency, discomfort and mild blood in urine can occur, but severe pain, fever, chills, inability to urinate or significant bleeding should receive prompt medical attention.

Successful stone treatment should also be followed by appropriate prevention and monitoring to reduce the likelihood of recurrence.

For individualized kidney evaluation and post-stone treatment care, consult Dr. Sandip Prabhakar Bhurke at Prabhakar Bhurke Clinic.

Medical Disclaimer

This article is intended for general educational and informational purposes only and should not be considered medical diagnosis, treatment or personalized medical advice. Laser lithotripsy, ureteroscopy and ureteral stent placement are medical procedures whose suitability depends on the stone's size, location, number, anatomy, obstruction, infection status, kidney function and overall health. A stent is not required for every patient and should be removed or exchanged according to the treating doctor's instructions. Do not attempt to remove a stent yourself unless specifically instructed by your healthcare professional. Do not start or stop pain medicines, antibiotics or other medicines without medical guidance. Seek urgent medical attention for fever or chills, severe uncontrolled pain, inability to pass urine, persistent vomiting, significant bleeding or rapidly worsening symptoms. Consult Dr. Sandip Prabhakar Bhurke or another qualified kidney or urinary-stone specialist for individualized care.