DJ stent (a small tube to keep the kidney draining)DJ stent (gurde ko nikaasi dene wali chhoti nali)

Yeh kya hai aur kyun lagaya jata hai

DJ stent (jise ureteric stent bhi kehte hain) aik patli, naram, mudne wali plastic ki nali hai. Yeh ureter ke andar rehti hai, yani us tang nali mein jo gurde se peshab bladder tak le jati hai. "DJ" ka matlab "double J" hai, kyunke is ke dono sirey angrezi harf J ki tarah mudey hote hain. Aik mudaa hua sira gurde mein aur doosra bladder mein rehta hai, jis se stent apni jagah se khisakta nahi.

Stent ka maqsad ureter ko khula rakhna hai taake gurde se peshab nikalta rahe. Aam wajohat: ureter mein pathri jo raasta rok rahi ho ya jalan paida kar rahi ho, pathri ke operation ke baad ureter ki soojan, ureter ki tangi ya koi aur rukawat, ya kisi operation se pehle ya baad mein gurde ki hifazat. Kabhi kabhi jab rukawat wale gurde mein infection bhi ho to stent foran lagaya jata hai, kyunke gurde ko nikaasi deni zaroori hoti hai.

Stent pathri ka ilaaj nahi hai. Yeh jagah banata hai aur gurde ko nikaasi deta rehta hai jab tak pathri ka ilaaj ho ya ureter theek ho (dekhein gurde ki pathri ki guide).

Procedure se pehle

• Stent ke baare mein aam tor par procedure se pehle bataya jata hai, ya emergency mein baad mein jald. Team se poochhein ke stent kyun zaroori hai aur kitni der rehne ka imkaan hai.
• Pehle peshab ka test hota hai. Peshab ka infection ho to aam tor par pehle us ka ilaaj hota hai, siwaye is ke ke infection wale gurde ko nikaasi dene ke liye stent foran chahiye ho (dekhein peshab ke tests ki guide).
• Khoon patla karne wali dawayein aur kisi bhi allergy ke baare mein team ko batayein. Meherbani karke apne taur par koi dawa band na karein. Aap ka urologist batayega ke kya karna hai.
• Bay-hoshi ya sedation: stent aam tor par bay-hoshi ya sedation ke saath lagaya jata hai. Team batayegi ke kaun si qism hogi. Khaane peene ke baare mein jo hidayaat milein un par amal karein.
• Aap se razamandi (consent) maangi jayegi jab doctor procedure samjha dega. Sawalaat poochhne ka yehi waqt hai.
• Pehle ke scans aur reports saath layein. Qeemat aur procedure kahan hoga, yeh bhi poochh lein.

Procedure ke dauran

Stent aam tor par cystoscopy ke zariye lagaya jata hai, yani peshab ki nali se camera guzar kar bladder tak. Koi cut nahi lagta.

Camera aur X-ray ki rehnumai mein aik patli taar (guidewire) ureter mein upar gurde tak pohanchayi jati hai. Stent us taar par sarkaya jata hai, phir taar nikaal li jati hai aur stent ke dono sirey apne aap mud kar apni jagah par baith jate hain.

Aksar stent kisi aur procedure, jaise pathri ke liye ureteroscopy, ke shuru ya akhir mein usi waqt lagaya jata hai. Stent lagana aam tor par mukhtasar hota hai. Bohat se log usi din ghar chale jate hain. Kabhi kabhi thori der ke liye peshab ki nali mein catheter rakha jata hai.

Stent ke saath rehna

Jo ehsaasaat aam hain

• Kamar ya pehlu mein dard ya bhaari pan, khaas tor par peshab karte waqt. Jab bladder peshab nikalta hai to kuch peshab stent ke raste wapas gurde ki taraf ja sakta hai, is se dard hota hai.
• Zyada baar peshab aana, achanak peshab ki hajat, aur kabhi halki jalan.
• Peshab mein halka gulabi ya khoon ka rang, jo aata jata rahta hai aur mehnat ke baad barh sakta hai.
• Pait ke neeche, ran ya jinsi hisson mein takleef ya khinchao.

Yeh ehsaasaat bohat aam hain aur aam tor par is ka matlab yeh nahi ke kuch ghalat hai. Har shakhs mein shiddat mukhtalif hoti hai, aur kuch logon ko stent bilkul mehsoos nahi hota.

Kya madad karta hai

• Bohat paani peeyein, siwaye is ke ke aap se kam karne ko kaha gaya ho. Is se peshab saaf rehta hai aur khoon kam hota hai.
• Dard ke liye aam dard kam karne wali dawayein, aur kabhi ureter ya bladder ko dheela karne wali dawa, team ke mashwaray se istemal karein.
• Jab zaroorat ho aaram karein. Bhaari kaam aur zor wali kasrat se khoon barh sakta hai.
• Roz ke halke kaam aksar mumkin hote hain. Gaari chalane aur kaam par wapas jane ke baare mein team se poochh lein.

Mumkina khatrat

• Aam: upar bayan kiye hue ehsaasaat, yani dard, zyada baar peshab aana aur peshab mein khoon ka rang.
• Kam aam: peshab ka infection, peshab mein khoon ke lothray, aur stent ka band ho jana jis se gurde mein dard ya rukawat aa sakti hai.
• Bohat kam: stent ka apni jagah se khisak jana (upar ya neeche), stent lagate waqt ureter ko chot, ya stent lagana mumkin na ho paana.

Stent jitna zyada der rehta hai, masail ka imkaan utna barhta hai. Isi liye waqt par nikalwana ya badalwana bohat zaroori hai.

Stent nikalwana aur follow-up

DJ stent aarzi hota hai. Ise kabhi bhoolna nahi chahiye.

• Ghar jane se pehle poochh lein: stent kyun lagaya gaya, kaun nikalega, kab nikalega, aur aap ko kaise bulaya jayega. Tareekh likh lein, phone mein reminder laga lein aur ghar walon ko bata dein.
• Nikalne ka tareeqa: aam tor par stent clinic mein jaagte mein flexible cystoscopy se nikala jata hai (dekhein flexible cystoscopy ki guide). Kuch stents ke saath aik patla dhaaga peshab ki nali se bahar aata hai taake camera ke baghair nikal sakein. Agar aap ke saath aisa hai to team batayegi, aur dhaagay ko apne aap na kheenchein.
• Agar pathri abhi baqi hai to pathri ka ilaaj aksar pehle se tay hota hai, aur stent usi ke saath ya baad mein nikala ya badla jata hai. Agar stent lambay arsay ke liye rakha gaya ho to use tay shuda waqfay se badalna padta hai.
• Agar aap ko nikalwane ki tareekh nahi mili ya waqt guzar gaya hai to bulaye jaane ka intezar na karein. Us unit se khud raabta karein jis ne stent lagaya tha.

Bohat der rehne par stent par namkiyat ki tah jam sakti hai ya woh band ho sakta hai, aur use nikalne ke liye bara operation chahiye ho sakta hai.

Aam sawalaat

What it is and why it is placed

A DJ stent (also called a ureteric stent) is a thin, soft, flexible plastic tube. It lies inside the ureter, the narrow tube that carries urine from the kidney to the bladder. "DJ" stands for "double J", because both ends curl like the letter J. One curl sits in the kidney and the other in the bladder, which stops the stent from slipping out of place.

A stent keeps the ureter open so that urine can drain from the kidney. Common reasons include a stone blocking or irritating the ureter, swelling of the ureter after a stone operation, a narrowing or other blockage, or protecting the kidney before or after surgery. Sometimes a stent is placed urgently when a blocked kidney is also infected, because that kidney must be drained.

A stent is not a treatment for the stone itself. It makes room and keeps the kidney draining while the stone is treated or the ureter heals (see the kidney stones guide).

Before the procedure

• You will usually be told about the stent before the procedure, or soon afterwards if it was placed in an emergency. Ask the team why it is needed and how long it is expected to stay.
• A urine test is usually done first. A urine infection is normally treated first, unless the stent is needed urgently to drain an infected kidney (see the urine tests guide).
• Tell the team about blood thinners and any allergies. Please do not stop any medicine on your own. Your urologist will tell you what to do.
• Anaesthetic or sedation: a stent is usually placed with an anaesthetic or sedation. The team will explain which type you will have. Follow any instructions about eating and drinking.
• You will be asked for consent once the doctor has explained the procedure. This is the time to ask questions.
• Bring earlier scans and reports. Ask about the cost and where the procedure will take place.

During the procedure

A stent is usually placed through a cystoscopy, which means a camera is passed along the urine tube into the bladder. There are no cuts.

Using the camera and X-ray guidance, a thin guidewire is passed up the ureter to the kidney. The stent is slid over the wire into position, the wire is taken out, and the two ends curl into place by themselves.

A stent is often placed at the start or end of another procedure, such as ureteroscopy for stones, during the same session. Placing the stent itself is usually short. Many people go home the same day. Occasionally a catheter is left in the bladder for a short time.

Living with a stent

Common feelings

• Aching or heaviness in the loin or side, especially when passing urine. When the bladder squeezes, a little urine can travel back up toward the kidney along the stent, which causes the ache.
• Passing urine more often, a sudden urge to go, and sometimes mild burning.
• Pink or blood-tinged urine, which can come and go and may increase after activity.
• Discomfort in the lower abdomen, groin or genitals.

These feelings are very common and usually do not mean anything is wrong. They vary a lot from person to person, and some people hardly notice the stent at all.

What helps

• Drink plenty of water, unless you have been told to limit fluids. This keeps the urine clear and reduces bleeding.
• For discomfort, simple pain relief, and sometimes a medicine that relaxes the ureter or bladder, can help. Use them as the team advises.
• Rest when you need to. Heavy work and strenuous exercise can make the bleeding worse.
• Light daily activity is often possible. Ask the team about driving and returning to work.

Possible risks

• Common: the feelings described above, meaning discomfort, passing urine more often and blood in the urine.
• Less common: a urine infection, blood clots in the urine, and the stent becoming blocked, which can cause kidney pain or blockage.
• Rare: the stent moving out of position (up or down), injury to the ureter while the stent is placed, or not being able to place the stent.

The longer a stent stays in, the more likely problems become. That is why removal or changing on time matters so much.

Removal and follow-up

A DJ stent is temporary. It must never be forgotten.

• Before you leave, ask: why was the stent placed, who will remove it, when, and how will I be contacted? Write the date down, set a reminder on your phone and tell your family.
• How it is removed: usually in clinic, awake, with a flexible cystoscopy (see the flexible cystoscopy guide). Some stents have a thin string that comes out through the urine tube so they can be removed without a camera. If you have one, the team will tell you, and you should not pull it yourself.
• If a stone is still there, treatment of the stone is usually planned, and the stent is removed or changed with it or afterwards. If a stent is meant to stay for a long time, it has to be changed at set intervals.
• If you were not given a removal date, or the date has passed, do not wait to be called. Contact the unit that placed the stent yourself.

If a stent stays in too long, it can become coated with mineral crust or blocked, and removing it may then need a bigger operation.

Common questions