Post Double J Catheter Removal: Pain and Urinary Symptoms

After the removal of the right-sided double J stent, there is tightness and soreness in the lower back, along with urinary pain?

Last week, I underwent ureteral lithotripsy and had a double J stent placed.
After the removal of the right-sided double J stent, I am experiencing tightness and soreness in my lower back, painful urination, and a slight sensation of urinary obstruction.
Is this symptom normal, and how long will it last? Additionally, before the removal of the double J stent, an X-ray revealed a small stone in the right kidney.
Why couldn't both issues be addressed in one surgery?

Ayan, 20~29 year old female. Ask Date: 2016/04/15

Dr. Chen Wenming reply Urology

The principle should be to temporarily schedule a follow-up consultation with a urologist.

Reply Date: 2016/04/15

More Info

After the removal of a Double J (DJ) catheter, it is not uncommon to experience a range of symptoms, including pain, urinary discomfort, and a sensation of incomplete bladder emptying. These symptoms can be attributed to several factors related to the catheter's presence and the underlying condition that necessitated its placement.

Firstly, the DJ catheter is designed to facilitate the drainage of urine from the kidney to the bladder, particularly in cases of ureteral obstruction, such as from kidney stones. When the catheter is removed, the urinary tract may still be sensitive and inflamed from the previous irritation caused by the catheter. This can lead to symptoms such as:
1. Pain and Discomfort: The removal process can cause temporary trauma to the urethra and bladder, leading to soreness or a feeling of tightness in the lower abdomen or back. This discomfort may last for several days to a week as the tissues heal.

2. Urinary Symptoms: It is common to experience urinary urgency, frequency, and pain during urination (dysuria) after the removal of the DJ catheter. This is often due to irritation of the bladder lining and the residual effects of the catheter. The sensation of urinary retention or "urinary blockage" can also occur as the bladder adjusts to the absence of the catheter.

3. Duration of Symptoms: Typically, these symptoms should gradually improve over the course of a week or two. However, if the pain persists or worsens, or if you experience significant changes in your urinary habits (such as fever, chills, or blood in the urine), it is crucial to follow up with your healthcare provider.

Regarding the presence of a small kidney stone discovered on X-ray prior to the removal of the DJ catheter, there are several reasons why it may not have been addressed during the same procedure:
1. Timing and Planning: The surgical team may have determined that it was best to first address the immediate issue of the ureteral obstruction caused by the stone, allowing for the placement of the DJ catheter to relieve pressure and facilitate healing. Once the obstruction is resolved, further evaluation and treatment of any remaining stones can be planned.

2. Stone Characteristics: The size, location, and composition of the stone can influence treatment decisions. If the stone is small and not causing significant obstruction or symptoms, the medical team may opt for a conservative approach, monitoring the stone's progression rather than performing an additional procedure immediately.

3. Patient Safety and Recovery: Performing multiple procedures in a single session can increase the risk of complications and may not be in the best interest of the patient. The healthcare team may prioritize the patient's recovery from the initial surgery before addressing any additional issues.

In conclusion, while experiencing pain and urinary symptoms after the removal of a DJ catheter is common, it is essential to monitor these symptoms and communicate with your healthcare provider if they persist or worsen. Additionally, the decision to delay treatment of the kidney stone may be based on clinical judgment regarding the best approach for your overall health and recovery. Always consult with your healthcare provider for personalized advice and treatment options tailored to your specific situation.

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