Can Ureteral Stone Surgery Be Done Without a Double J Stent? - Urology

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Ureteral stone surgery can indeed be performed without the placement of a double J (DJ) stent, but this decision is highly dependent on the specific circumstances of the patient and the surgeon's judgment. The use of a DJ stent is typically recommended for several reasons, particularly when dealing with ureteral stones located in the lower segment of the ureter, which is less than 0.5 cm from the bladder.


Reasons for Using a DJ Stent
1. Preventing Obstruction: After ureteral stone surgery, there is a risk of swelling or scarring that can lead to obstruction. A DJ stent helps to keep the ureter open, allowing urine to flow from the kidney to the bladder, even if there is some post-operative swelling.

2. Facilitating Stone Passage: If any fragments of the stone remain after surgery, the DJ stent can help facilitate their passage through the ureter, reducing the risk of complications.

3. Monitoring and Follow-Up: The presence of a DJ stent allows for easier monitoring of the ureter's condition post-surgery. It can be removed later, and imaging studies can be performed to check for any remaining stones.


Risks of Not Using a DJ Stent
Choosing not to place a DJ stent can lead to several potential complications:
1. Increased Pain and Discomfort: Without a stent, patients may experience increased pain due to ureteral spasms or obstruction from swelling.

2. Risk of Ureteral Stricture: If the ureter becomes narrowed due to scarring or inflammation, it can lead to a condition known as ureteral stricture, which can cause significant complications.

3. Infection: The risk of urinary tract infections may increase if the ureter is obstructed, as urine can back up into the kidney, creating an environment conducive to bacterial growth.

4. Need for Additional Procedures: If complications arise from not using a DJ stent, it may necessitate further surgical interventions, which could have been avoided with the initial placement of the stent.


Patient Considerations
It is understandable that you may have concerns about the discomfort associated with the removal of a DJ stent. Many patients report discomfort during the removal process, but it is generally a quick procedure. Discussing your concerns with your urologist can help you understand the necessity of the stent and the potential risks of not using one.

Conclusion
In conclusion, while ureteral stone surgery can technically be performed without a DJ stent, the decision should be made in consultation with your healthcare provider, taking into account your specific medical condition, the location of the stone, and your overall health. The benefits of using a DJ stent often outweigh the discomfort associated with its placement and removal. If you have strong feelings about avoiding a DJ stent, it is crucial to communicate these with your urologist, who can provide personalized advice and alternative options based on your unique situation.