Managing Frequent Urination After Double J Stent Placement - Urology

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Managing frequent urination after the placement of a double J stent can be quite challenging and uncomfortable for patients. The symptoms you are experiencing, including a strong urge to urinate and frequent urination, are common after the placement of a double J stent, especially following ureteroscopy. Here’s a comprehensive overview of your concerns and some suggestions based on medical knowledge.

1. Frequent Urination and Medication Adjustment: It is not uncommon for patients to experience increased urinary frequency and urgency after the placement of a double J stent. This can be due to irritation of the bladder wall caused by the stent itself. The medication you mentioned, Oxybutynin (often referred to as "O舒" in some regions), is an anticholinergic agent that helps reduce bladder spasms and can alleviate some of the urgency and frequency. However, if you find that the medication is not providing sufficient relief, it is advisable to consult your physician. They may consider adjusting your medication or trying a different class of drugs, such as beta-3 adrenergic agonists (like Mirabegron), which can help relax the bladder and reduce urgency.

2. Addressing Ureteral Stricture: Regarding the narrowness of your ureteral end, it is important to monitor this condition closely. The placement of a double J stent is often a temporary solution to help keep the ureter open and allow urine to flow from the kidney to the bladder. If the stent is effective in alleviating obstruction, it may be possible to remove it after a certain period. However, if the stricture recurs, your doctor may recommend a longer-term stenting solution or other interventions.

Beyond the Da Vinci robotic surgery you mentioned, there are other options available for treating ureteral strictures. These may include:
- Ureteral Balloon Dilatation: This procedure involves using a balloon to widen the narrowed area of the ureter.

- Ureteral Stenting: In some cases, a longer-term stent may be placed to keep the ureter open.

- Ureteroplasty: This surgical procedure involves removing the narrowed segment of the ureter and reconnecting the healthy ends.

- Endoscopic Techniques: These may include laser treatment or other minimally invasive methods to address strictures.

3. Follow-Up and Monitoring: It is crucial to maintain regular follow-up appointments with your urologist. They can monitor the effectiveness of the stent and any changes in your urinary symptoms. If you experience worsening symptoms, such as increased pain, fever, or blood in your urine, you should seek medical attention promptly.

4. Lifestyle Modifications: In addition to medical management, certain lifestyle changes may help manage urinary frequency. These include:
- Fluid Management: Adjusting your fluid intake, particularly in the evening, may help reduce nighttime urination.

- Bladder Training: Gradually increasing the time between urinations can help your bladder adapt and reduce urgency.

- Pelvic Floor Exercises: Strengthening the pelvic floor muscles can improve bladder control and reduce urgency.

In conclusion, while frequent urination after double J stent placement can be distressing, there are various management strategies available. It is essential to communicate openly with your healthcare provider about your symptoms and any concerns you have regarding your treatment plan. They can provide personalized recommendations and adjustments to your medication or treatment approach based on your specific situation.