Persistent Fever After Double J Stent Placement: What to Do?

Q: Persistent Fever After Double J Stent Placement: What to Do?

Hello： Due to the abnormal fever (an adult's ear temperature should be around 37.5°C), the attending physician does not believe that extraction is advisable, as they are aware of your examination data and made this decision accordingly. <br>Currently, in addition to treatment, th

Persistent fever preventing the removal of double J stents?

Hello,
Initially, I sought medical attention due to frequent urination and urinary weakness.
Urinalysis revealed red blood cells in the urine at 100-150, along with renal edema, but no bacteria were cultured from the urine.
A double J stent was placed for over two weeks, and it was originally scheduled to be removed today.
However, after discussing my daily temperature readings, which have mostly ranged between 37.7 and 38 degrees Celsius, the doctor decided to postpone the removal until next week.
The attending physician previously mentioned that fever is normal and that antipyretic analgesics should only be taken if the temperature reaches 38.5 degrees Celsius, but today they stated that a temperature of 37.5 degrees Celsius is considered abnormal.

In recent days, I have experienced frequent bowel movements and urination, but my abdomen has become distended and hard, and I feel a sharp pain in the flank on the surgical side (not like the post-operative cramping pain), which raises my concern about the displacement of the drainage tube.
However, the attending physician insists that this is normal and that an abdominal ultrasound is not necessary.

Could you please provide your advice? Is it normal to have this temperature fluctuation for over two weeks after the double J stent placement? What temperature constitutes a fever? It has been a month and a half since the first treatment, and the cause of my frequent urination, urinary weakness, renal edema, and hematuria has not been identified.
When I asked the attending physician, they said they could not determine the cause because the renal area could not be accessed during the previous endoscopic surgery.
Are there other medical approaches to investigate the underlying causes of these symptoms? Should I consider consulting a gynecologist to rule out any gynecological conditions? I am truly concerned about the delay in treatment and the inability to identify the underlying cause.
I would appreciate your suggestions.
Thank you!

Teng, 20~29 year old female. Ask Date: 2019/04/11

Dr. Du Shixi reply Urology

Hello: Due to the abnormal fever (an adult's ear temperature should be around 37.5°C), the attending physician does not believe that extraction is advisable, as they are aware of your examination data and made this decision accordingly.
Currently, in addition to treatment, the underlying cause of the incomplete recovery should be investigated.
If the cause cannot be identified, consider switching to a medical center (remember to choose a large hospital) for further evaluation.
Since the cause has not been ruled out, it is challenging to determine a treatment direction.

Reply Date: 2019/04/11

More Info

Persistent fever after the placement of a double J stent can be a concerning symptom, and it is important to understand the underlying causes and appropriate management strategies.
Firstly, it is essential to clarify what constitutes a fever. In general, a body temperature above 100.4°F (38°C) is considered a fever. However, in the context of post-operative care, especially after procedures like double J stent placement, slight elevations in temperature can occur due to various reasons, including the body's response to surgery, inflammation, or infection.

In your case, you mentioned that your temperature has been fluctuating between 37.7°C and 38°C. While your doctor initially indicated that a fever above 38.5°C would require treatment, the subsequent advice suggesting that any temperature above 37.5°C is abnormal may reflect a more cautious approach to your post-operative care. It is not uncommon for patients to experience mild fevers after such procedures, but persistent low-grade fevers should be monitored closely.

The symptoms you describe, such as abdominal distension and pain on the side where the stent was placed, warrant further investigation. While your doctor may consider these symptoms as normal post-operative effects, they could also indicate complications such as stent migration, obstruction, or infection. If the pain is sharp and persistent, or if you notice any changes in your urine output or characteristics, it is crucial to communicate these changes to your healthcare provider.

Given that your urinary symptoms (frequency, urgency, and hematuria) have not been resolved and the underlying cause remains unclear after a month and a half, it may be beneficial to seek a second opinion or further evaluation. This could include imaging studies such as an abdominal ultrasound or CT scan to assess the kidneys and urinary tract for any abnormalities that may not have been visible during previous examinations. Additionally, consulting a urologist or nephrologist may provide more specialized insight into your condition.

If you are considering whether to see a gynecologist for potential gynecological issues, it is essential to keep in mind that urinary symptoms can sometimes be related to pelvic conditions. However, it is advisable to first exhaust the urological evaluations to rule out any urinary tract-related causes.

In summary, while mild fever can be a normal response after double J stent placement, persistent low-grade fever, abdominal pain, and other symptoms should not be ignored. It is crucial to maintain open communication with your healthcare provider, advocate for further diagnostic evaluations if necessary, and ensure that you receive appropriate care to address your ongoing symptoms. If your symptoms worsen or you feel that your concerns are not being adequately addressed, seeking a second opinion may be a prudent step.

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