DJステント / 尿管ステント：適応、副作用、およびケア

最終更新日： 2026年8月30日

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The ureteral stent is one of the most useful instruments in endoscopic urological surgery, and one of the least understood by the patients who receive it. The questions I am asked most often are simple ones: what exactly is this thing, is it dangerous, and why does it cause so many symptoms? This article answers them.

A ureteral stent, or “Double-J stent”, is a soft tube with a coiled pigtail at each end. It was introduced in 1976 and transformed urological management. Its shape mirrors the anatomy of the ureter — about 25 cm long, with a diameter smaller than the ureteral lumen — and the two coils hold it in position, one in the kidney and one in the bladder, so it cannot migrate. With the stent in place, urine flows freely from kidney to bladder without pain, even when the ureter itself cannot do the job.

When a ureteral stent is indicated

1. Severe kidney infection where urine drainage is obstructed.
2. Severe kidney or ureteral injury following an accident.
3. Acute stone pain that cannot be controlled.
4. Pre-stenting before ESWL for a large kidney stone.
5. Ureteral swelling after endoscopic laser surgery.

How long a stent can stay in

A standard stent is designed to remain in the urinary system for up to 3 months. The sooner it comes out, the lower the risk of encrustation — calcium deposits from the urine building up on the stent surface, which makes removal considerably more difficult. This is why the removal appointment matters and should not be postponed.

The forgotten stent: the one complication worth being frightened of

Everything else in this article is about discomfort. This section is about harm, and it is the reason I would rather a patient remembered one thing from the whole page.

A stent left in far beyond its intended life is called a forgotten stent, and it is not a rare curiosity — it happens to people who felt fine, moved house, changed hospitals, lost a phone number, or were simply never told there was a deadline. Over months to years the stent encrusts, stone forms along it and inside the coils, and it can block the very system it was placed to drain. What began as a five-minute outpatient removal can become several operations, and in the worst cases the kidney on that side is damaged beyond recovery or lost.

The protection against it is entirely administrative, which is why it is worth doing properly rather than trusting memory:

• Before you leave hospital, write down the date the stent was placed and the date it is due out, and put the removal date in your phone as a reminder rather than relying on a card in a drawer.
• Feeling well is not evidence the stent can stay. Some people have almost no symptoms, and those are precisely the patients who forget.
• If you are already past the date, do not wait and do not feel embarrassed. Contact a urology department now. It is a far smaller problem this month than next year, and no urologist will think less of you for it.
• If your stent has a string left outside, do not pull it yourself, and take care with it when showering or using the toilet. It is there so that removal can be done without a cystoscope, at a time your urologist decides.

Why the stent causes symptoms

ステント関連の症状 affect up to 80% of patients, so if you are uncomfortable, you are in the majority rather than the exception. Reported frequencies are: incomplete emptying (76%), urinary urgency (57–60%), urinary frequency (50–60%), irritation on urination (40%), suprapubic discomfort (30%), flank discomfort (19–32%), and blood in the urine (25%).

The good news is that these symptoms are temporary. For the great majority of patients they settle within days of the stent coming out, because they are caused by the stent itself rather than by damage to the urinary tract. A minority notice some irritation for a little longer, particularly after a difficult stone or a long stenting period, and that is worth mentioning at follow-up rather than assuming something has gone wrong.

Blood in the urine is expected and typically comes and goes, often more noticeable after a day on your feet or after exercise. Keeping well hydrated helps.

Can medication make the stent easier to live with?

Often, yes. It helps to know the order things are usually tried in, because patients sometimes arrive asking for two tablets when one is the right place to start.

Step one is an alpha-blocker. This is a tablet that relaxes muscle around the bladder outlet, and it is the treatment European guidelines specifically recommend for stent symptoms — a strong recommendation, not a suggestion (Bellos et al., 2023). Most people start on one of these and need nothing else.

Step two, if the urgency is still hard to live with, is adding a bladder-relaxant tablet on top. There is decent trial evidence for this pairing: a randomised study of 158 patients found the two together beat either alone across the standard stent symptom questionnaire (Hanna et al., 2025), and a large analysis pooling 26 trials ranked combinations at the top for most symptom groups (Hinojosa-Gonzalez et al., 2023).

What that evidence does いいえ do is make two tablets the normal starting point, and I want to be straight about that because it is easy to read a headline finding and assume otherwise. The guideline recommendation attaches to the alpha-blocker on its own. The pooled ranking is built largely on indirect comparisons, and its own authors say it needs head-to-head trials to confirm. Several individual studies have found combination no better than a single drug. So: one tablet first, a second added if the first is not enough — a sensible ladder rather than a race to the top of it.

Two things are worth knowing before a bladder-relaxant is added, particularly for an older man, because they are the reason your urologist may hesitate where you would not expect it.

• It can make it harder to empty the bladder. These tablets work by damping down the bladder’s squeeze, so in someone who already empties incompletely they can occasionally tip things over into being unable to pass urine at all. The absolute risk is small, but it is the reason a quick bladder scan to see how much urine is left behind is worth doing first — and the reason the bladder relaxant is given alongside the alpha-blocker rather than instead of it, since the alpha-blocker offsets much of that risk (Cochrane review, 2021).
• They can add to fogginess or confusion in older people. This is a real effect of the drug class and it builds up with long-term use and with every other medicine that acts the same way. The reassuring part is that a stent is a short-term situation: a specialist review found short courses of the modern drugs of this type are likely to be fine for most people, with frail or already forgetful patients, and those on many medicines, the group to be careful with (SUFU white paper, 2022). Keep the course short, and tell your doctor everything else you take.

Whatever the plan, do not start, stop or change any of this on your own — ask the team who placed the stent. And if you are simply uncomfortable and nobody has offered you anything, that is worth raising rather than enduring.

当日受診すべき場合

The symptoms above are expected. The following are not, and with a stent in place they can mean infection in an obstructed kidney, which becomes dangerous quickly. Go to an emergency department the same day — in Thailand you can call 1669:

• 発熱または寒気と震え, with or without flank pain
• Pain that is worsening rather than settling, or that painkillers no longer control
• Inability to pass urine, or heavy bleeding with clots
• Feeling confused, faint, or unwell out of proportion to the pain — in an older patient this can be the first sign of a serious infection, before any fever appears
• Vomiting so persistent that you cannot keep fluids down

Tell whoever assesses you that you have a ureteral stent in place, and on which side. It changes how the problem is investigated and treated, and it is easily missed if nobody says it.

お客様からよくいただくご質問

Q1：尿管（DJ）ステントとは何ですか？また、なぜ挿入されるのですか？

尿管ステントは、一般的にダブルJ（DJ）ステントと呼ばれ、腎臓から膀胱への尿の流れを維持するために尿管内に留置される細くて柔軟なチューブです。腎臓結石、尿管損傷、結石除去手術後の術後腫脹、または重度の腎感染症により尿の排出が妨げられたり、損なわれたりした場合に挿入されます。ダブルピッグテールデザインは、ステントが位置ずれするのを防ぎます。.

Q2: 尿管ステントはどのくらいの期間留置できますか？

標準的な尿管ステントは、最長3ヶ月間、尿路系内に安全に留まるように設計されています。推奨期間を超えてステントを留置すると、尿石症のリスクが高まります。尿石症とは、尿中のカルシウム沈着物がステント表面に蓄積し、除去を困難にする状態です。泌尿器科医は、医学的に不要になったら速やかにステント抜去を予約します。.

Q3: What happens if a stent is left in and forgotten?

This is the complication that matters most. A stent left far beyond its intended life encrusts with mineral deposits, stone forms along it and within its coils, and it can obstruct the kidney it was placed to drain. Removal may then require several procedures rather than one simple outpatient visit, and in severe cases the kidney on that side can be permanently damaged or lost. Feeling well is not evidence that the stent can stay, because some people have almost no symptoms. Record the removal date when the stent is placed. If you are already past that date, contact a urology department now rather than waiting — it is a much smaller problem dealt with early.

Q4: Why do I have so many urinary symptoms with a ureteral stent?

Stent-related discomfort is very common, affecting up to 80% of patients. The body recognizes the stent as a foreign object and the ureter naturally tries to contract and expel it. This causes symptoms including urinary frequency, urgency, flank discomfort, and blood in the urine. These symptoms are expected and are not a sign of a serious complication, and for the great majority of patients they settle within days of removal. Fever, worsening pain, inability to pass urine, or feeling generally unwell are different and need same-day assessment.

Q5: What medication helps with stent symptoms?

The usual first step is an alpha-blocker, a tablet that relaxes muscle around the bladder outlet. European guidelines recommend this class specifically for stent symptoms, and for most people it is all that is needed. If urgency remains hard to live with, a bladder-relaxant tablet can be added alongside it, and good trials support that combination as a second step. It is not, however, the routine starting point: the guideline recommendation is for the alpha-blocker alone, and evidence that two tablets beat one is mixed. Before adding a bladder relaxant, particularly in an older man, your doctor may check how well the bladder empties, since these tablets can occasionally make it harder to pass urine, and will want to keep the course short because the drug class can add to confusion in older people over time. Never start, stop or adjust any of this yourself.

Q6: Can I go about normal daily activities with a ureteral stent?

Most patients can continue light daily activities with a ureteral stent in place. However, strenuous physical activity, heavy lifting, and intense exercise may worsen stent-related discomfort and make blood in the urine more noticeable. If your stent has a string left outside the body, do not pull it and take care with it when showering or using the toilet. Always follow your urologist’s specific activity recommendations.

Q7: How is a ureteral stent removed?

A ureteral stent is typically removed using a flexible cystoscope inserted through the urethra under local anesthesia in an outpatient setting. Some stents have a retrieval string attached that extends through the urethra, allowing removal without a cystoscope. Stent removal is generally quick and straightforward, with symptoms settling rapidly afterward. A heavily encrusted stent is the exception and may need a more involved procedure, which is the practical reason removal is not left late.

Q8: Can I discuss a stent by video consultation?

Yes, for planning and for questions. Bangkok Hospital Headquarters offers a Telemedicine service, arranged in advance by email to the Urology department at bhquro@bdms.co.th, and it is a practical way to review previous imaging and operation notes and to arrange a removal date — particularly for patients who had the stent placed abroad or in another city. Removal itself is a procedure and must be done in person. Samitivej Sriracha is in-person only, booked through the Urology department line 088-022-1445. If you have fever, uncontrolled pain, or cannot pass urine, do not wait for a video appointment — go to an emergency department the same day.

If you have questions about your ureteral stent, or you are not sure when yours is due to come out, Dr. Soarawee Weerasopone offers specialist consultations at Bangkok Hospital Headquarters. 診療をご予約. サミティウェート・シーラチャ病院のご予約は、泌尿器科（電話番号：）までお問い合わせください。 088-022-1445. Questions about the cost of consultation, removal or surgery should go to the hospital directly — for Bangkok Hospital, by email to bhquro@bdms.co.th.

参照

• Joshi HB et al. Ureteral stent symptom questionnaire and stent-related morbidity. PubMed 19955667
• Bellos TC et al. Ureteral stent-related symptoms and pharmacotherapy: a brief narrative review. J Clin Pharmacol. 2023. doi:10.1002/jcph.2314
• Hinojosa-Gonzalez DE, Segall MR, Eisner BH. Pharmacological management of ureteral stent-related symptoms: systematic review and Bayesian network meta-analysis. J Urol. 2023. doi:10.1097/JU.0000000000003616
• Hanna P et al. Tamsulosin, solifenacin and their combination for lower urinary tract symptoms in ureteric stent patients: a randomised study. World J Urol. 2025. doi:10.1007/s00345-025-05695-1
• Pang R et al. Anticholinergics combined with alpha-blockers for lower urinary tract symptoms related to benign prostatic obstruction. Cochrane Database Syst Rev. 2021. doi:10.1002/14651858.CD012336.pub2
• Zillioux J et al. SUFU white paper on overactive bladder anticholinergic medications and dementia risk. Neurourol Urodyn. 2022. doi:10.1002/nau.25037

免責事項 This content is written and reviewed by Dr. Soarawee Weerasopone, a board-certified urologist at Bangkok Hospital Headquarters. It is intended for educational purposes only and does not constitute medical advice, and it cannot account for the reason your own stent was placed or how long it is meant to stay. Medication decisions depend on your own kidney function, other medicines and bladder emptying, and must be made by the doctor looking after you. No medical advice, diagnosis or prescription is provided through personal messaging channels or social media. Always consult a qualified healthcare professional before starting any medical treatment. In an emergency, attend the nearest emergency department — in Thailand the emergency number is 1669.