Persistent hematuria after ureteral stent placement

Oct 13, 2022 Source: Cainiu Health

Dr. Cao Zhiqiang

Introduction

Persistent hematuria after ureteral stent placement may be caused by stent irritation, mucosal injury, abnormal coagulation function, urethritis, or ureteritis, and can be managed according to the specific cause. It is recommended to seek timely medical attention at a hospital and receive treatment under the guidance of a physician. Pay attention to rest, avoid strenuous exercise and heavy physical labor to reduce irritation to the ureter, and drink plenty of fluids to increase urination.

Continuous hematuria after ureteral stent placement may be caused by stent irritation, mucosal injury, coagulation dysfunction, urethritis, or ureteritis. Management should be tailored according to the specific cause. It is recommended to seek timely medical attention and receive treatment under the guidance of a physician.

1. Stent Irritation

As a foreign body, the ureteral stent may irritate the ureteral mucosa, causing mucosal congestion and edema, which can lead to hematuria. Patients should rest adequately, avoid strenuous exercise and heavy physical labor to reduce irritation to the ureter. Additionally, they should drink plenty of fluids and urinate frequently to flush the urinary tract and minimize the dwell time of blood in the urinary system.

2. Mucosal Injury

During stent placement, some degree of trauma to the ureteral mucosa may occur. Mucosal healing takes time postoperatively, during which hematuria may appear. Patients are advised to increase fluid intake to 2000–3000 mL per day, maintain unobstructed urination, and avoid holding urine to reduce irritation from urine on injured mucosa and promote healing.

3. Coagulation Dysfunction

Some patients may have underlying coagulation disorders, such as those taking anticoagulant medications long-term or suffering from hematologic diseases. These individuals are more prone to develop prolonged hematuria after stent placement. For patients on anticoagulants, dosage adjustments or temporary discontinuation should be made under medical supervision based on individual conditions, while actively managing the underlying disease.

4. Urethritis

Bacterial infection can cause congestion and swelling of the urethral mucosa, resulting in hematuria, often accompanied by symptoms such as frequent urination, urgency, and dysuria. Patients may follow medical advice to use medications such as levofloxacin tablets, cefixime capsules, or amoxicillin-clavulanate potassium tablets to alleviate symptoms.

5. Ureteritis

The presence of a stent within the ureter may trigger a local inflammatory response in the mucosa, leading to bleeding. Under medical guidance, patients may use medications such as diclofenac sodium sustained-release tablets, ibuprofen sustained-release capsules, or Yunnan Baiyao capsules to relieve discomfort. Close observation of changes in the color of hematuria and the amount of bleeding is also recommended.

In daily life, it is advisable to maintain a light diet, regular sleep patterns, and appropriate rest to support recovery.

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