Double J Stent

What is a double J stent?

A double J stent is a soft tube that is placed during surgery. This tube has a curl at both ends designed to prevent the stent from moving down into the bladder or up into the kidney. Some stents have a string attached to them which exits from the urethra. Stents are placed in the ureter which is the tube that runs from the kidney to the bladder.

Why is a stent placed?

A stent is placed to prevent or relieve a blockage in the ureter. After many stone surgeries the small pieces of stone can drop down into the ureter and block it, causing severe pain and occasionally infection. A stent allows the ureter to dilate, which makes it easier for stones or stone fragments to pass.

Other surgeries in which stents are used includes :

• Removal of tumors from either the ureter or the kidney

• Repair of scars in the ureter

• Removal of tumors from around the ureter

Ureteral catheters and stents

Ureteral catheters and stents are fundamental to the practice of Urology. These devices allow one to bypass and drain an obstructed ureter, determine urine output from a particular renal unit, and inject contrast to study the upper urinary tract With the advent of newer methods to manage upper urinary tract stones (ESWL and ureteroscopy), the indications and use of Ureteral catheters have and will continue to further increase.

History of its development

A review of the literature shows that although there are references on the use of the Ureteral catheter before 1967, the history of its development began in that year, when Zimskind and co-workers designed and used the first selfretaining catheter that was inserted cystoscopically. However, it was not until 1978 when the double-J shape was adopted following the design of Finney.

Ideal Ureteral catheter

The ideal Ureteral catheter should allow one to measure urine output from a particular renal unit, drain even ten aciously purulent material, allow injection of contrast for imaging and finally remain indwelling and self contained if longterm ureteral stenting or drainage is required.

The presently available devices consist of external or internal ureteral catheters. Both types are usually passed through the Ureteral meatus via a cystoscope, though they can be placed openly through different sites in the urinary tract.

Externalized ureteral catheters drain the upper urinary tract and pass through the bladder, exiting the urethra and draining into an external collecting device. They allow drainage through ports and a central lumen and can be irrigated as needed to drain tenacious and obstructing material By draining externally, the output from the involved renal unit can be carefully monitored. Contrast can be injected as needed to evaluate the upper tract.

Unfortunately, these devices are not self contained and must be secured to an indwelling urethral catheter or they will migrate and be extruded by Ureteral peristalsis. They therefore are not suitable for long term outpatient care.

With this objective in mind, internalized Ureteral catheters were developed. The most commonly used type is a plastic catheter with a curl at both the proximal and distal ends; i.e. Double J catheter.

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