The following information was taken from an audio interview with Robert Marino, M.D., a urologist with UF Health Jacksonville.
What is a ureteral stent?
The word stent is more familiar to us when we think about a stent in the heart, but there are also stents we place in the urinary system to let urine come out. In general terms, a stent is a device that allows the flow of fluid through a conduit.
This flow of fluid may be obstructed by kidney stones that fall into the ureter and block it. When such conditions occur we sometimes place a small tube, which is about the size of thin spaghetti and containing multiple holes, from the kidney all the way to the bladder, so that urine can reach its destination in the bladder.
Helping a patient prepare for a hurricane
There are times when it is not easy to go to the operating room, and yet, it is imperative to relieve the obstruction. In those cases, the placement of a stent may be attempted at the bedside.
I recall a patient once that was helping his family get ready for a hurricane, and he developed a renal colic, because he had a stone fall into the ureter. The pain was intense enough that he could not help his family.
When he came to the emergency room at UF Health Jacksonville, the operating room was closed, except for life-threatening emergencies, or life and limb. So using the operating room was not an option, but he wanted to help his family. In the emergency room, we were able to put the stent in the ureter with local anesthesia, and relieve his pain immediately.
The patient was able to leave and take care of business with his family regarding the hurricane. So, prompt relief of the obstruction with a small little plastic tube can sometimes give instantaneous relief, and it’s remarkable how well the patient feels right afterward.
How can I look for signs of urological cancer?
As far as what a patient may notice that might be a sign of a cancer, there are some external things. For example, in male patients, if there is a lump or a hard knot in the testicle, even though it may be painless, that can be a sign of cancer. It’s important for male patients to do self-examinations of the testicles.
In older patients in their fourth, fifth, sixth and seventh decades, another sign of possible urological cancer is the presence of visible blood in the urine. This is definitely an alarming sign.
In the absence of an infection, this needs to be investigated to see if it might represent a cancer of the urinary lining, most commonly a cancer in the bladder. Long before this manifests as visible blood in the urine, a simple urine test can detect the early presence of microscopic amounts of blood in the urine, which can also be a sign long before there are symptoms. This urine test can be done with a 10-cent strip that is dipped into the urine and available in most physicians’ offices.
Bladder cancer is a silent disease, all the way until the point you can see blood in the urine.
Occasionally, bladder cancer may affect the urinary system, and so we rely on the urine dipstick and urine screening. Paying attention to the character of the urine and following up with your primary care physician on routine screening tools is the best approach to look for signs of urological cancer. For more information or to get connected with our urology team, visit UFHealthJax.org/urology or call 904-383-1016 to make an appointment.