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Prof. Dr. Ali Avanoğlu
UPJ Obstruction • After surgery and follow-up

JJ (Double-J) Stent: Why It's Placed, How Long It Stays, How It's Removed

A JJ (double-J) stent is a temporary, thin tube placed between the kidney and bladder after pyeloplasty; it keeps the newly rejoined junction open while it heals. How long it stays in a child, which symptoms are normal, and how it's removed are among the questions families ask most.

Who this is forFamilies whose child had a JJ stent placed during pyeloplasty, or who want to know what the stent period is like
Reading≈6 min
ByProf. Dr. Ali AvanoğluUpdated
This page is part of UPJ obstruction.Read the full treatment overview on the hub page
KIDNEY END (COILED)sits in the pelvis, does not slipBLADDER END (COILED)floats free in the bladder4–6 WEEKSremoved afterward by cystoscopyTHIN, FLEXIBLE TUBEcarries urine from kidney to bladderprotects the suture lineprevents blockage from swellingJJ (DOUBLE-J) STENT
JJ stent: kidney end in the pelvis, bladder end in the bladder, 4–6 weeks; function
01 · What a JJ stent is, and why it's placed02 · How long the stent stays in03 · Which symptoms are normal during the stent period04 · When you should see a doctor right away05 · How the stent is removed
In brief5 madde
  • What a JJ stent is, and why it's placed: A JJ stent is a soft plastic tube, named "double-J" because both ends curl.
  • How long the stent stays in: After pyeloplasty, a JJ stent typically stays in for about 4–6 weeks; reported durations range from 2–8 weeks depending on the center and the case.
  • Which symptoms are normal during the stent period: Because the stent mildly irritates the bladder, certain symptoms are expected and are usually harmless.
  • When you should see a doctor right away: With a stent in place, some symptoms differ from the usual complaints and can mean obstruction, infection, or a shifted stent.
  • How the stent is removed: In children, a JJ stent is removed under brief general anesthesia via cystoscopy: a thin camera is passed up through the urinary tract into the bladder, the bladder…
01

What a JJ stent is, and why it's placed

A JJ stent is a soft plastic tube, named "double-J" because both ends curl. One end sits in the renal pelvis, the other in the bladder; it isn't visible from outside, and children usually don't notice it's there.

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  • In pyeloplasty, once the narrow segment is removed and the ureter is re-sewn to the renal pelvis, the suture line is swollen in the first weeks. During this time the stent lets urine flow from the kidney to the bladder without obstruction, reduces pressure on the suture line, and lowers the risk of a urine leak. This is the most common form of drainage in pediatric urology.
  • A stent isn't mandatory. Some surgeons perform a stentless repair in selected cases; others use an externalized stent or nephrostent that exits through the skin. Guidelines find no evidence that one drainage method is superior to another for surgical success; the choice depends on the surgeon's experience, the child's age and anatomy, and is finalized during surgery through the joint assessment of two specialists.
02

How long the stent stays in

After pyeloplasty, a JJ stent typically stays in for about 4–6 weeks; reported durations range from 2–8 weeks depending on the center and the case. This period is considered enough for the suture line to heal; leaving it in longer has not been shown to add any benefit.

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  • It matters that the stent is removed on the planned date. A stent left in too long can accumulate a crust (encrustation), making removal harder. This is why the removal date is written on your discharge paperwork when the stent is placed — mark it on your calendar too.
  • If an externalized stent or nephrostent was used instead, the duration is shorter: it's usually removed in the outpatient clinic within 7–14 days, without anesthesia. This approach avoids a second anesthetic, but the external tube needs care and carries a risk of being pulled out by a young child.
03

Which symptoms are normal during the stent period

Because the stent mildly irritates the bladder, certain symptoms are expected and are usually harmless. Drinking plenty of fluids and urinating often without letting the bladder get too full reduces these complaints.

  • Frequent, small-volume urination, sudden urgency.
  • Mild burning when urinating and flank pain on the same side while urinating.
  • Mild pink urine, especially after activity.
  • Temporary fussiness and a pink tinge in the diaper, in infants.
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  • Guidelines and textbooks list frequent urination, burning when urinating, mild pink-to-red urine, and flank pain during urination as normal stent symptoms. The flank pain during urination comes from urine being briefly pushed back up the stent toward the kidney as the bladder contracts, and it stops once the stent is removed.
  • In infants, these symptoms may show up as fussiness, crying while wetting a diaper, or a slight pink tinge in the diaper. Keep following your doctor's pain-medicine plan; some centers may suggest medicines that ease bladder discomfort — this decision is made for your child specifically.
04

When you should see a doctor right away

With a stent in place, some symptoms differ from the usual complaints and can mean obstruction, infection, or a shifted stent. If any of the following occurs, contact us the same day without waiting for your appointment, or go to the nearest emergency department.

  • Fever (38 °C/100.4 °F and above), shivering, with flank pain: possible infection in a stented kidney.
  • Severe flank or abdominal pain that doesn't ease or keeps worsening, nausea and vomiting.
  • Dark red, clotted urine, or the inability to pass urine.
  • With a nephrostomy or externalized stent in place: the tube coming out, drainage stopping, or leaking around it.
  • In a child with a solitary kidney or bilateral hydronephrosis: a marked drop in urine output, swelling, weakness.
  • The tip of the stent becoming visible at the urinary opening (migration).
05

How the stent is removed

In children, a JJ stent is removed under brief general anesthesia via cystoscopy: a thin camera is passed up through the urinary tract into the bladder, the bladder end of the stent is grasped, and it's pulled out. The procedure takes a few minutes, involves no incision, and is done as a same-day case.

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  • This second, small procedure is the point families ask about most: for most children, pyeloplasty itself is a single operation, and stent removal is not a second operation but a short check-up procedure. Some centers leave a thread attached to the stent so it can be pulled out without anesthesia; this depends on the center's preference and the child's age.
  • After the stent comes out, mild burning and pink urine can occur for a day or two before settling. The first ultrasound is usually planned around 3 months after surgery; the hydronephrosis is not expected to disappear right away once the stent is out. The full follow-up schedule is covered under a separate heading.
UPJ Obstruction video guide3 short videos, in order
Frequently asked questions
How long does a JJ stent stay in a child?
The typical duration after pyeloplasty is about 4–6 weeks; 2–8 weeks has been reported depending on the center and case. The removal date is given in writing at discharge, and it's important not to delay it.
Does removing the stent hurt my child?
In children, the stent is removed under brief general anesthesia via cystoscopy, so your child feels no pain during the procedure. Mild burning and pink urine can occur for a day or two afterward — this is expected.
Can my child bathe or go to school with the stent in?
Yes. A JJ stent is entirely inside the body; showering, school and everyday play are all fine. Strenuous sports and activities with a risk of impact to the abdomen are postponed until the wound has healed and the stent is out.
What happens if the stent shifts out of place?
This is rare. The tip of the stent becoming visible at the urinary opening, sudden severe pain, or the inability to pass urine suggest migration; contact us the same day if this happens. If needed, the stent can be repositioned with a short procedure, or removed early.
Is stentless pyeloplasty possible?
Yes, in selected cases; some surgeons use a short-term external tube instead of a stent, or place no drain at all. Guidelines find no evidence that one drainage method is superior for success; the decision is based on the surgeon's experience and the child's anatomy.
←Previous • After surgery and follow-upAfter Pyeloplasty: Care at HomeNext • After surgery and follow-upFollow-Up After Pyeloplasty→
Related pagesFull index →
After surgery and follow-upAfter Pyeloplasty: Care at HomeThe first days after pyeloplasty raise more questions for most families than the operation itself. This page walks through what happens in the hospital, what the drain and catheter are for, pain, feeding and wound care at home, and when you should call us right away.After surgery and follow-upPyeloplasty ComplicationsPyeloplasty is a safe, high-success operation, but like any surgery it carries possible risks. On this page we explain, in plain language, complications such as urine leak, infection, stent problems, bleeding and recurrent narrowing — how often they occur, and which symptoms mean you should see a doctor right away.Pyeloplasty and approachesWhat Is Pyeloplasty? The UPJ Obstruction Surgery, Step by StepPyeloplasty is the operation that repairs the narrow junction (UPJ) between the renal pelvis and the ureter. This page explains why the operation is done, the steps from preparation to discharge, and the question families ask most: "how many surgeries are needed."After surgery and follow-upFollow-Up After PyeloplastyFollow-up after pyeloplasty answers more than just "has the hydronephrosis gone away?" Ultrasound tracks the widening's course, and MAG3 tracks function and drainage when needed; a slow improvement in kidney swelling is expected, and success is defined by the overall course, not a single measurement.
UPJ Obstruction topic clustersMain treatment page →
Basics 7Diagnosis and evaluation 6Follow-up or surgery? 7Conservative follow-up 5Pyeloplasty and approaches 7After surgery and follow-up 6By age, and special situations 7
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