Illustration of lidocaine application on a ureteral stent

Stent Pain Relief: Does Lidocaine Hold the Key?

Mira Elwood in Health & Wellness July 2025 • 4 min read.

"A randomized study explores the effectiveness of intraureteral lidocaine for managing post-ureteroscopy stent symptoms, offering insights into alternative pain relief strategies."

Ureteroscopy (URS) has become a cornerstone treatment for kidney and ureteral stones. Often, a small tube called a ureteral stent is placed after the procedure to aid healing. However, many patients experience pain and discomfort related to these stents, impacting their quality of life.

Traditional approaches to manage stent-related symptoms include oral medications, modified stent designs, and even drug-eluting stents. Yet, the problem persists, prompting researchers to explore novel solutions. One such approach involves delivering medication directly into the urinary tract.

A study published in the Canadian Urological Association Journal investigated the use of intraureteral lidocaine—a local anesthetic—to alleviate pain and urinary symptoms after ureteroscopy. This randomized, placebo-controlled trial aimed to determine if direct instillation of lidocaine could provide significant relief.

The Lidocaine Study: A Deep Dive into Design and Results

Illustration of lidocaine application on a ureteral stent

The study enrolled 41 patients undergoing elective ureteroscopy for kidney or ureteral stones. Following stone removal, participants were randomly assigned to receive either intraureteral lidocaine plus bicarbonate or a normal saline solution. Pain levels were assessed using a visual analog scale (VAS) at various time points, including one hour, two hours, four hours, 24 hours, four days, and seven days after the procedure. Researchers also collected data on medication use and urinary symptoms.

The primary goal was to determine if lidocaine could reduce early postoperative pain. Secondary objectives included evaluating the safety of intraureteral lidocaine and its impact on lower urinary tract symptoms (LUTS), such as frequency, urgency, and dysuria (painful urination).

No Significant Pain Reduction: The study found no statistically significant difference in pain scores between the lidocaine and placebo groups at any time point.
Modest Improvement in Dysuria: Patients in the lidocaine group reported slightly lower dysuria scores, but the difference did not reach statistical significance.
Similar Complication Rates: The incidence of complications and adverse effects was comparable between the two groups.

While the study did not demonstrate a significant reduction in pain, it did highlight the safety of intraureteral lidocaine. This is an important consideration for future research exploring alternative delivery methods or drug combinations.

Future Directions: Finding Better Solutions for Stent Discomfort

Although intraureteral lidocaine may not be the definitive answer, this study contributes valuable insights to the ongoing quest for effective stent pain management. Further research is needed to explore alternative approaches, such as different anesthetic agents, optimized delivery techniques, or combination therapies. In the meantime, open communication with your urologist is key to finding the best strategy to manage stent-related symptoms and improve your overall well-being.

About this Article -

This article was crafted using a human-AI hybrid and collaborative approach. AI assisted our team with initial drafting, research insights, identifying key questions, and image generation. Our human editors guided topic selection, defined the angle, structured the content, ensured factual accuracy and relevance, refined the tone, and conducted thorough editing to deliver helpful, high-quality information.See our About page for more information.

This article is based on research published under:

DOI-LINK: 10.5489/cuaj.4408, Alternate LINK

Title: Intraureteral Lidocaine For Ureteral Stent Symptoms Post-Ureteroscopy: A Randomized, Phase 2, Placebo-Controlled Trial

Subject: Urology

Journal: Canadian Urological Association Journal

Publisher: Canadian Urological Association Journal

Authors: Gregory Roberts, Robert Leslie, Syliva Robb, D. Robert Siemens, Darren Beiko

Published: 2017-10-12

Everything You Need To Know

What is Ureteroscopy (URS) and why is it relevant?

Ureteroscopy (URS) is a procedure used to treat kidney and ureteral stones. It involves inserting a scope into the ureter to visualize and remove stones. Following URS, a ureteral stent is often placed to aid in healing. The placement of the ureteral stent after the URS is a common practice to assist in the healing process and prevent complications, such as obstruction.

Why are ureteral stents used, and what problems can they cause?

Ureteral stents can cause pain and discomfort, impacting the patient's quality of life. The study explored the use of intraureteral lidocaine to address this issue. The traditional methods for managing stent-related symptoms include oral medications, modified stent designs, and even drug-eluting stents. However, the symptoms often persist, leading researchers to investigate new solutions like the direct instillation of medication into the urinary tract.

What is intraureteral lidocaine, and how was it used in the study?

Intraureteral lidocaine is a local anesthetic that was investigated in a study. The study was a randomized, placebo-controlled trial, which means that participants were randomly assigned to receive either intraureteral lidocaine plus bicarbonate or a normal saline solution. The primary goal of the study was to determine if lidocaine could reduce early postoperative pain, and the secondary objectives included evaluating the safety of intraureteral lidocaine and its impact on lower urinary tract symptoms (LUTS).

What were the main findings of the study regarding intraureteral lidocaine?

The study did not find a statistically significant reduction in pain scores between the lidocaine and placebo groups at any time point. Patients in the lidocaine group reported slightly lower dysuria scores, but the difference did not reach statistical significance. The incidence of complications and adverse effects was comparable between the two groups. These findings suggest that intraureteral lidocaine, as used in this study, may not be effective for reducing pain related to ureteral stents.

What are the implications of this study, and what are the next steps for managing stent discomfort?

While intraureteral lidocaine didn't significantly reduce pain in this study, it highlighted the safety of the approach. This research underscores the need for further investigations into alternative approaches like different anesthetic agents, optimized delivery techniques, or combination therapies for effective stent pain management. Open communication with your urologist is key to find the best strategy to manage stent-related symptoms and improve overall well-being.