Shockwave lithotripsy

Welcome to St. Michael's Kidney Stone Center. This is a provincial program affiliated with the University of Toronto. The

lithotripsy

room houses one of the three lithotripters in the province. Our program, which has been in operation since 1987, has treated more patients than any other center in the world and is recognized for its leadership role internationally. Upon arrival, you will be asked to complete the registration process, where administrative staff and nurses will ensure that all pre-treatment tests and x-rays have been completed. Most patients will have a single x-ray taken before treatment to ensure that the location of the stone has not changed.

You will then have the opportunity to view this educational video. The current procedure is called shock wave

lithotripsy

or SWL for short. Lithos comes from the Greek word meaning stone and trippy comes from Trivian, to rub or break. The shock wave energy is produced by an electromagnetic shock head and focused through your body towards the stone. The goal today is to break the stone into small enough particles, two millimeters or less, that they can pass through the urinary system with minimal discomfort. To help you understand your urinary system, here is a diagram. Most patients have two kidneys that filter urine from their body.

Urine collects in cavities inside the kidneys and drains through tubes called ureters to the bladder for storage. The bladder empties through the urethra, the tube that leads to the outside. A kidney stone or stone forms inside the cavity inside the kidney. It may stay there attached to the wall, but it can pass into the ureter where it can get stuck. Stones can be treated with SWL in the kidney or ureter. Before entering the lithotripsy treatment room, you will be interviewed by a nurse, your treating urologist, and the anesthetist. Your history, test results and x-rays will be reviewed and some of the questions are repetitive.

You will then be taken to the lithotripsy treatment room. You will be asked to remove your robe, but you will leave it on to ensure your privacy. You will then be asked to stand up on the lithotripsy table. It's like an x-ray table with a soft elastic membrane in the center to support it. The anesthetist will then insert an IV to give you some medications to help keep you relaxed and comfortable. ECG leads and a blood pressure cuff will be applied to monitor your heart rate and blood pressure during the procedure. You will be given supplemental oxygen to breathe while you are sedated.

Your position on the table will be adjusted and a small amount of water will be poured over the elastic membrane that supports your body. You will feel your body resting in a small amount of water. The shock head will then rotate into position. The table will move and a C-shaped x-ray arm will rotate to aim at the stone. You will be notified when the treatment is about to begin and then you will hear a click and feel a tapping sensation on your back. Try to remain fairly still during treatment, as any movement can interfere with stone treatment.

The power of the shocks will gradually increase, and if you feel any discomfort, remember to raise your left hand so that the anesthetist can administer more painkillers. The treatment lasts about half an hour, after which you will be transferred to the post-anesthesia care unit, where you will be monitored until the effects of the sedation have largely worn off. While you are in this area, your blood pressure will be taken and the treatment area will be checked. It is common for an area of ​​redness to appear that usually disappears in the next few days. You will be offered something to eat and drink when you are ready.

Usually after one or two hours you will be ready to go home, but since you will still feel some effects of the sedation, you need to have someone with you and you should not drive a car for 24 hours. Upon discharge, you will receive written and verbal instructions about what to expect after your treatment. You will also be given a sieve to collect some stone fragments, an application form and a pre-addressed envelope for stone analysis. If you feel any pain, you can take the prescribed pain reliever. However, you should call your urologist or go to the nearest emergency room if you have severe pain that is not relieved by oral medication, or if you develop chills with a fever above 38.5 degrees Celsius, or if you develop persistent nausea. . or vomiting.

If you are located within the Toronto area, you will be scheduled for an appointment at the lithotripsy clinic approximately two weeks after your treatment to evaluate the results of lithotripsy. If you live more than an hour outside of the Toronto area, you will be advised to make an appointment with your own urologist after two weeks. Some patients with larger stones or stones in the ureter may not break up adequately with one treatment, and approximately 15 percent of our patients require a second treatment. This can be booked immediately after treatment or when you are seen at your two-week follow-up visit.

If you are interested in stone prevention, ask the staff about the Provincial Kidney Stone Prevention Clinic. If you have any questions, please call the Kidney Stone Center at 416-864-3030 or toll-free 1-800-263-2885. During your stay in the unit, please do not hesitate to ask us any questions you may have about the treatment or the period after lithotripsy. The staff is here to take care of you.