Local Urologists Aim for Excellence in Care

By Raiili Pellizzari, Communications Specialist and Project Lead at the Thunder Bay Regional Health Sciences Centre



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Dr. Walid Shahrour and Dr. Hazem Elmansy have been working hard at advancing care for urology patients in Northwestern Ontario by bringing the latest treatments to the Thunder Bay Regional Health Sciences Centre (and in some cases, developing them). When the worldrenowned urologists came to Thunder Bay in 2016 and 2017 respectively, their vision was to establish TBRHSC as a hub for urology care, which is starting to take shape. “Nobody is going to leave town for treatment because we are the town,” says Elmansy. In fact, patients are coming here for care they can’t get elsewhere. “[Recently], I treated a patient from southern Ontario who had a catheter for four years. That patient walked out the door the same day, catheter-free.” That patient was treated with the state-of-the-art technique Holmium Laser Enucleation of the Prostate (HoLEP). This procedure uses a laser to treat men with urinary outflow obstruction caused by an enlarged prostate. Compared to the traditional method of treatment, HoLEP is less invasive, more precise, and has a very low retreatment rate (under 1%). HoLEP is a day surgery, which means patients are discharged sooner and have a much shorter recovery time. In all of Canada, the unique skill set required to perform HoLEP is limited to three locations: Thunder Bay, Vancouver, and Montreal. “We are treating patients from Toronto, from Saskatchewan—from everywhere,” says Elmansy. Another advanced procedure available at the hospital was actually pioneered in Thunder Bay by Shahrour, who specializes in reconstructive surgery. He developed a technique for correcting the urethral damage that often comes as a result of prostate cancer treatment, improving the quality of life for survivors. The full-spectrum, world class care available at TBRHSC includes consultation, ambulatory procedure, and surgery. “It took some convincing and a lot of hard work, but we are now seeing a remarkable difference in the urology department and it means we can offer our patients techniques that weren’t available even a few short years ago,” says Shahrour. These enormous improvements to care for patients have gotten the attention of urologists from around the world, who are lining up to train in Thunder Bay. “We have physicians from Toronto, Winnipeg, and Montreal coming here to learn from us,” says Shahrour. Additionally, Elmansy spearheaded the creation of a one-year Minimally Invasive Urologic Surgery Fellowship Program, the first of its kind in all of Northwestern Ontario. “I have multiple international fellows who wish to come to Thunder Bay to work and learn with me,” Elmansy says. “Thunder Bay is now a hot spot for urology and we don’t see it slowing down anytime soon.” During the pandemic, the Minimally Invasive Urologic Surgery Fellowship Program has conducted three randomized controlled trials that have helped improve clinical practice. Patients undergoing HoLEP and other laser prostatectomy procedures are able to go home on the same day. Not only is this more convenient for patients and their families, it frees up resources and beds for more acute cases. The first international urological fellow completed program training in July 2021, and the first Canadian fellow completed in March 2022. Two new fellows have started since. The vision of improving access to care for urology patients in Northwestern Ontario has only just begun, but the advances in care, training and research has positioned TBRHSC as a centre for urological excellence. “Once people start to share in your vision, it gets really exciting. We’re at that stage now where our colleagues and our community are behind us and realize that we can serve patients here with the most up-to-date techniques so they have better care,” Elmansy says. “That’s what it really comes down to: providing the best care we can, using our knowledge, and helping teach others to do the same. Without Walid’s initial vision, none of this would have happened. I’m excited to see what lies ahead and how we can continue to provide even better care for our patients.”