Lighting the way to more efficient treatment

Markham Stouffville Hospital’s new GreenLight Laser is reducing hospital stays and wait times for prostate surgeries.

In a darkened operating room, Dr. Adeel Sheikh, a urologist at Oak Valley Health’s Markham Stouffville Hospital (MSH), dons purple-tinted goggles, as do the rest of the medical professionals that surround him. Dr. Sheikh is handed a surgical instrument—a long, slim tube attached to a machine, which a nurse turns on—and it lights up neon green, casting the room in a futuristic glow.

It’s the first time Dr. Sheikh and his team are using the hospital’s new GreenLight Laser, and they’re about to make the life of Bradley Steele, a 59-year-old Markham resident and risk insurance specialist, a whole lot easier.

Like many men in their late fifties, by the time Steele realized that his prostate was the source of his discomfort, he was feeling the reverberations in all aspects of his life.

“You don’t notice it because it’s happening every day and ramping up very slowly,” he notes. “Then all of a sudden, you’re going, ‘Wait a second, I’m getting up every hour and a half to go to the bathroom! What’s going on here?’”

In some ways, it’s like the analogy of the frog in water: place a frog in a pot of water and slowly turn up the heat until it boils. The frog won’t realize anything is wrong until it’s too late.

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Dr. Sheikh and Bradley Steele

Far-reaching effects

Steele was experiencing a very common condition in men (or people assigned male at birth) as they age—benign prostatic hyperplasia (BPH), or enlarged prostate. The prostate encircles the urethra, but when it increases in size, it starts to constrict the urethra, resulting in a long list of symptoms related to urination. These include decreased flow and an inability to completely empty the bladder, which often causes the person to feel an increased need to urinate, and in some cases, pain.

In Canada, more than 50 per cent of men in their sixties experience symptoms of BPH, and that increases to approximately 90 per cent for men in their eighties and nineties. Sometimes medication can control the condition, but when that doesn’t work, surgery is needed to hollow out the inner part of the prostate.

It may not seem like much, but that continual anticipation of needing to urinate can have a serious impact on a person’s quality of life. In Steele’s case, he was constantly anxious about whether he would be able to get to the bathroom in time, or disturbing people around him in theatres and on planes. But while the mental burden was significant, it was the physical impact that drove Steele to seek medical advice in the spring of 2023.

“I went to see my family doctor, and I said, ‘Look, I can’t handle this anymore. This is not a good life,’” he recounts. “I was up every 15 to 20 minutes some nights and tired all the time.”

Steele’s family doctor referred him to Dr. Sheikh at MSH, who specializes in minimally invasive surgery. Dr. Sheikh performed a quick consultation and told him he was a great candidate for surgery, and it just so happened that the hospital had recently acquired a GreenLight Laser, funded with the generous support of the community through the Markham Stouffville Hospital Foundation. He asked Steele if he was willing to be one of the first patients, and he said yes.

Dr. Sheikh gave my life back to me.

Bradley Steele

Clear advantages

The most common surgery for BPH is performed endoscopically through the urethra, during which the surgeon hollows out the prostate by shaving tissue away with a cautery loop. It’s effective, but there’s a fair amount of bleeding, and patients need to stay in the hospital for a few days to recover.

In recent years, however, the GreenLight Laser has become the tool of choice because it enables surgeons to essentially vaporize prostate tissue instead, eliminating most of the bleeding. Even better, the surgery is now an outpatient procedure, allowing surgeons to discharge patients the same day and free up much-needed hospital beds.

“When you tell patients that they have to have surgery, their first question is, ‘How long do I have to stay in hospital?’” notes Dr. Sheikh. “And to be able to say, ‘This is just a day procedure,’ it really puts their mind at ease and helps them accept the need for the surgery. And they’re quite satisfied afterwards, so it’s a very gratifying procedure.”

Dr. Sheikh estimates that about 70 to 80 per cent of BPH-related surgeries at MSH will be done with the GreenLight Laser moving forward, with endoscopic or open surgery used for other cases where a tissue biopsy is needed. The move will increase the hospital’s capacity to treat this common problem and subsequently reduce wait times. MSH’s Department of Surgery is approaching the task of increasing capacity and reducing wait times from multiple angles – opening a ninth operating room in 2024 and kicking off a fundraising campaign to acquire new surgical robotics equipment.

As for Steele, he can’t believe the difference this surgery made. He can sleep through the night and no longer worries about getting to a bathroom when he’s out.

“This has been a game changer for me,” he notes. “It’s the physical thing, but it’s also really eased some of that mental pressure as well—the anxiety and the potential embarrassment. Dr. Sheikh gave my life back to me.”

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