Story by Olivia Piché | Photograph by Jared Synch
Patients with enlarged prostates can now access an enduring non-invasive procedure called HoLEP
Benign Prostatic Hyperplasia (BPH) is the enlargement of the prostate; it’s rare under the age of 40, but present in most men in their 70s and 80s, according to the Canadian Urological Association. BPH can cause several obstructions in the urinary system. Symptoms include the need to urinate multiple times during the night, having a sense of incomplete emptying of the bladder, and a weak urine stream.
BPH can also lead to more serious complications like kidney failure, recurrent infections, or requiring a catheter to drain your bladder. Traditionally, treatments for complicated cases required abdominal and bladder incisions, with a higher risk of complications and longer postoperative hospital stays. But now, there’s an effective, non-invasive solution thanks to Dr. Mark Assmus.
Safe and effective treatment of enlarged prostates
In 2022, Assmus established the Holmium Laser Enucleation of the Prostate (HoLEP) program at Rockyview General Hospital, the first of its kind in Alberta.
“HoLEP is a very durable and safe surgery that allows us to tackle the most complex cases in the province,” says Assmus. “It’s a very satisfying procedure because many of the patients come in with a catheter that’s been draining their bladder for months, and they can walk out of the hospital peeing on their own.”
During the surgery, surgeons use a laser to core out the overgrown prostate tissue, which blocks the flow of urine. They then suction the tissue out, leaving a wide-open channel for urine to pass. As the surgery is done through the urethra, it doesn’t require an incision. This sets HoLEP apart from other higher-risk treatment options that require more recovery time. And, since all the problematic tissue is fully removed, there’s little chance of regrowth or a need for further treatments.
“Prior to the establishment of this program, many men in the province have had multiple prostate surgeries to try and kick the can down the road until a more definitive surgery like this was available,” says Assmus.
And now it is. Thanks to the backing of Calgary Health Foundation and support of its donors, the much-safer and durable HoLEP procedure became fully funded in July 2023. With the advanced and refined laser and enucleation (tissue removal) technique, there is less than a one per cent chance of the need for a blood transfusion. And with such a minimally invasive procedure, patients can go home much quicker than with traditional surgeries.
Long-lasting treatment supports patients and the system
“Having a durable treatment that lasts decades definitely impacts care in more than just the direct surgical benefits for patients,” says Assmus. “It frees up subsequent care, emergency department visits, admissions to hospitals for complications of large prostates and the need for multiple surgeries in the same patient.”
With HoLEP, same-day discharges have increased since 2022. The current average length of stay is under 24 hours. A second surgeon was also hired to the program at the end of 2024, allowing Rockyview to treat approximately 150 cases a year. A HoLEP program has also been established in Edmonton, and Assmus is working to train more urologists in Alberta.
“This has totally changed how we’re managing complex, large prostates,” he says. “This is better for patients, our healthcare system and our provider team.”
HoLEP may be fully funded, but there are many other projects that need your support. If you have the means to give, donate toward more firsts in healthcare today.
