Sharing the wealth of knowledge

The field of urology is continually evolving. New techniques, new research and new equipment are advancing care of the urinary-tract system and male reproductive organs. 

Canada is among the leaders in the changing landscape of clinical care but for other countries, simply remaining current is a challenge.

Dr. Emmanuel Muhawenimana and Dr. Denstedt
Dr. John Denstedt and Dr. Emmanuel Muhawenimana at St. Joseph’s Hospital.

Lack of funding, outdated equipment or facilities and inadequate training in a very skill-driven and diverse area of care are among the barriers for developing countries. 

A life or death matter for patients

“The absence of up-to-date techniques could mean life or death for patients,” says Dr. John Denstedt, urologist at St. Joseph’s Hospital.

“Some countries only have the resources to perform older or invasive surgical methods, which makes recovery time longer and can lead to complications. Teaching surgeons who otherwise would not have access to current techniques can help them to care for their patients more effectively.”

A hallmark of St. Joseph’s, and encompassed in its mission, is to work with people to minimize the effects of injury, disease and disability by pursuing excellence in education. This is where Dr. Denstedt lends his expertise.  

Dr. Denstedt wears many hats. Not only is he a urologic surgeon with a full clinical practice at St. Joseph’s, his leadership responsibilities extend to many organizations. A professor of urology at Western University’s Schulich School of Medicine and Dentistry and former Chair/Chief of the Department of Surgery – a title he held for 14 years – Dr. Denstedt is currently the incoming Secretary of the American Urological Association and editor of the Journal of Endourology.

With nearly 30 years of clinical experience, he is a preeminent leader and passionate teacher dedicated to training people across the globe and here at home. 

Exploring minimally invasive training techniques

This past summer, Dr. Denstedt was host to Emmanuel Muhawenimana, a junior urologist consultant from Rwanda. One of only eight urologists in his country serving a population of about 12 million people, Emmanuel came to St. Joseph’s to be mentored by Dr. Denstedt, and his colleagues Dr. Hassan Razvi and Dr. Stephen Pautler. The Endourological Society, an international urological association focused on minimally invasive approaches to urological disorders, sponsored the observership.

Together with a senior urologist consultant, Emmanuel provides care for half of the Rwandan population seeking specialized urological treatment. Limited clinical time, high demand for services and lack of education on the latest surgical techniques add to the pressure in his home country. 

“Despite the availability of equipment in our hospital we are currently not preforming any urological procedures laparoscopically because of the limited number of trained providers,” says Emmanuel. 

With the Urology Masters training program in Rwanda in its infancy, having only launched five years ago, Emmanuel felt the need for more exposure to minimally invasive training techniques. As an up-and-coming urologist, he was ranked first in his application for the Endourology Society International Traveling Scholarship and was chosen to travel to Canada and train at both St. Joseph’s Hospital in London, and Bluewater Health in Sarnia

His first time in Canada, Emmanuel arrived in the summer and spent three days each week in surgical theaters observing such procedures as percutaneous nephrolithotomy (PCNL), a minimally-invasive process to remove kidney stones through a small “key hole” incision. PCNLs were on his education wish list.

Emmanuel viewed many surgeries and procedures during his six-week stay. Reflecting upon the experience, the young physician said he was pleased with the new skills and “tricks” he gained, and felt he had a “good package” to take home and share with his colleagues.

“Seeing how things are done in Canada definitely opened my mind,” he stated. Emmanuel was so thankful to the teams at the hospital including the theater team, urologists, fellows, residents and nurses. “They were very welcoming and good to me, and helped me integrate easily into the team. Everyone had a smile on their face and was ready to help.”

“We are very fortunate in Canada to have excellent facilities and equipment and top-notch training. Other countries sometimes need a little nudge in the right direction which can help considerably with outcomes for their patients.” Dr. Denstedt also emphasizes that education is a two way flow of information. “We can also learn from the unique experiences both in medicine, and in life from other countries.” 

Guangzhou China
Dr. Denstedt in Guangzhou, China.

Recent visitors from Japan glowed about their experience at St. Joseph’s, one even calling it the “best experience in my life thanks to the friendly, kind and impressive staff.”

It is most fitting that Dr. Denstedt’s image graces the side of the building at St. Joseph’s Hospital. Strategically placed on the busiest corner, his gentle smile speaks volumes showing a genuine interest in the quality of life of his patients and the education of those he mentors. Emmanuel’s appreciation is heartfelt. “Talking to John is like reading a book.  He has so much knowledge and wisdom to share. I’m very grateful for his time.”


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