Shortly after George Michelis was born in August 2019, doctors discovered a birth defect – the opening to his urethra was located along the shaft of his penis, rather than at the tip.
Although they are quite common and not life threatening, medical experts say that hypospadias should ideally be operated on within six to 18 months to correct the position of the urethra. This is because patients can develop physical and psychological problems if left untreated.
George’s parents, Stefanos Michelis and Peggy Karagianis, took him to see a specialist in November at the urology department at the Hospital for Sick Children, where they were told he was a candidate for surgery.
“They said they would let us know the surgery date within six months to a year,” Michelis said. “But the pandemic hit in March 2020 and since then we’ve kind of been in a black hole.”
This left George languishing for the past three years on a waiting list for hypospadias surgery at SickKids. He is one of 698 children awaiting the procedure, according to SickKids. Because hospitals prioritize emergencies and urgent procedures, elective patients like George can linger at the bottom of the list for months or even years, not knowing when their surgery will be.
The family’s long wait is emblematic of what many of them are going through at SickKids, as the number of children awaiting operations continues to rise. According to the hospital, there were 6,021 patients waiting for all kinds of pediatric surgeries at SickKids as of October 31, an increase of 280% since 2017.
“There is a huge volume of children who need surgery and we just don’t have enough resources to take care of them all,” said Dr. Simon Kelley, associate chief of perioperative services at Sick. Kids.
“It’s a situation that has evolved over many, many years and COVID really was probably the straw that broke the camel’s back.”
Kelley said the hospital is facing a shortage of surgeons, specialist staff who support surgeries and recovery, and operating room time.
“You’re in Canada. You didn’t expect this to happen to us here,” Karagianis said. “It’s disappointing actually, and discouraging.”
Only one doctor regularly performs hypospadias surgery
Hypospadias affects approximately one in every 150 to 300 male babies born worldwide, according to the SickKids website. If left untreated, patients may develop urinary blockage, reproductive issues, or psychological issues as they age.
Kelley said SickKids has three pediatric urology surgeons who can perform hypospadias surgery, but only one performs it regularly. The other two focus on different procedures.
“A comparable city in North America would have 10 to 12 pediatric urology surgeons and that’s for the same size population,” Kelley said.
Meanwhile, the waiting list for hypospadias surgery has grown.
- Are you a parent whose child is part of Ontario’s surgical backlog and would like to talk about it? Contact [email protected]
According to a letter from the urology department that Michelis shared with CBC News, there were “over 500” patients on the waitlist as of July. A follow-up letter from George’s urological surgeon in mid-October said “over 600” were on the list at that time. Now, just two weeks later, that number has increased by almost 100.
This week, after CBC Toronto began investigating the family’s situation, George was given a January 2023 date for his operation.
“We are just delighted to have George taken care of,” Michelis said. “I feel guilty that we are going through and there are other children waiting.”
‘System-wide’ change needed, says SickKids doctor
The number of children waiting for surgery at SickKids continues to rise despite the hospital performing roughly the same number of surgeries last year as before the pandemic. The hospital implemented a voluntary weekend surgery program, improved its waiting list system and set up an ethics team to make decisions about which patients should be prioritized.
Kelley said “system-wide” improvements are needed to increase health system capacity, including training and hiring more surgeons and specialist support staff and working with regional hospitals and clinics. communities to perform more surgeries.
“We need a solution that involves not just individual hospitals, but networks of hospitals across the region and across the province,” Kelley said.
In a statement, the Ontario Ministry of Health said it will invest $300 million in 2022-23 in the province’s surgical recovery strategy, for a total of $800 million since the start of the pandemic.
“Our surgical recovery strategy will expedite surgeries and procedures, address long wait times, and support and optimize the post-acute pediatric care pathway with a focus on areas where service reduction is greatest. significant due to the pandemic,” the ministry said.
The province said it has added 3,500 hospital beds, more than 11,900 healthcare workers and deployed more than 1,000 internationally trained staff to hospitals so they can learn the language skills and practical experience they need to work as nurse practitioners.