Robotic / Laparoscopic Radical Prostatectomy

No. Every movement is made by the surgeon; the system transmits the movements of their hands to fine instruments and provides a magnified three-dimensional view. The device does not decide or move on its own. The outcome is therefore determined by the surgeon at the console.

Leakage in the first period after catheter removal is expected, because continence now depends on a single muscle. Most men improve over weeks and months, and recovery can continue for up to a year. In a small number it is permanent, and that possibility should be stated before surgery rather than after.

That is decided from your biopsy result, your MRI and the examination. The rule does not change: complete removal of the cancer first, preservation of the nerves second where possible. If the cancer extends towards the nerve bundle, it is not preserved. One-sided preservation is also possible, and the plan may be revised during the operation.

No. Even with the nerves preserved, recovery takes months and is not the same for everyone. Age, diabetes, vascular disease, smoking and — most importantly — your function before surgery all affect it. In a man with significant erectile difficulty beforehand, nerve preservation may not deliver the expected benefit.

Not naturally. With the prostate and seminal vesicles removed, there is no ejaculate. If you wish to father children, this must be discussed before surgery and sperm banking considered. The opportunity does not exist afterwards.

Tumour may be found at the surgical margin, or the disease may be more advanced than anticipated. This does not mean the operation failed; it means additional treatment may be needed, usually radiotherapy and sometimes hormone therapy. Knowing this possibility in advance softens the shock of hearing it.

With the prostate removed, PSA is expected to fall to an undetectable level. It is then measured at intervals, and a rising trend prompts further assessment. Establish before you leave who reviews these results and on what schedule.

Both are valid in the right patient, and neither is definitively superior. One advantage of surgery is that examining the removed gland reveals the true stage, and radiotherapy can still be added afterwards if needed. The advantages of radiotherapy are that it avoids surgery and anaesthesia and causes less incontinence. The right choice depends on which side effects you would rather live with.

Usually 7–10 days, and it is the catheter that sets the timetable. It is removed here so that any difficulty passing urine is managed close to the hospital. Book a changeable ticket and allow a few days' margin.

Flying clearance is given individually and is normally planned for after the review and catheter removal. Pelvic surgery and immobility raise the risk of clots in the legs, so take seriously the advice about walking in the aisle, hydration and compression stockings. Seek medical help immediately for calf pain or swelling, chest pain or breathlessness.

Your PSA values over time, the complete biopsy pathology report (how many cores were taken, how many were positive, the Gleason score or ISUP grade), the MRI report and the MRI images themselves, any staging investigations, your medication list and your other medical conditions. With these, it can be assessed before you travel whether this operation is right for you.