Does the robot perform the operation?

No. The robotic instruments are controlled by the surgeon throughout the procedure. The system translates the surgeon’s movements into precise movements inside the body.

Does robotic prostatectomy guarantee that the cancer is cured?

No treatment can guarantee a cure. The likelihood of cancer control depends on factors such as the stage and grade of the tumour, PSA level, pathology findings and surgical margins. Some patients may require additional treatment.

Will I need a urinary catheter?

Yes. A temporary catheter is left in place while the connection between the bladder and urethra heals. It commonly remains for one week, although the duration may vary.

Will I still produce semen?

No. Removal of the prostate and seminal vesicles means that semen is no longer produced during orgasm, resulting in permanent infertility. If future fertility is important, sperm storage should be discussed before treatment.

How do I know whether surgery is right for me?

The decision requires an individual assessment of your cancer, health, priorities and alternative treatment options. A consultation allows these factors to be reviewed carefully before a recommendation is made.

Robotic Radical Prostatectomy for Prostate Cancer

Robotic radical prostatectomy is a minimally invasive operation used to treat prostate cancer by removing the prostate gland and seminal vesicles. In selected cases, nearby lymph nodes may also be removed for analysis.

The procedure is performed through several small abdominal incisions using robotic instruments controlled entirely by the surgeon. The robotic system provides a magnified three-dimensional view and allows precise movement within the pelvis; it does not perform the operation independently.

Dr Carlo Bravi offers private consultations in Northampton and London for men considering robotic prostatectomy, seeking a second opinion or wishing to discuss their prostate cancer treatment options.

What Is a Robotic Radical Prostatectomy?

A radical prostatectomy involves removing the entire prostate gland, together with the seminal vesicles. After the prostate has been removed, the bladder is carefully reconnected to the urethra.

The operation is performed under general anaesthetic. Robotic instruments are introduced through small keyhole incisions in the abdomen and remain under the surgeon’s control throughout the procedure.

The principal aim is to remove the cancer while preserving urinary control and, where oncologically safe and technically possible, the nerves involved in erectile function.

What Happens During the Operation?

Several small incisions are made in the abdomen to allow the robotic camera and surgical instruments to be positioned. The surgeon separates the prostate from the bladder and urethra, removes the prostate and seminal vesicles, and then reconnects the bladder to the urethra using fine sutures. A urinary catheter is left in place temporarily while this new connection heals.

Depending on the characteristics of the cancer, pelvic lymph nodes may also be removed and sent for laboratory analysis.

The prostate and any lymph nodes removed during surgery are examined by a specialist pathologist. These results help determine the final stage of the cancer and whether any additional monitoring or treatment may be required.

Diagram showing the bladder, prostate and urethra before and after robotic radical prostatectomy.

Risks and Possible Side Effects

Robotic radical prostatectomy is a major operation. Potential risks and consequences include:

Temporary or persistent urinary incontinence
Erectile dysfunction
Bleeding or the need for a blood transfusion
Infection
Blood clots
Urine leakage from the join between the bladder and urethra
Narrowing of the bladder neck or urethra
Lymph fluid collection if lymph nodes are removed
Injury to surrounding structures (e.g. bowel)
Complications associated with anaesthesia
Positive surgical margins or the need for additional cancer treatment

Further detailed information about the procedure, including potential risks and complications, is available in the BAUS patient information leaflet on robotic-assisted radical prostatectomy.

Your individual risks will be discussed during consultation and before consent for surgery.

Frequently Asked Questions

Nerve-Sparing Robotic Prostatectomy

The nerves involved in erectile function run very close to the prostate. When the position and extent of the cancer allow, the surgeon may attempt to preserve one or both of these nerve bundles. Nerve-sparing surgery is not appropriate in every case. The priority is the safe and complete removal of the cancer, and nerves should not be preserved if doing so could compromise cancer control.

Even when nerve-sparing surgery is possible, erections commonly become weaker or absent after the operation and may take months or longer to recover. Some men will require tablets, injections, vacuum devices or other treatments as part of penile rehabilitation.

Urinary Control After Surgery

Urinary leakage is common immediately after the catheter is removed. Most men notice gradual improvement as healing progresses and the pelvic floor becomes stronger. Pelvic floor exercises are an important part of preparation and recovery. You may be advised to begin them before surgery and restart them after catheter removal.

The speed and extent of recovery vary considerably. A small proportion of patients experience longer-term urinary incontinence and may require further assessment or treatment.

What Happens After the Operation?

The removed prostate is examined under a microscope. The pathology report provides information about the cancer’s grade, stage and surgical margins. A PSA blood test is usually arranged after surgery and subsequently monitored. PSA is expected to fall to a very low or undetectable level after successful removal of the prostate.

If the pathology or PSA results suggest that cancer may remain or return, further monitoring, radiotherapy, hormone treatment or another treatment may be recommended.

Why Consult Dr Carlo Bravi?

Dr Carlo Bravi is a consultant urologist with specialist experience in robotic and minimally invasive urological surgery. He has performed several hundred robotic procedures and has particular expertise in robotic surgery for prostate and kidney conditions.

During your consultation, Dr Bravi will review your medical history, biopsy, imaging and other available results. He will explain whether surgery is appropriate, discuss alternative treatments and provide an individual assessment of the potential benefits and risks.

Private consultations and second opinions are available in Northampton and London.

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