A prostate cancer diagnosis can be a life-altering experience, and it’s completely normal for patients and their families to feel anxious and overwhelmed. It is important to educate yourself by understanding prostate cancer, it’s stages (link to prostate cancer staging) and treatment options.

Our urologists offer a comprehensive range of treatment options for prostate cancer, supported by specially trained urology nurses.

Treatment Options

Robotic-Assisted Radical Prostatectomy

Robotic-assisted radical prostatectomy is a minimally invasive (keyhole) procedure used to remove the prostate gland and some surrounding tissue, with the goal of eliminating all cancer. This surgery is performed using specialized robotic equipment, providing enhanced precision and control.

Dr. Lam is highly experienced in using the da Vinci Surgical System, the advanced robotic technology employed for this procedure. He offers a fully individualised approach to care and will discuss all available treatment options with you, including your suitability for robotic-assisted surgery.

Am I a Suitable Candidate for Robotic-Assisted Radical Prostatectomy?

Robotic-assisted radical prostatectomy is a potentially curative surgical option for men diagnosed with prostate cancer who have a life expectancy of more than 8 to 10 years. This approach may be appropriate for patients who:

• Have cancer that is confined to the prostate
• Have clinically significant cancer that is likely to impact their health if left untreated
• Are in generally good overall health
• Prefer the reassurance of having the cancerous prostate physically removed, compared to other treatment options

What Are the Advantages of Robotic-Assisted Radical Prostatectomy?

Robotic-assisted radical prostatectomy offers several potential advantages over traditional open surgery, benefiting both patients and surgeons.

Potential benefits include:

• Less blood loss during surgery
• Smaller incisions, resulting in reduced scarring
• Shorter hospital stays
• Faster recovery times, helping you return to daily activities sooner
• High-definition 3D vision, giving surgeons a clear, magnified view inside the body
• Advanced surgical instruments with a greater range of motion than the human hand
• Improved dexterity and precision, allowing for enhanced control and accuracy during the procedure

These features help support a safer and more effective surgical experience.

Dr. Lam can assess your individual case and help determine whether robotic-assisted surgery is the most suitable option for you.

How Is a Robotic-Assisted Radical Prostatectomy Performed?

A robotic-assisted radical prostatectomy is a minimally invasive procedure involving several precise steps:

• General anaesthesia is administered to ensure the patient remains unconscious and pain-free throughout the procedure, which typically lasts between 2 to 4 hours.
• Several small incisions are made in the abdomen to insert the robotic surgical instruments and a high-definition camera.
• The abdomen is inflated with carbon dioxide gas to create space, allowing the surgeon a clear and magnified view of the organs.
• The surgeon controls the robotic instruments from a nearby console to carefully remove the prostate gland and seminal vesicles.
• In cases of high-risk cancer, nearby lymph nodes may also be removed to assess whether the cancer has spread beyond the prostate.
• The urethra is precisely reattached to the bladder (a process known as anastomosis) to restore urinary function.
• The carbon dioxide is released, and all instruments are withdrawn.
• The incisions are closed using techniques designed to reduce the risk of hernia and minimize scarring.

What to Expect After a Robotic-Assisted Prostatectomy

Recovery from a robotic-assisted prostatectomy is generally smooth, with most patients experiencing only mild discomfort and a gradual return to normal activities. Here’s what you can typically expect:

• Hospital Stay: Most patients remain in hospital for 2 to 3 nights following surgery.
• Pain Management: Some mild pain or discomfort is expected, but this is usually well managed with medication.
• Early Mobilization: You’ll be encouraged to get out of bed, walk around, and perform deep-breathing exercises to reduce the risk of complications such as pneumonia or blood clots (deep vein thrombosis or pulmonary embolism).
• Urinary Catheter: A urinary catheter will remain in place for 10 to 14 days to allow the surgical connection between the bladder and urethra (anastomosis) to heal properly.
• Discharge: Minor urine leakage or blood-tinged discharge around the catheter is common and usually not a cause for concern.

Uncommon complications may include:

• Injury to major blood vessels or surrounding organs during the procedure
• Incisional hernia, particularly if wound healing is impaired

Aftercare and Support:

• If you have concerns following discharge, you can contact the clinic or hospital ward during business hours to speak with the nurse in charge.
• For after-hours concerns, you may contact the ward nurse directly. For urgent or serious issues, attend your nearest emergency department—staff will liaise with your surgeon if needed.

Returning to Normal Activities After Surgery

After a robotic-assisted prostatectomy, it’s important to allow your body time to heal. Below is a general guide to help you understand when it’s safe to resume common activities:

• Driving: Avoid driving for at least 2 weeks after surgery. You should only resume once you are pain-free, off strong pain medication, and can comfortably perform an emergency stop.
• Work: Time off work is necessary. The duration will depend on the nature of your job—sedentary roles may require 2–3 weeks off, while physically demanding jobs may require more time.
• Lifting: Avoid heavy lifting and straining (including when opening your bowels) for a minimum of 4 weeks to reduce the risk of bleeding or hernia.
• Physical Activity: Light walking is encouraged from the early recovery phase. However, strenuous activities such as running, gym workouts, golf, cycling, and swimming should be avoided for at least 4 weeks.
• Sexual Activity: Refrain from sexual activity for 4 weeks post-surgery to allow for proper healing.

Procedure Outcomes

Robotic-assisted radical prostatectomy offers excellent long-term outcomes for many men, particularly when the cancer is confined to the prostate:

• Curative Potential: For men whose cancer has not spread beyond the prostate, this procedure can offer a long-term cure.
• Follow-Up Care: Ongoing monitoring is essential. Regular PSA (Prostate-Specific Antigen) testing and follow-up appointments will help ensure early detection of any recurrence.
• Urinary Incontinence: Some degree of urinary leakage is common after surgery but usually improves over time. Pelvic floor muscle training plays a key role in recovery.
• Physiotherapy Support: You will be referred to a pelvic floor physiotherapist who will guide you through exercises to begin after your catheter is removed.
• Erectile Function: There is a risk of temporary or permanent erectile dysfunction, as the nerves responsible for erections are located close to the prostate.
• Treatment Options: If erectile function does not fully return, there are several effective treatment options available to help manage this.