The surgeon makes several small incisions in your lower abdomen to remove the prostate. He or she sits at a console, using instruments attached to a mechanical device robot. Using the robotic device allows a more precise response to movement of the surgeon's hands. The surgeon controls the robotic prostate surgery robotic arms from the robot console using natural hand and wrist movements.
Robotic prostatectomy is designed to allow greater precision than is normally achievable in open and laparoscopic prostatectomy surgery.
He or she will discuss what you should know and whether further treatment is necessary. Many men do not need any more treatment. One month after surgery : Doctors recommend no strenuous activity or heavy lifting for at least one month after surgery.
Most people take off work for three to four weeks. If you work from home, you could return to work sooner. By one month after surgery, your life should start getting back to normal. Some men experience side effects, including:. Recovery from surgery takes time. These side effects are often temporary. Patients with significant abdominal adhesions or obesity, however, may not be appropriate candidates for the this procedure.
The use of the robotic equipment in surgery means a more precise and less disruptive dissection, which helps control potential sources of bleeding. Blood loss is also reduced because of the pressure generated by the gas used in inflate the abdomen during surgery, which provides surgeons with a better and more expansive view of the operating area around the prostate. As with any major surgery done under general anesthesia, there is a certain amount of risk, including heart attack, stroke and death.
Prostatectomies, including those done with a robotic-assisted surgery system, are also associated with the risks of impotence and incontinence.
Urinary continence depends on the internal, involuntary sphincter and the voluntary striated external sphincter. The internal sphincter is removed during all forms of prostatectomy, as it is anatomically at the junction of the prostate and bladder. Performing specialized Kegel exercises after surgery to strengthen muscles enables patients to control their external sphincter and gain continence dryness. This takes several weeks to several months. Overall, significant urinary leakage occurs in only 0.
About 15 percent of patients report mild stress incontinence. Return of normal erectile function depends on a number of physical and psychological factors, including the type of prostatectomy unilateral or bilateral; nerve-sparing or non-nerve sparing, etc. Function may return from one week to one year after surgery, It typically takes several months. Additional factors that can affect erectile function include hypertension, diabetes, obesity, atherosclerosis, smoking and anxiety.
Rarely, part of the intestine might be injured during surgery, which could lead to infections in the abdomen and might require more surgery to fix. Injuries to the intestines are more common with laparoscopic and robotic surgeries than with the open approach. If lymph nodes are removed, a collection of lymph fluid called a lymphocele can form and may need to be drained.
In extremely rare cases, a man can die because of complications of this operation. Your risk depends, in part, on your overall health, your age, and the skill of your surgical team. The major possible side effects of radical prostatectomy are urinary incontinence being unable to control urine and erectile dysfunction impotence; problems getting or keeping erections.
These side effects can also occur with other forms of prostate cancer treatment. Urinary incontinence: You may not be able to control your urine or you may have leakage or dribbling. Being incontinent can affect you not only physically but emotionally and socially as well. These are the major types of incontinence:. After surgery for prostate cancer, normal bladder control usually returns within several weeks or months. This recovery usually occurs slowly over time.
In general, older men tend to have more incontinence problems than younger men. Large cancer centers, where prostate surgery is done often and surgeons have a lot of experience, generally report fewer problems with incontinence.
Incontinence can be treated. To learn about managing and living with incontinence, see Bladder and Bowel Incontinence. Erections are controlled by 2 tiny bundles of nerves that run on either side of the prostate. If you can have erections before surgery, the surgeon will try not to injure these nerves during the prostatectomy.
This is known as a nerve-sparing approach. But if the cancer is growing into or very close to the nerves, the surgeon will need to remove them.
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