A radical prostatectomy is a surgical procedure to remove the entire prostate gland, seminal vesicles, and a part of vas deferens. In some cases, lymph nodes around the area will be removed as well. This surgery is typically recommended for men with prostate cancer that is confined to the prostate, and is clinically significant (poses a risk of spreading). This procedure is done using robotic technology. 

By the time you are ready to have this procedure, you have already had a thorough medical assessment, including blood tests and imaging studies, to ensure you’re fit for surgery.

• Medications: Inform your doctor about all medications and supplements you’re taking. You may need to adjust or temporarily stop certain medications before surgery.
• Fasting: Typically, you’ll be asked not to eat or drink anything (not even water) after midnight before your surgery. No breakfast/juice/water before surgery. 
• Planning your day: If your surgery is the first procedure of the day, you should be able to go home on the day of surgery. if it is later in the day, or depending on other circumstances, you may stay one night in the hospital. If everything goes well, we encourage walking after surgery. You will have dinner before you go to bed, and can go up or down the stairs next day.  
• Anesthesia: You will receive general anesthesia, ensuring you’re comfortable and pain-free during the surgery.
• Duration: The procedure usually takes between 2 to 4 hours, depending on the surgical method used. To put you to sleep and wake you up will be half an hour on each side, so for you to see your family back, will be about 4-5 hours. 
• Robotic surgery: We use the da Vinci 5 or the Xi Robot for this procedure. Robotic-assisted surgeries result in smaller scars, less blood loss, and quicker recovery times compared to open surgery.
• Incisions and catheter: When you wake up after surgery, you will have 6 small keyhole incisions on your belly. One of them will be a little bigger, about 6-10 cm (that’s where the prostate comes out from). You will have a urinary catheter, which will be removed after 7-10 days after surgery to help you urinate while your body heals.

Potential Side Effects

While radical prostatectomy is effective in treating prostate cancer, it can have side effects, including:

• Urinary Incontinence: Temporary or, in some cases, long-term difficulty controlling urine. Approaches that can help early recovery of continence include Retzius sparing (for selected patients), bladder neck preservation, posterior reconstruction. Dr. Arora will make a game time decision on what approaches will be best in your case to preserve urinary function. Most patients will make full recovery of continence within 4 months. You will work with physical therapists who are part of our team, to train your pelvic floor muscles before and after surgery. Pelvic floor exercises can aid in regaining urinary control  as well as sexual function.
• Erectile Dysfunction: Nerve-sparing techniques can help preserve sexual function, but some men may experience challenges. We work with those men and offer drugs like sildenafil, and intracavernosal injections as a part of penile rehabilitation after surgery. 
• Healthy Lifestyle: Maintaining a balanced diet and regular exercise can support your overall recovery and well-being.
• Medication Management: You will be given a personalized plan for medication after surgery. Most of our patients will not need opioid pain medication after this surgery.