Before agreeing to any operation, it is important to understand the possible risks as well as the benefits. Robotic prostatectomy is generally a safe and well-established operation, and serious complications are uncommon. Even so, every major operation carries some risk. This guide sets out the robotic prostatectomy risks explained in plain terms, so that you can weigh the decision with confidence.
A brief reminder of the operation
A robotic prostatectomy removes the whole prostate through several small incisions, with the surgeon controlling precise instruments from a console. It usually means less blood loss, less pain and a shorter hospital stay than open surgery. Our robotic prostatectomy page describes the operation.
Common effects after surgery
These are expected for many men and usually improve with time.
Urinary leakage
Some leakage is normal after the catheter is removed. Most men regain good control within months, helped by pelvic floor exercises. A small number have longer-lasting leakage, for which further treatment is available.
Changes to erections
Erections are often affected after surgery, even when the nerves are preserved. Recovery is gradual and depends on age, function before surgery and the extent of nerve-sparing. Our article on erectile function after surgery explains this in detail.
Changes to orgasm and ejaculation
After the prostate is removed, men no longer ejaculate semen, although orgasm is usually still possible. This means natural conception is no longer possible, so fertility should be discussed before surgery if it matters to you.
Less common complications
Bleeding and infection
Blood loss is usually low with robotic surgery, and transfusion is rarely needed. Infections of the wounds or urine can occur and are generally treated with antibiotics. Tell your team promptly if you develop a fever or feel unwell.
Blood clots
Any major operation increases the risk of clots in the legs or lungs. Early walking, compression stockings and sometimes blood-thinning injections reduce this risk. The NHS explains the signs of deep vein thrombosis.
Narrowing at the join
Occasionally, scar tissue narrows the join between the bladder and urethra, slowing the urine flow. This can usually be treated with a minor procedure.
Injury to nearby structures
Rarely, nearby organs such as the bladder, bowel or ureters can be injured during surgery. Experienced surgeons take great care to avoid this, and any injury is usually recognised and repaired at the time.
Hernia
A small number of men develop a hernia at one of the incision sites in the months after surgery. This appears as a bulge near a scar and can be repaired if needed.
How risks are reduced
Several factors lower the chance of complications:
- careful assessment of your health before surgery
- an experienced surgeon and theatre team
- precise technique, including nerve-sparing methods such as Professor Dasgupta's SAFE technique
- early mobilisation and clear instructions for recovery at home
- prompt follow-up if any problem arises
Our article on why surgeon experience matters explains why experience has such a strong influence on results.
Questions to ask about risk
- Which risks are most relevant to me?
- How often do you see these complications in your own patients?
- What would happen if a complication occurred?
- Who do I contact if I am worried after going home?
NHS information on prostate cancer treatment provides an independent summary of the risks of each option.
Balanced information for a confident decision
For most men, the benefits of robotic prostatectomy outweigh the risks, but the balance is personal. A good consultation explains the risks honestly and in the context of your own health and diagnosis.
To talk through the benefits and risks of surgery for you, please contact the clinic to arrange a consultation with Professor Dasgupta.