Prostatectomy and robotic prostate surgery are both terms for prostate removal surgery. Today, surgeons use robotic or laparoscopic prostatectomy to remove a cancerous prostate, but early methods involved traditional or open surgery.
David B. Samadi, MD, is at the forefront of prostatectomy and prostate removal surgery and has performed more than 7,000+ successful procedures to date. His innovative SMART technique uses robotic prostate surgery enhancements to improve vision and precision. In Dr. Samadi’s skilled hands, patients are assured superior quality of life results in both sex after prostate surgery and urinary control after prostate surgery.
Today’s Prostate Removal Surgery/Prostatectomy
A robotic prostatectomy requires 5 small incisions, each about one-quarter of an inch in the lower abdomen, through which instruments are inserted. A sophisticated video camera is one of the instruments, which gives Dr. Samadi a three-dimensional, 10x magnified field of vision. The keyhole incisions drastically reduce blood loss and the camera provides unprecedented visual clarity. The result is a clear surgical field during the prostatectomy with nothing to obstruct Dr. Samadi’s view of the prostate and surrounding tissue.
Cameras are also used in laparoscopic prostatectomy, but they provide only a two-dimensional image and no magnification.
Urinary Control after Prostate Surgery
Is there a risk of incontinence after prostatectomy?
Following proper prostatectomy recovery guidelines, patients who experienced normal continence prior to surgery should regain function within 12-13 months.
Loss of bladder control, or urinary incontinence, is a potential side effect of prostate removal surgery. Because the prostate sits just below the bladder and encircles the urethra, the urinary tract can be damaged during a radical prostatectomy. In the hands of an experienced robotic surgeon like Dr. Samadi, preservation of the urinary sphincter and competent rebuilding of the urinary tract can eliminate the risk of long-term incontinence. Uniquely, Dr. Samadi does not sever the endopelvic fascia and cuts the bladder neck very narrowly during robotic prostatectomy.
Urinary incontinence is far more common after open prostatectomy, as is risk of infection.
Sex after Prostate Surgery
Is there a risk of impotence after prostatectomy?
Following proper prostatectomy recovery guidelines, patients that were able to achieve sexual function before prostate surgery, 83% regained normal sexual function.
Dr. Samadi’s unique nerve-sparing technique for prostate removal surgery is crucial to preserving sexual function. These tiny nerves surrounding the prostate course laterally along the prostate and rectum and provide nerve connections to the proximal penis deep in the pelvis. If they are damaged during prostatectomy, so is erectile function. Put simply, preserving the cavernous nerves preserves sexual potency after prostate surgery. There are treatments for erectile dysfunction resulting from prostatectomy surgery, but with the right surgeon and prostate surgery technique, they are often unnecessary.
More commonly, traditional prostatectomy inadvertently results in damage to one or both of the cavernous nerves.
Prostate Surgery/Prostatectomy – Recovery
Prostate surgery recovery time is substantially improved in comparison to open prostatectomy. As mentioned earlier, the much larger incision required in open surgery means pain is greater and recovery takes longer. Dr. Samadi’s prostate surgery takes just 1.5-2 hours and almost all of his patients return home the day after having a robotic prostatectomy. Around 80% of open prostatectomy patients leave the hospital within the first week.
Eradicating prostate cancer is the true measure of prostate surgery success, be it open, laparoscopic or robotic. Nowhere is the evolutionary progression more pronounced than with this marker. The positive surgical margin is the measurement used to determine whether any cancer remains or is likely to recur. A physician always seeks low positive margins. In a recent study, there was a steep drop-off in positive margins from open, to laparoscopic, to robotic. Open prostatectomy received a positive surgical margin of 23% and laparoscopic 19%, whereas robotic prostatectomy received a positive margin of only 12%.