Language matters

Sex and gender exist on spectrums. This article uses the term “men” to reflect a term that has been historically used to gender people. It’s important to note that not everyone assigned male at birth identifies with the label “man.”

While we aim to create content that includes and reflects the diversity of our readers, specificity is key when reporting on research participants and clinical findings.

Unfortunately, the studies and surveys referenced in this article did not include data on, or include, participants who were transgender, nonbinary, gender nonconforming, genderqueer, agender, or genderless.

About 1 in 8 men will get a diagnosis of prostate cancer in their life. Older men and non-Hispanic Black men are at the highest risk, according to the American Cancer Society (ACS).

Advancements in treatment have led to 5-year relative survival rates of over 99% for people with prostate cancer that hasn’t yet spread.

Surgery is one of the most common treatments for early stage prostate cancer. Scientists have developed various surgical techniques. One minimally invasive option is robot-assisted prostatectomy (robotic prostatectomy).

During this procedure, a surgeon removes your prostate by guiding a robotic arm from behind a control panel. The robotic arm allows for greater precision than if they perform the surgery by hand.

Keep reading to learn more about robotic prostatectomy, including what happens during the procedure and how it compares with other treatment options.

a doctor looking through a console while controlling robotic arms, while two other medical professionals partake in a robot-assisted surgeryShare on Pinterest
A surgical team uses a robot with mechanical arms controlled through a console to assist in surgery. فاطمه درستی, CC BY-SA 4.0, via Wikimedia Commons

Your surgeon will give you specific instructions before your surgery, including how long in advance you should stop eating and drinking. It’s important to tell your surgeon ahead of time about any medications or supplements you’re taking.

Here’s a general idea of what to expect during your surgery. The actual procedure that your surgeon follows may be slightly different.

  1. Medical staff will give you general anesthesia through an IV so that you’ll be asleep during your surgery. They’ll also give you antibiotics to prevent an infection.
  2. Your surgeon will make about six small keyhole incisions in your abdomen to allow access to your prostate. Some surgeons may use more or fewer incisions.
  3. They will then insert a robot-controlled camera and other instruments through the incisions.
  4. They will then guide the robotic system from behind a control panel that allows them to perform finer movements than are possible by human hand.
  5. They will remove your prostate, seminal vesicles, and surrounding tissue through one of the small incisions.
  6. They will connect your bladder to your urethra, the tube that carries urine outside your body.
  7. They will suture the wounds to minimize your risk of infection.
  8. They will place a catheter into your urethra to help it heal. You may also receive a wound drain, which is a tube they place in the wound to carry fluid away from the surgical site.
  9. After your procedure, you’ll go to a recovery room for monitoring.

Although rare, in some cases, your surgeon may need to switch from a robotic prostatectomy to a traditional open surgery. You won’t know until you wake up after your procedure.

What is the success rate for robotic prostatectomy?

Robotic prostatectomy has a high chance of success.

In a 2018 study, researchers examined the outcomes of robotic prostatectomy in 202 people divided into two groups: people under 50 years and people over 65 years. Six months after the procedure, they found the following:

  • Cancer recurred in 4% of people over 65 years, and 11.6% in people under 50 years. They defined recurrence as a prostate-specific antigen (PSA) level above 0.2 nanograms per milliliter.
  • More than 90% of people in both groups had urinary continence (no urine leakage).
  • Almost half of the people over 65 years and more than 90% of those under 50 years could achieve an erection.

Robotic prostatectomy is a very safe procedure. Complication rates are low when an experienced surgeon performs them. In 2015, roughly two-thirds of prostatectomies in the United States were robot-assisted, and this number continues to rise.

Possible complications include:

In a 2021 study, researchers found that robotic prostatectomy was linked to fewer complications than open or laparoscopic prostatectomy.

When you wake up in the hospital, you’ll have a catheter attached to your urethra. The catheter will remain in place for at least 7 days to allow the area between your bladder and urethra to heal.

You’ll likely go home the morning after your procedure. It may take some time to regain control of your bladder. You may need to wear pads in your underwear.

It’s typical to experience a high urine output for several days after your surgery. You may also have bladder spasms that feel like cramping. Blood in your urine is also typical.

You may have swelling in your face that can last up to 48 hours.

It’s important to attend all your scheduled follow-ups to make sure the surgery was effective. How often you have a follow-up will depend on factors, such as your risk group and age. Generally, a doctor will schedule follow-ups every 3 to 6 months for 5 years, and about once a year after that.

Your surgeon will let you know how long you need to avoid activities like exercise and sexual activity. Many people put on some weight after their procedure.

Your doctor will usually recommend you avoid alcohol for several weeks to avoid irritating your bladder.

How long does it take to recover from a robotic prostatectomy?

The recovery time for a robotic prostatectomy can be as short as 2 to 3 weeks. But it can be longer if you develop complications or have other health problems. Your surgeon can give you the best idea about what to expect.

Here’s a general idea of what your timeline will look like:

  • You’ll likely be able to walk immediately after the procedure.
  • After about 2 weeks, you can perform aerobic exercises like easy jogging.
  • After about 4 weeks, you’ll be able to resume light weightlifting.
  • You can usually drive about 2 weeks later.
  • You’ll be free to perform sexual activity once your healthcare team removes the catheter. But nearly all people lose erectile function in the first few months.

Treatment for early stage prostate cancer often involves some combination of:

A doctor may also recommend active surveillance, which is regular monitoring of your cancer with no active treatment.

Here’s a look at some of the alternatives for robotic prostatectomy. The information in this chart is meant to serve as a rough guide. Factors like cost, recovery time, and risk of complications can vary widely on a case-by-case basis. The costs listed are comparative only as the range of costs can vary considerably.

Robotic prostatectomyOpen prostatectomyLaparoscopic prostatectomyCryotherapyRadiation therapy
Invasive?minimallyyesminimallyminimallyno
Cost$$$$$$$$$$$$ to $$$$
Recovery time2 to 3 weeks4 to 8 weeks3 to 5 weeks1 to 3 weekspersistent side effects like nausea for up to about 6 weeks
Risk of complicationslowest (among surgical options)mediumlowlowvery low risk of long-term complications
Cancer stagecontained to prostate or surrounding tissuecontained to prostate or surrounding tissuecontained to prostate or surrounding tissuecontained to prostate or part of prostateearly or late stage prostate cancer

Robotic prostatectomy is a surgical option for early stage prostate cancer that hasn’t spread beyond the surrounding tissue. During this procedure, a surgeon uses a robot to remove your prostate and other tissue from behind a control panel.

Robotic prostatectomy is usually a safe procedure with a low risk of complications.

Your doctor can give you the best idea about what to expect and whether they recommend this procedure or a different treatment. They may also recommend another type of surgery, hormone therapy, radiation therapy, or some combination of these.