Prostate Cancer Treatment
da Vinci Robotic Prostatectomy
For many men with localized prostate cancer, surgery to remove the prostate offers the best chance at a cure. Texas Regional Urology performs radical prostatectomy using the da Vinci Surgical System — a robotic-assisted approach that allows our surgeons to operate with greater precision through a few small incisions rather than one large one. For most patients, that means less blood loss, a shorter hospital stay, and a faster return to normal life, without compromising the goal that matters most: removing the cancer completely.
Robotic Prostate Removal
What Is Robotic Prostatectomy?
A radical prostatectomy removes the entire prostate gland along with the seminal vesicles and, in many cases, nearby lymph nodes. What makes the robotic approach different is how the surgeon reaches and removes it.
Rather than opening the abdomen, your surgeon makes several small incisions and operates through them using the da Vinci system. Seated at a console beside you, the surgeon controls the instruments directly — the robot does not act on its own and never moves independently. What the system provides is a high-definition, three-dimensional view magnified well beyond what the eye can see, and instruments that bend and rotate more freely than the human wrist, allowing careful work in the narrow space around the prostate.
That precision matters here more than almost anywhere else in the body. The prostate sits against the bladder, the urethra, and the delicate bundles of nerves that control erections. Removing it well means separating it from all three without unnecessary damage.
Rather than opening the abdomen, your surgeon makes several small incisions and operates through them using the da Vinci system. Seated at a console beside you, the surgeon controls the instruments directly — the robot does not act on its own and never moves independently. What the system provides is a high-definition, three-dimensional view magnified well beyond what the eye can see, and instruments that bend and rotate more freely than the human wrist, allowing careful work in the narrow space around the prostate.
That precision matters here more than almost anywhere else in the body. The prostate sits against the bladder, the urethra, and the delicate bundles of nerves that control erections. Removing it well means separating it from all three without unnecessary damage.
Robotic vs. Open Surgery
Benefits Compared to Open Surgery
Smaller Incisions
Robotic prostatectomy typically involves several incisions under an inch rather than a single large abdominal incision, and is associated with significantly less blood loss and a lower likelihood of needing a transfusion.
Shorter Hospital Stay
Most patients go home the day after surgery, and some qualify for same-day discharge. Open prostatectomy has historically required a longer stay.
Faster Recovery
Less tissue disruption generally means less post-operative pain, fewer narcotics, and a quicker return to walking, working, and driving.
Nerve-Sparing Precision
When the cancer's location and stage allow it, our surgeons use a nerve-sparing technique to preserve the neurovascular bundles that control erectile function. Magnified 3D visualization makes this delicate dissection more feasible.
Who Qualifies
Am I a Candidate?
Robotic prostatectomy is generally considered for men with prostate cancer that appears confined to the prostate and who are healthy enough for surgery and anesthesia. Your urologist will weigh your biopsy Gleason score, PSA level, imaging results, age, and overall health.
Surgery is not the right answer for everyone. Men with low-risk, slow-growing cancer are often better served by active surveillance, and men with certain advanced or metastatic disease may benefit more from radiation, hormone therapy, or a combination. Prior abdominal surgery, significant obesity, or certain heart and lung conditions can also affect whether a robotic approach is advisable. The purpose of your consultation is to determine which option fits your specific cancer and your specific life — not to steer you toward surgery.
Surgery is not the right answer for everyone. Men with low-risk, slow-growing cancer are often better served by active surveillance, and men with certain advanced or metastatic disease may benefit more from radiation, hormone therapy, or a combination. Prior abdominal surgery, significant obesity, or certain heart and lung conditions can also affect whether a robotic approach is advisable. The purpose of your consultation is to determine which option fits your specific cancer and your specific life — not to steer you toward surgery.
Recovery Time
What to Expect
Before Surgery
You'll have a pre-operative visit covering labs, imaging, and a review of your medications — blood thinners and certain supplements typically need to be stopped in advance. You'll receive bowel preparation and fasting instructions for the night before, and you should arrange for someone to drive you home and help for the first few days.
The Day of Surgery
The procedure is performed under general anesthesia and generally takes two to four hours. A urinary catheter is placed during surgery and stays in place afterward. You'll wake up in recovery and be encouraged to get up and walk the same day, which helps prevent blood clots and speeds recovery.
In the Hospital
Most men stay one night. You'll be walking, drinking, and eating light foods before discharge, and you'll go home with the catheter in place and instructions for caring for it.
The First Two Weeks
The catheter typically comes out about seven to ten days after surgery at a follow-up visit. Expect fatigue, some incisional soreness, and urinary leakage once the catheter is removed — this is normal and expected, not a sign that something went wrong. Walking is encouraged; lifting, straining, and driving are not.
Weeks Three Through Six
Most men doing desk work return in two to four weeks. Avoid lifting anything over ten pounds and skip strenuous exercise and cycling until your surgeon clears you, usually at around six weeks.
Pathology and Follow-up
Your removed prostate is examined by a pathologist, and those results — the final Gleason score, margin status, and lymph node findings — tell us how completely the cancer was removed and whether any additional treatment is warranted. We'll review them with you at a follow-up visit. From then on, you'll have periodic PSA testing, which should fall to an undetectable level after the prostate is removed.
Risks & Side Effects
Side Effects
Every prostate cancer treatment carries trade-offs, and you deserve a clear picture of them before you decide.
Urinary Control
Nearly all men leak urine after the catheter comes out. For most, control improves substantially over the following weeks and months, with continued improvement up to a year. Pelvic floor exercises help, and we'll show you how to do them correctly. A small percentage of men have lasting leakage that may warrant additional treatment.
Erectile Function
Erections are usually affected after surgery even when nerves are spared, and recovery is gradual — often taking months to more than a year. How much function returns depends on your age, your erectile function before surgery, and whether nerve-sparing was possible. Medications, vacuum devices, injections, and other treatments are available, and our practice manages this actively rather than leaving you to figure it out.
Fertility and Ejaculation
Removing the prostate and seminal vesicles ends ejaculation permanently. Orgasm is still possible, but it will be dry. If you may want biological children, discuss sperm banking with your urologist before surgery.
Other Risks
As with any surgery, there are risks of bleeding, infection, blood clots, anesthesia complications, injury to nearby structures, and rarely the need to convert to an open procedure. Your surgeon will review these in detail during your consultation.
Answers to your da Vinci Robotic Prostatectomy Questions
Frequently Asked Questions
No — your surgeon controls every movement.
The da Vinci system has no autonomy and cannot move on its own; your surgeon sits at a console in the operating room and directs every instrument in real time. What the technology adds is magnified 3D vision and instruments that rotate more freely than the human wrist.
Usually one night.
Most men go home the day after surgery, and some qualify for same-day discharge depending on how the procedure goes and how they recover in the first few hours. You'll be walking and eating before you leave.
About seven to ten days.
The catheter is placed during surgery and removed at a follow-up office visit once the connection between the bladder and urethra has healed enough. We'll show you exactly how to manage it at home before you're discharged.
Two to four weeks for desk work.
Men with sedentary jobs typically return within two to four weeks, while physically demanding work usually requires closer to six. Lifting over ten pounds, strenuous exercise, and cycling are off-limits until your surgeon clears you.
Leakage is normal at first and improves.
Nearly every man leaks urine after the catheter comes out, with control improving substantially over the following weeks and continuing to improve for up to a year. Pelvic floor exercises speed recovery, and lasting leakage is uncommon and treatable when it happens.
Often yes, but recovery takes time.
When nerve-sparing is possible, many men regain erectile function gradually over several months to more than a year, depending on age and function before surgery. Medications, injections, and vacuum devices are available throughout that recovery, and our team manages this actively rather than leaving you to sort it out.
Not naturally — bank sperm beforehand.
Removing the prostate and seminal vesicles permanently ends ejaculation, so natural conception is no longer possible afterward. If biological children may be in your future, talk with your urologist about sperm banking before your surgery date.
No — surveillance and radiation are alternatives.
Low-risk, slow-growing cancers are often best managed with active surveillance, and radiation or hormone therapy may be more appropriate depending on your stage, grade, and health. Your consultation is about finding the right fit for your specific cancer, not steering you toward the operating room.
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