Prostate Cancer

Prostate cancer is the most common cancer in men in the United States, and is the second leading cause of cancer deaths among men. While many men live for years without knowing they have prostate cancer, it can spread. Urologists take many approaches to treatment, including watchful waiting and other medical interventions. In some cases, urologists may recommend removal of the prostate.

Common Symptoms of Prostate Cancer

Prostate cancer is silent in the initial stages, but later on, these symptoms may occur:

• Frequent urination, especially at night
• Difficulty in starting or stopping urination
• Weak or interrupted urine flow
• Painful and/or burning when urinating; blood sometimes in urine
• Pain with ejaculation and sometimes blood in semen
• Discomfort or pain in lower back, hips and legs

Robot-Assisted Radical Prostatectomy

At WakeMed, our fellowship-trained urologists perform robot-assisted radical prostatectomy, which involves the surgical removal of the entire prostate and seminal vesicles. This is recommended typically when the disease is confined to the prostate, with the intent of curing the disease.

Robotic prostatectomy outcomes are comparable to open surgery in terms of both tumor removal and minimizing the likelihood of post-operative side effects, including impotence or incontinence. The technology allows improved vision and dexterity for the surgeon, and reduces blood loss and decreases recovery time for the patient.

After the patient is anesthetized, five small incisions are made across the abdomen and ports are placed in them, four for the robot’s camera and instrument arms and a fifth for passing needles in and out during surgery. An additional, smaller incision is made for the passing of instruments. The urologist is able to reach the prostate precisely by entering the abdominal cavity. The prostate is removed through an incision with a scalpel or similar instrument. In most cases, the lymph nodes are then removed for sampling to guide future treatment. Robotics allows the intricate dissection of the lymph nodes from nerves and blood vessels with minimal blood loss and accuracy. Once the tissue has been removed, the area is cleaned with sterile solution, a catheter is inserted and the incisions are closed.

In general, robot-assisted prostatectomy requires a one- to two-day hospital stay. The day after surgery, patients are encouraged to walk. The catheter will be removed in about one to two weeks, based on how the connection between the bladder and urethra have healed. Most patients can return to normal activities within a month following surgery; however, urinary and sexual function may take a few months to a year to improve.

Learn What to Expect from Prostatectomy