Robotic Urology Surgery in Seattle

The usual length of stay is less than 24 hours. We admit you to the hospital after the surgery and have you stay overnight. The nurses on the floor will tend to your needs, administer medications, help you ambulate and answer any questions you may have. The next morning, we will go over discharge instructions and set you up for discharge by the afternoon. The vast majority of our patients feel comfortable enough to leave the day after surgery but we have no problem keeping you an extra night if needed.

Most patients are walking later that evening on the day of surgery. You may have some tenderness in your abdominal muscles in the first couple of days. Many patients describe the feeling as if they’ve done a ton of sit ups or crunches. Generally, by about 1-2 weeks after surgery, most patients will feel much better and resume most activities.

No heavy lifting more than 15 lb and no excessive bending or twisting activities.

Showers are ok after two days and no baths or swimming (submerging incisions) for two weeks.

There are no specific foods to avoid or consume after surgery.

We remove your catheter after 1 week. We perform a voiding trial where we fill your bladder up in the clinic, remove the catheter and ensure you can urinate prior to leaving the office. If you live outside the Seattle area, we can also coordinate with your local urologist to have them remove the catheter for you. Another alternative is to have you remove the catheter yourself at home.

We have a post-operative visit 1 week after surgery. We will remove your catheter, check your incisions, assess your recovery and review pathology results.

The two main side effects that can occur after a prostatectomy include urinary incontinence (leakage of urine) and erectile dysfunction. However, these side effects tend to be temporary and may recover with time.

When it comes to incontinence, 90% of our patients are completely dry at the 1-year mark after surgery. The remaining patients may wear a security pad when they go out. Only 2-3% of patients leak significantly 1 year after surgery and may require another surgery (either a urethral sling or artificial sphincter). One caveat is that if you are older (>70 years old), diabetic, smoker or obese you may have a higher risk for incontinence.

A lot of this is very patient specific. Depending on your erectile function, men who have borderline function may find it much more difficult to have erections afterwards. Patients with significant cardiovascular disease and diabetes will have more difficulties. Another major factor is the type of prostate cancer you have and if a nerve sparing operation can be performed. If a bilateral (both sides) nerve sparing operation is performed, 70% of patients will return to their baseline erectile function at the 1-year mark. If a unilateral (one side) nerve sparing is performed, 30-40% of patients will get back to their baseline function.

Generally if the prostate cancer is higher risk (Gleason score 4+4 or higher, cribriform or intraductal pattern, extraprostatic extension among other features), we do not recommend nerve sparing on that side of the prostate due to the risk of leaving high risk prostate cancer behind. We’ll discuss your specific case during consultation and determine if nerve sparing is an option. We will always strive for nerve sparing whenever possible if it fits within your goals.

We check a PSA (blood test) 8 weeks after surgery. PSA is only made by your prostate and prostate cancer. If your prostate is removed and all the cancer is gone, your PSA should be undetectable. We then check your PSA every 6 months to monitor for recurrence.

Typically, we are able to schedule you within 4-6 weeks. With higher risk prostate cancer, we attempt to get you on the schedule sooner. We will also occasionally have a patient reschedule, and we do have a waitlist for people who want to go sooner.