Dr. Sachin Arakere Nataraj is a uro-oncologist, robotic surgeon and focal HIFU therapist. He has performed about 2,000 robotic surgeries since 2014. He sees patients in Noida, Delhi NCR and Bangalore.
This page explains robotic radical prostatectomy, an operation to remove the prostate for prostate cancer. It covers who may be suitable, what the operation involves, recovery, and how it compares with focal therapy.
What is robotic radical prostatectomy?
In a radical prostatectomy the whole prostate and the seminal vesicles are removed. Nearby lymph nodes may be removed too, depending on the risk of spread. In robotic surgery the surgeon controls the instruments from a console, working through several small keyhole incisions in the abdomen. The robotic system gives a magnified 3D view and fine wrist-like instrument movement in the narrow space of the pelvis.
Where the cancer allows, the surgeon tries to preserve the nerves that control erections (nerve-sparing) and the structures that support urinary control. Whether nerve-sparing is possible depends on where the cancer is and how far it extends, which is assessed from the MRI and biopsy results.
Who may be a candidate?
Robotic prostatectomy may be considered when:
- The cancer is confined to the prostate, or has spread only just outside it.
- The cancer is intermediate or high risk, or low risk where the man prefers treatment to active surveillance.
- The man is fit enough for general anaesthesia and is expected to benefit from treatment over his lifetime.
Dr. Sachin reviews your PSA history, MRI, biopsy results, any staging scans (such as a PSMA PET scan when indicated) and your general health. He then discusses all your options, including active surveillance, focal HIFU and radiotherapy.
The operation: what to expect
- Before surgery: blood tests, a fitness check for anaesthesia, and advice on pelvic floor exercises.
- Anaesthesia: general anaesthesia.
- Duration: usually about 2–4 hours.
- Incisions: several small keyhole cuts in the abdomen.
- Catheter: a urinary catheter is usually kept for about 5 days while the join between the bladder and urethra heals.
- Hospital stay: usually 1–3 days.
Recovery after robotic prostatectomy
- Walking is encouraged from the day after surgery.
- Most men return to desk work and light activity in about 2–4 weeks.
- Avoid heavy lifting and strenuous exercise for about 4–6 weeks.
- Urinary control: some leakage is common after the catheter is removed. It usually improves over weeks to months, and pelvic floor exercises help. Recovery varies from man to man.
- Erections: recovery varies with age, erection quality before surgery and whether nerves could be spared. It can take months, and treatments are available to help.
- Follow-up: the removed prostate is examined in the laboratory, which gives a full pathology report. PSA is checked at about 6–8 weeks and then regularly.
Robotic prostatectomy compared with focal HIFU
| Robotic radical prostatectomy | Focal HIFU | |
|---|---|---|
| What is treated | The whole prostate is removed | Only the cancer-bearing area |
| Incisions | Small keyhole incisions | None |
| Anaesthesia | General | Spinal (usually) |
| Hospital stay | Usually 1–3 days | Day care or overnight |
| Catheter | Usually about 5 days | About 1 day |
| Full pathology report of whole gland | Yes | No |
| Suitable for | Wider range, incl. higher-risk and multi-area disease | Selected localised, one-area cancers |
Read more on the Focal HIFU in Noida page. Dr. Sachin performs both treatments and can explain how each fits your scan and biopsy results. There is also a general guide to robotic prostatectomy and prostate cancer care.
Frequently asked questions
How long does robotic prostatectomy take? Usually about 2–4 hours under general anaesthesia. Most men stay in hospital for 1–3 days.
How long is the catheter kept after robotic prostatectomy? Usually about 5 days, while the join between the bladder and urethra heals.
Will I have urine leakage after surgery? Some leakage is common after the catheter is removed. It usually improves over weeks to months, and pelvic floor exercises help. Recovery varies from man to man.
Can erections be preserved? When the cancer allows, the nerves that control erections can be spared. Recovery of erections varies with age, function before surgery and the extent of nerve-sparing, and can take months.
When can I return to work? Most men return to desk work in about 2–4 weeks. Heavy lifting should be avoided for about 4–6 weeks.
Is robotic prostatectomy better than focal HIFU? They suit different situations. Prostatectomy removes the whole gland and suits a wider range of cancers; focal HIFU treats only one area and suits selected localised cancers. A specialist needs to review your MRI and biopsy reports.
Where can I consult Dr. Sachin for robotic prostatectomy? In Noida, Delhi NCR and Bangalore. Call +91 7676273920 for an appointment. Please bring your PSA reports, MRI and biopsy reports.
Book a consultation
Call +91 7676273920 to arrange a consultation in Noida, Delhi NCR and Bangalore. Please bring your PSA reports, MRI films or CD, biopsy reports and slides, and any staging scans.