Robotic prostatectomy: a patient's perspective
– Ian Doherty

Mr Ian Doherty has recently been treated for prostate cancer with a da Vinci prostatectomy (robot-assisted surgery). Mr Doherty, a 54-year-old IT consultant, describes his experience of the procedure and subsequent recovery.

“I work for myself, so my health is very important – if I don’t work, I don’t get paid. I decided to have a full BUPA medical, which included a PSA test. My result was slightly elevated, but I didn’t think too much about it.

“I left it for a few months and it was only after a friend’s suggestion that I followed it up with a second PSA test. I saw Marc Laniado and as well as the PSA test, he did a new genetics based test called a PCA3 test. After considering the results of both tests, he recommended a biopsy.

“A small amount of cancer cells were found in the biopsy – 11 out of 12 samples were clear, but one did show a low number of cancer cells. To be honest, my reaction was fairly positive. Although I was diagnosed with prostate cancer, it had been found very early, rather than at a later stage with many more consequences and symptoms.

“I did a lot of my own research on the internet. Pretty quickly, I decided a radical prostatectomy was the best course of action – I’m not that old and I didn’t want to continue with cancer cells in my prostate with the potential for developing into something much more serious. I’m fit and healthy and felt it would be better to have the operation because I would be able to recover well and get on with the rest of my life.

“The da Vinci prostatectomy appealed to me. I could see how it makes the procedure easier for surgeons because the area they are working in is magnified. They can make large hand movements which are translated exactly into smaller, precise movements by the robot.

“I went in for surgery on Saturday, February 13, 2010. My wife was with me as I was given the anaesthetic and when I came round, I felt brilliant. I had been quite anxious about the anaesthetic because I’d had surgery 30 years ago and felt really sick and nauseous afterwards. It was a completely different experience this time.

“I was able to walk around the ward on Sunday and went home on Monday after two nights in hospital. I had to take things easy, but I was surprised at how quick the recovery was. I had been warned about incontinence after a prostatectomy and bought three big boxes of male incontinence pads. I’ll have to give them to someone else because I only used a few of them because I was dry within a week. Before the operation, the cancer is your main focus. You think – if there is some incontinence, I can cope with that. But with hindsight, if I had been incontinent for a longer period of time after surgery, that would have worn me down.

“There was no pain at all and only very minor discomfort in the early stages as I sat down, but it was nothing to speak of. I was back at work within three days and able to walk for a few hundred yards without difficulty during the first week after surgery.

“Erectile dysfunction after a prostatectomy is something you are told about and expect. It is very early days for me, six weeks after surgery. I am taking medication to assist erectile function and there has been some improvement, but there is a long way to go before full recovery. I am seeing a specialist and am expecting recovery to take about one year.

“The treatment you choose will depend upon your age and health. I would say, if a man is relatively young and in good health, the radical prostectomy is a good option. The da Vinci prostatectomy certainly reduces the side-effects of surgery, compared with the traditional radical prostatectomy. The recovery is certainly much quicker and for me, the side-effects have not been difficult to cope with compared with the consequences of leaving the prostate cancer untreated. My first instinct was for surgery and my experience has vindicated that decision.

“I found out that I had prostate cancer almost by accident. I could have gone for several years without ever considering it as a possibility and not being aware of any symptoms. I have noticed a slower flow of urine, but it was something which happened so gradually that it didn’t enter my consciousness as a potential problem.

“So my advice would be if anyone has a history of prostate cancer in their family, or experiences any symptoms, even if they seem very slight, they should have a PSA test. It is a very small, simple test and it can put your mind at rest or in my case, provide an early warning about prostate cancer.”

Find out more

▸ Read more about the robotic prostatectomy at Harley Street Urology
▸ Find out more about prostate cancer
▸ The PSA test for prostate cancer at Harley Street Urology