Robotic prostatectomy: a patient's perspective –
Steve

Steve is a 51-year-old who lives in the south-east. He was diagnosed with prostate cancer in 2010 and was treated with a robotic prostatectomy.

“Prostate cancer runs in my family. My father had the traditional prostatectomy at the age of 55, which left him with long term urinary problems and permanently impotent. My grandfather died of prostate cancer aged 47.

“With this in mind, my partner suggested I should have a Life Scan in November 2009 which included a PSA test (prostate specific antigen). My result was 3.4, above the reading of 3 which is considered normal for a man of my age. There was obviously something that was not quite right.

“Life was very busy – I have a demanding job. It was the following year before I had a repeat PSA test and found my level had risen to 4.0. I have private health insurance and looked on the internet to find an urologist. What appealed to me about Marc Laniado was the fact that he used the latest robotic technology and was one of the most experienced specialists in this field within the UK.

“My biopsy confirmed that I had prostate cancer. Although with my family history and rising PSA scores, it was not unexpected, the words still come as a stark shock. You immediately fear you may not see your children grow up, or be able to provide for your family. It was a very harrowing time for us all.

“Mr Laniado went to a great deal of trouble to establish before surgery whether the cancer had breached the prostate in any way. I had a skeletal MRI focused on my chest and spine and a procedure when a miniature camera is passed up the urethra to examine the area. Fortunately, the cancer appeared to be confined to the prostate but we would not know for sure until after my operation.

“Before surgery, which took place in January 2011, I met a specialist incontinence nurse. She explained exactly what happens to the bladder during and after a prostatectomy and why pelvic floor exercises are so important to firm up bladder muscles and help to regain control.

“As I approached the operation, I was very conscious of my dad. His entire nerve system was removed during prostate surgery and he was left with long term bladder problems and impotence. Marc explained the scope of the operation would depend upon whether any cancer cells had breached the prostate, but assured me that he would spend the time to do detailed nerve-sparing and achieve the best possible outcome.

“The operation took place in January 2011. It took seven-and-a-half hours, which shows how much care and attention was paid to nerve-sparing. When I came round, I remember there was very little pain. There was a little discomfort under the ribs from the gas which is used during the operation to create more space around the prostate during surgery. I found peppermint tea really effective in helping the discomfort to settle down within a couple of days.

“I was mobile very quickly, walking up and down the hospital corridor within 24 hours. I spent four days in hospital before going home. Two weeks after surgery I saw Marc Laniado who judged me to be fit enough to return to work. It seems astonishing to say that just two weeks after major surgery I felt fit, but that was my experience. There were five tiny key hole scars where the incisions had been made, but no pain other than occasional very mild twinges.

“My catheter came out at 10 days post-op and after that, I was completely dry – there was no leakage whatsoever. While I was still wearing the catheter, I had some erectile sensations, which I felt was a good sign. Thanks to such painstaking nerve-sparing surgery, I found I was able to have normal sex again without medication pretty quickly. It is very important – you can have the most understanding partner in the world, but as a man, if you have long term erectile dysfunction it will certainly affect you.

“When I had a PSA test at six weeks post-op, my result was 0.01ng/ml, which is the optimal reading. Robotic surgery was certainly the right choice for me. It is dynamic and minimally invasive, so the operation causes as little disruption to your life as possible. There was no leakage from day one and I was quickly back to normal sexual relations.

“The experience does knock you for six. I have an eight year-old daughter, as well as two daughters in their twenties, and the first thing that hits you is the fear that you won’t see her grow up, or be able to provide for your family. I offset the anxiety with exercise – it gets the endorphins into your blood and keeps you calm and focused. I wanted to be as fit as I possibly could going into the operation and I am sure that helped me to recover so quickly. I also started my pelvic floor exercises two to three weeks before surgery and kept up with them. "My job? - I am a commercial pilot and so my career as well as my quality of life depends on my medical status. My licence has now been restored.”

Find out more

▸ Robot Assisted Prostatectomy
▸ Prostate cancer
▸ The PSA Test