Frequently Asked Questions
Below is a list of questions we are frequently asked pertaining to laparoscopic surgeries, robotic prostatectomies, and sexual rehabiliation. If you have a question that is not answered below, please contact our office. A member of our staff will respond to you as soon as possible.
Laparoscopic & Robotic Surgery FAQs
- What is laparoscopic surgery?
- What is robotic-assisted surgery?
- What is the da Vinci robot?
- What is a robotic prostatectomy?
- What are the benefits of laparoscopic robotic surgery, as opposed to the more tradition open-surgery method?
- Am I a candidate for robotic surgery?
- What are the possible risks and complications of prostatectomy?
- Will general anaesthesia be required with robotic prostatectomy?
- Will a catheter be inserted in my urethra during robotic prostatectomy?
- When will the catheter be removed?
- Can I take a bath after robotic prostatectomy?
- Am I allowed to travel after robotic prostatectomy?
- After the robotic prostatectomy, when can I go back to the gym or resume working out?
- How long will robotic prostatectomy take?
- Will I need to have blood transfusion with robotic prostatectomy?
- How long will I stay in the hospital?
- What are the extra measures that should be done after discharge?
- Will I have urinary incontinence after prostatectomy?
Sexual Rehabilitation FAQs
- Will I still be able to have an erection after prostatectomy?
- When can erection return after prostate surgery?
- Why is it that erections are affected by prostatectomy?
- After regaining erectile function, will its quality be the same as before?
- What will happen if the nerves were not spared during surgery?
- Will I still be able to ejaculate after prostatectomy?
- Will I still be able to have an orgasm after prostatectomy?
- Can I still have a baby after prostatectomy?
- Will prostatectomy affect my sexual desire and libido?
- Are the nerves responsible for sexual function being spared during laparoscopic and robotic prostatectomy?
- When can I resume sexual activities after prostatectomy?
Laparoscopic & Robotic Surgery Answers:
1. What is laparoscopic surgery?
Laparoscopic surgery, or minimally invasive surgery, is a modern surgical technique in which short, narrow tubes (trochars) are inserted into the abdomen through small (less than one centimeter) incisions. Long, narrow instruments are inserted through the trochars. The surgeon uses these instruments to manipulate, cut, and sew tissue. The use of a laparoscope, a telescopic rod connected to a camera, illuminates the area that is being operated on and creates a viewing space for the surgeon.
3. What is the da Vinci robot?
The da Vinci robot is commonly used to perform prostatectomies, or removal of the prostate gland, in the case of prostate cancer. It is perhaps the most famous robotic surgery apparatus in the world, as it was the first robotic system allowed in operating rooms in the year 2000 for laparoscopic procedures. It falls under the category of telesurgical devices, meaning a human directs the motions of the robot. The technology allows the surgeon to get closer to the surgical site than human vision will allow. The da Vinci system contains three parts: a surgeon's console, a patient-side robotic cart with four arms manipulated by the surgeon; one to control the camera, and three to manipulate the instruments, and a high-definition 3D vision system.
4. What is a robotic prostatectomy?
A robotic prostatectomy is a surgical procedure, aided by a robotic system, to completely remove the prostate gland when cancer is present. The da Vinci robotic system is the most famous and widely used system today to assist the surgeon in performing a robotic prostatectomy.
5. What are the benefits of laparoscopic robotic surgery, as opposed to the more tradition open-surgery method?
There are several benefits to undergoing a robotic surgery, which is performed laparoscopically:
- Because of the minimally invasive incisions into the abdomen, there is less tissue damage and scarring.
- Da Vinci robotic surgeries typically result in less post-operative pain and discomfort for the patient.
- Quicker recovery time for the patient: Da Vinci robotic surgeries require shorter post-operative hospital recovery time as well as a faster return to a normal activity level.
- Enhanced precision: Robotic assistants decrease the fatigue that doctors experience during long surgeries that last several hours. Even the steadiest of human hands cannot match those of a surgical robot, especially after a long period of time.
6. Am I a candidate for robotic surgery?
Most men who have been diagnosed with localized cancer are candidates for obtaining robotic surgery. Call Dr. Scherr's office today to learn more about the procedure, or to schedule an appointment with Dr. Scherr.
7. What are the possible risks and complications of prostatectomy?
The prostatectomy have major risks since it is a surgical procedure. Patients run the risk of infection at the catheter’s exit and at the incision site. Other possible risks are excessive bleeding, blood clots, impotence, urinary incontinence, hernia at the site of incision, and sterility.
8. Will general anaesthesia be required with robotic prostatectomy?
Robotic prostatectomy is a major surgery that requires general aneasthesia to keep you sedated and prevent pain during the operation.
9. Will a catheter be inserted in my urethra during robotic prostatectomy?
Yes. Just like any type of prostatectomy, robotic prostatectomy, a catheter is left in the urethra and is connected to a drainage bag. This is used to align the suture line for the bladder and urethra connection, and drain the bladder.
13. After the robotic prostatectomy, when can I go back to the gym or resume working out?
It is expected for patients to return to normal activities within 4 weeks, but patients should avoid vigorous exercises such as lifting and straining until six weeks after the surgery.
15. Will I need to have blood transfusion with robotic prostatectomy?
No. With robotic prostatectomy, the estimated blood loss is 300mL which is less than 3% of the requirement to have blood transfusion.
16. How long will I stay in the hospital?
Generally, patients spend one night at the hospital. They are expected to be discharged the next day if the pain is controlled with oral medications, are able to tolerate oral liquids and have acceptable laboratory results.
17. What are the extra measures that should be done after discharge?
You should take medications as directed by your doctor, these may include antibiotics, pain medication and stool softeners, however, aspirin and aspirin-containing products should be avoided. It is advised to drink plenty of liquids and avoid vigorous exercises for six weeks. The incision should also be washed gently with mild soap and water. Also, to avoid deep vein thrombosis, keep your legs elevated when resting in bed. And, you should avoid food and drinks such as alcohol, caffeinated drinks and spicy foods because these may irritate your gastrointestinal and urinary tract.
18. Will I have urinary incontinence after prostatectomy?
Prostatectomy causes temporary urinary incontinence or an involuntary leakage of urine, but typically, when the catheter is removed, bladder control also improves. Normal continence or the normal control of urination is regained within 6 to 8 months.
Sexual Rehabilitation Answers:
1. Will I still be able to have an erection after prostatectomy?
Immediately after the removal of the prostate, erectile function will normally be lost. Erection may still be regained but this will depend on your age, sexual function prior to the operation, concurrent illnesses, medications, the presence of emotional and psychological stress, the extent of your cancer, whether the nerves were spared by the surgeon and the level of current sexual activity.
2. When can erection return after prostate surgery?
The recovery of erectile function is variable, it may be regained in 1 to 2 years after prostatectomy, but there have been a few reported cases of return of function in as early as 4 weeks spontaneously or with the aid of some medications such as Viagra and having penile injection therapy.
3. Why is it that erections are affected by prostatectomy?
The prostate does not affect the ability to have erections; however, the nerves that are important to have an erection can be damaged during prostatectomy due to its close proximity to the prostate gland.
4. After regaining erectile function, will its quality be the same as before?
84 percent of those who underwent prostatectomy reported 1 to 2 years later that their erectile function were returned to normal but around 13 percent had erections that were weaker than what was before the operation.
5. What will happen if the nerves were not spared during surgery?
Depending on the extent of your cancer, there may be instances wherein it is required to remove the important nerves for sexual function causing impotence or the inability to have erections. However, there are still available reproductive procedures such as nerve graft and reconstruction that may help in restoring its function.
6. Will I still be able to ejaculate after prostatectomy?
The prostate and seminal vesicles make the fluid in the semen and after radical prostatectomy the semen’s pathway is removed, thus you will experience a dry orgasm or the absence of ejaculate.
7. Will I still be able to have an orgasm after prostatectomy?
Orgasm can occur as long as the normal sensation is intact even in the absence of ejaculation; this is because the prostate has little to do with it since orgasm mainly happens in the brain, so you will still be able have an orgasm even with the absence of the prostate.
8. Can I still have a baby after prostatectomy?
Men will usually be sterile because the semen can no longer be ejaculated due to the removal of the semen’s pathway during radical prostatectomy; however, if you still plan to have children, the sperm cells may be extracted from the testes or the epididymis since they are still produced, you may also opt to cryopreserve the sperm prior to prostatectomy.
9. Will prostatectomy affect my sexual desire and libido?
The removal of the prostate gland will not affect the libido. Sex drive is mainly affected by the hormone testosterone, when the levels of testosterone drop sex drive also diminishes, occurring naturally with aging, other illnesses and some medications.
10. Are the nerves responsible for sexual function being spared during laparoscopic and robotic prostatectomy?
If the cancer has not yet spread to the adjacent nerves, an experienced surgeon will make every effort to spare these nerves that are responsible for sexual function. The structures are magnified with laparoscopic and robotic surgeries, an advantage when nerve sparing. However, satisfactory erectile function is not guaranteed by nerve sparing, since it is also influenced by many factors such as your age, sexual function prior to the operation, concurrent illnesses, medications, the presence of emotional and psychological stress, the extent of your cancer and the level of current sexual activity.
11. When can I resume sexual activities after prostatectomy?
As soon as you feel better after the surgery, it is important to again establish the physical intimacy with your partner and continue being sexually active even before regaining erectile function, this is to give you a better chance of earlier functional return. You can have sexual intercourse when erectile function has recovered which normally happens in 1 to 2 years after prostatectomy. Treatments such as Viagra and penile injection therapy are available in aiding the resumption of satisfactory sex life.