Prostate Enucleation

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Who is suitable for robotic enucleation of prostate?

What are the advantages of robotic enucleation of prostate?

How is a robotic enucleation of prostate performed?

What to expect after a robotic enucleation of prostate?

Procedure outcomes

Are you suitable for Robotic enucleation of prostate?

INTRODUCTION

Robotic enucleation of prostate is a surgical procedure to remove non-cancerous enlarged prostate tissue (BPH) that is causing urinary symptoms. This procedure is performed using specialized robotic equipment. It is a minimally invasive keyhole procedure.

Doctors Shekib Shahbaz and Tony de Sousa of Melbourne Urology Centre are highly experienced in the use of the da Vinci System, which is the specialized surgical device that is used to carry out the robotic enucleation of prostate. They offer an entirely individualized service and can discuss your treatment options, including your suitability for this procedure.

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Who is suitable for robotic enucleation of prostate?

  • Those experiencing moderate to severe symptoms of enlarged prostate (BPH)
    • Weak stream of urine
    • Incomplete emptying of the bladder
    • Stop and start when urinating
    • Straining to begin urination
    • An increased need to urinate
    • Interrupted sleep because of the need to urinate
    • Complications of enlarged prostate
  • Those who want an alternative option to TURP for management of their BPH
  • Those who have enlarged prostate symptoms and have failed minimally-invasive treatment options
  • Those whose prostate anatomy is not appropriate for other treatment options
  • Those who have failed medical therapy, don’t want to take medication or have had side effects
  • Those who want to improve their quality of life to what it was before BPH symptoms

What are the advantages of robotic enucleation of prostate?

Robotic enucleation of prostate is generally performed for patients with very large prostates (usually more than 150cc) in which case other procedures are not safe or possible:

  • Very effective treatment option
  • Durable improvement in urinary symptoms with low revision rates
  • Quick recovery with minimal bleeding and recovery time after surgery
  • Eliminates the need for lifelong use of medications

The minimally-invasive robotic approach offers both surgeons and patients various benefits when compared to traditional open surgery:

  • Less blood loss
  • Smaller incisions
  • A shorter hospital stay
  • Faster recovery time

Surgeon benefits include:

  • High definition 3D vision inside the body
  • Small instruments that allow a greater range of movements than the human hand
  • Improved dexterity and vision that allows for very precise movements and enhanced control

How is a robotic enucleation of prostate performed?

This procedure replicates with a minimally invasive approach, the traditional open surgery (Millen’s or Freyer’s procedure) historically performed for patients with a very large prostate:

  • The patient is placed under general anaesthetic for the duration of the procedure, which usually lasts between 2-4 hours
  • Several small incisions are made in the abdomen, through which the surgeon inserts the surgical tools and camera
  • The abdomen is filled with carbon dioxide gas, which creates space and allows the surgeon to view the organs clearly and access them accurately
  • The surgeon controls the robotic tools to carefully remove only the part of the prostate which is enlarged (BPH) and causing symptoms of obstruction. The enlarged lobes of the prostate are ‘shelled out’ (enucleated) and then removed via a small incision in the bladder, creating an open prostatic urethra
  • The bladder is then meticulously repaired using an absorbable suture
  • The carbon dioxide is released and surgical instruments are removed
  • Incisions are closed with a technique that minimizes the risk of hernia or scarring

What to expect after a robotic enucleation of prostate?

  • Patients generally remain in hospital for 2-3 nights following the procedure
  • You will be able to walk around the day following surgery
  • A urinary catheter will temporarily be in place. It is a thin tube that runs from the bladder through the penis, allowing urine to drain into a bag on the outside of the body. This allows healing of the bladder. This will need to remain for 5-7 days after the surgery.

Procedure outcomes

  • This procedure is not to be confused with ‘radical’ prostatectomy where the entire prostate is removed for treatment of prostate cancer. In Robotic enucleation of prostate the prostate capsule and surrounding nerves and urinary sphincter are not disrupted, significantly reducing the chance of erection problems and incontinence
    Most patients will notice an immediate improvement in their urinary flow, pressure and bladder emptying
  • Bladder symptoms of urinary frequency, urgency and nocturia (getting up at night to pass urine) tend to take longer (up to 3 months) to improve
  • The seminal vesicles are not removed but ‘retrograde ejaculation’ occurs in most cases; this is where semen fluid goes back into the bladder after orgasm. This is not dangerous or harmful.

Are you suitable for Robotic enucleation of prostate?

Melbourne Urology Centre offers Robotic enucleation of prostate treatment in Melbourne to local and interstate patients. Your case will be thoroughly evaluated including a discussion of other appropriate management options. We offer a full range of surgical options for enlarged prostate (BPH), including:

Request an Appointment

We are here to assist you before, during and after your visit to the Melbourne Urology Centre. To request an appointment, simply complete the form below and we will contact you within 48 hours to confirm your appointment with us. For urgent enquiries or consulations please contact us on 1300 702 811