Radical prostatectomy is one of the most effective surgical treatments for prostate cancer. It involves the complete removal of the prostate gland, and today, many surgeons perform it using advanced robotic technology. This article explains what the procedure involves, its key benefits, what recovery looks like, and how Canadian men can access support through their healthcare system.

What Is Radical Prostatectomy?

Radical prostatectomy is a surgical procedure that removes the entire prostate gland. The surgeon also removes both seminal vesicles and, in higher-risk cases, nearby lymph nodes. The goal is to eliminate cancerous tissue while protecting the surrounding healthy organs.

Prostate cancer is one of the most common cancers in Canadian men. According to Health Canada, early detection and timely treatment significantly improve outcomes. Radical prostatectomy is often recommended when the cancer is confined to the prostate and has not spread to other parts of the body.

Not every man with prostate cancer will need surgery. Your doctor may also discuss other options, such as radiation therapy, hormone therapy, or active surveillance. Active surveillance means carefully monitoring the cancer over time without immediate treatment, since prostate cancer often grows very slowly.

How Doctors Diagnose and Stage Prostate Cancer Before Surgery

Before recommending radical prostatectomy, your doctor needs to understand how far the cancer has spread. This process is called staging, and it helps determine the best treatment plan.

Your doctor will review your biopsy results alongside your PSA levels. PSA stands for prostate-specific antigen — a protein produced by the prostate gland. Higher PSA levels can sometimes indicate cancer, though they can also rise for other reasons.

Additional Tests Your Doctor May Order

Depending on your PSA levels and biopsy results, your doctor may order further tests. These can include a CT scan, bone scan, MRI, or ultrasound. Each test gives a clearer picture of whether the cancer has moved beyond the prostate.

If there is a higher risk that cancer has spread to nearby lymph nodes, your surgeon may also perform a pelvic lymph node dissection during the same procedure. This means removing a small number of lymph nodes to check them for cancer cells.

Radical Prostatectomy Using Robotic Surgery

Modern radical prostatectomy is often performed using a robotic surgical system. This approach uses several small cuts — typically at least five — in the abdominal wall. The surgeon inserts small instruments and a camera through these openings.

The surgeon does not operate directly with their hands. Instead, they sit at a nearby console and control robotic arms with great precision. The robotic system translates the surgeon’s hand movements into smaller, more exact movements inside the body. According to the Mayo Clinic, robotic-assisted prostatectomy is now one of the most widely used approaches for treating localised prostate cancer.

How the da Vinci Robotic System Works

The da Vinci surgical system is the most widely used robotic platform for this type of surgery. It gives the surgeon a 3D, high-definition view of the surgical area — magnified up to 12 times. This level of detail is simply not possible with the naked eye.

The robotic arms can rotate 360 degrees. This gives the surgeon a far greater range of motion than the human wrist allows. In addition, the system filters out any natural hand tremors, making every movement smoother and more controlled.

Before the procedure, patients are advised not to drink water on the morning of surgery. A bowel preparation (enema) is also required beforehand. The surgery itself typically takes around three hours, not including the time needed for any lymph node removal.

Key Benefits of Robotic Radical Prostatectomy

Robotic radical prostatectomy offers several important advantages over traditional open surgery. These benefits apply to both the patient and the surgical team.

Less Pain and Discomfort

Because the incisions are very small and precise, patients typically experience much less pain after surgery. The surrounding tissue is disturbed as little as possible. As a result, most men find recovery far more comfortable than they expected.

Reduced Blood Loss

The surgeon’s 3D view through the robotic system allows them to clearly see blood vessels. This significantly reduces the risk of excessive bleeding during the procedure. Furthermore, inflating the abdomen with gas during the surgery also helps minimise blood loss.

Greater Precision and Nerve Protection

One of the most important benefits of robotic surgery is the ability to protect the delicate nerves near the prostate. These nerves control erectile function and urinary continence. Therefore, protecting them carefully can help preserve sexual function and bladder control after surgery.

The robotic system allows the surgeon to perform micro-dissections — tiny, highly controlled cuts — that would be extremely difficult by hand. This level of precision reduces the chance of damaging nearby structures.

Faster Recovery

Most patients recover more quickly after robotic radical prostatectomy than after traditional open surgery. Many men are able to get out of bed and walk a few steps on the day of the operation. They can usually eat solid food soon after surgery as well.

Patients are typically discharged from hospital within two to three days. A urinary catheter is placed during surgery and secured to the leg. It is generally removed around 10 days after the procedure. After discharge, most men return to light daily activities within a few weeks.

What to Expect During Recovery

Recovery from radical prostatectomy is a gradual process. The first few days are the most important for rest and monitoring. Most patients are moved to a urology ward — rather than an intensive care unit — shortly after surgery.

You may have a drip (IV line) for fluids, but this is often removed the same afternoon. Walking short distances early in recovery helps prevent blood clots and supports healing. However, you should avoid strenuous activity until your surgeon gives the go-ahead.

Long-Term Recovery Considerations

It is normal to experience some urinary leakage (incontinence) in the weeks following surgery. Pelvic floor exercises, sometimes called Kegel exercises, can help speed up the return of bladder control. Your family doctor or a continence physiotherapist can guide you through these exercises.

Sexual function may also be affected after surgery. Many men do recover erectile function over time, especially when nerve-sparing techniques are used. However, full recovery can take several months. Healthline’s guide on radical prostatectomy offers helpful information on what to expect during the recovery period.

When to See a Doctor

If you have been diagnosed with prostate cancer, or if you are experiencing symptoms such as difficulty urinating, blood in your urine, or pelvic discomfort, speak with your family doctor as soon as possible. Your doctor can refer you to a urologist or oncologist through your provincial health plan.

If you do not have a family doctor, a walk-in clinic can be a good starting point. Clinic staff can order initial blood tests, including a PSA test, and refer you for further assessment if needed. Early detection gives you the most treatment options.

Always consult a qualified healthcare professional before making any decisions about prostate cancer treatment. Every person’s situation is different, and only your medical team can recommend the right approach for you.

Frequently Asked Questions About Radical Prostatectomy

A radical prostatectomy is a surgical procedure to remove the entire prostate gland, typically used to treat localised prostate cancer. It is usually recommended when cancer is confined to the prostate and has not spread to other organs. Your doctor will consider your age, overall health, and cancer stage before recommending this option.

How long does recovery from radical prostatectomy take?

Most men leave hospital within two to three days after a radical prostatectomy. Light activity can usually resume within two to four weeks, while full recovery — including the return of urinary and sexual function — may take several months. Your surgical team will provide a personalised recovery plan.

What are the risks of radical prostatectomy?

Like any major surgery, radical prostatectomy carries some risks, including temporary urinary incontinence and changes in sexual function. However, robotic techniques have significantly reduced these risks compared to traditional open surgery. Discuss all potential risks and benefits thoroughly with your urologist before deciding on treatment.

Is robotic prostatectomy better than open surgery?

Robotic radical prostatectomy generally offers less blood loss, smaller incisions, less pain, and a faster recovery compared to traditional open surgery. The robotic system also gives surgeons a magnified 3D view, improving precision and nerve protection. However, the best approach depends on your individual circumstances, so speak with your specialist.

Will my provincial health plan cover radical prostatectomy in Canada?

In Canada, radical prostatectomy is considered a medically necessary procedure and is generally covered by provincial and territorial health plans when performed in a publicly funded hospital. Coverage for robotic-assisted surgery may vary by province, so it is worth confirming the details with your healthcare provider or provincial health authority.

Can prostate cancer come back after radical prostatectomy?

Yes, prostate cancer can return after radical prostatectomy, which is why regular follow-up appointments and PSA monitoring are essential. If PSA levels begin to rise again after surgery, your doctor will investigate and may recommend additional treatment such as radiation or hormone therapy. Early detection of recurrence greatly improves treatment outcomes.

Key Takeaways

  • Radical prostatectomy removes the entire prostate gland and is a primary treatment option for localised prostate cancer.

  • Robotic surgery, such as the da Vinci system, offers greater precision, less blood loss, less pain, and faster recovery than open surgery.

  • Before surgery, your doctor will use PSA tests, biopsies, CT scans, MRIs, and bone scans to stage your cancer.

  • Recovery typically involves a two-to-three day hospital stay, with a urinary catheter removed about 10 days after the procedure.

  • Temporary urinary incontinence and changes in sexual function are possible after surgery, but many men recover these functions over time.

  • Canadian men can access prostate cancer care through their provincial health plan, family doctor, or a walk-in clinic referral.

  • Always speak with your family doctor or a specialist to determine the treatment approach that is right for your individual situation.