Robotic prostate surgery can be an effective treatment for localised prostate cancer, and many men recover well after the procedure. However, you should remember that it is still a major operation, so understanding the possible disadvantages is an important part of deciding whether it is the right choice for you.
The disadvantages are not limited to surgical risks. You may need to consider possible urinary leakage, changes in erections, fertility concerns, catheter discomfort, recovery time, emotional adjustment, and the possibility of needing additional treatment in the future.
A balanced discussion can help you compare robotic prostate surgery with other options, such as active surveillance or radiotherapy. NICE recommends that you should have the opportunity to discuss all suitable treatment choices, including potential serious side effects, with the relevant specialists before making a decision.
Robotic Prostate Surgery Is Still Major Surgery
Robotic prostate surgery is sometimes misunderstood as a minor procedure because it involves smaller incisions. However, you should know that the operation inside the pelvis is still complex and requires careful surgical skill.
During the procedure, your prostate and seminal vesicles are removed, and the bladder is reconnected to the urethra. This creates a significant change in the body, so recovery takes time even if the external wounds appear small.
The size of the incision does not show the full complexity of the operation. Robotic surgery can reduce some aspects of surgical trauma, but you will still need proper preparation, anaesthesia, catheter care, and follow-up during recovery.
It May Not Be the Right Treatment for Every Man
Robotic prostate surgery is not automatically the right choice for every man with prostate cancer. Your suitability depends on several factors, including the stage and grade of your cancer, PSA level, MRI findings, age, general health, and your personal treatment goals.
NICE recommends offering active surveillance to people with CPG 1 localised prostate cancer. For CPG 2 disease, active surveillance, radical prostatectomy and radical radiotherapy may all be discussed when radical treatment is suitable. For CPG 3 disease, surgery or radiotherapy is generally offered, although surveillance may be considered when immediate radical treatment is declined.
For some men, treatments such as radiotherapy, hormone therapy, or a combination of approaches may be more suitable. The best treatment is not always the newest technology, but the option that matches your cancer, health, and personal priorities.
The Robot Does Not Remove Surgical Risk
The surgical robot is a tool that is controlled by your surgeon. It can provide magnified vision and precise instrument movement, but it does not perform the operation independently or make decisions during surgery.
The quality of your procedure still depends on your surgeon’s experience, judgement, technical skill, and the support of the wider operating team. Robotic technology can improve certain aspects of surgery, but it cannot replace the expertise of trained healthcare professionals.
You should feel confident asking your surgeon about their experience, expected outcomes, and how potential complications are managed. The robotic system is only one part of your overall care, and the skill of the team remains extremely important.
| Potential disadvantage | Typical pattern | When it may need further help |
| Urinary leakage | Common after catheter removal and often improves gradually | Persistent or severe leakage may need specialist continence treatment |
| Erectile dysfunction | Very common initially and recovery may take considerable time | Medication, vacuum therapy, injections or specialist sexual support may help |
| Dry orgasm and infertility | Permanent expected consequence | Fertility preservation must be discussed before surgery |
| Catheter discomfort | Temporary during early healing | Poor drainage, severe pain or large clots require prompt advice |
| Infection or bleeding | Uncommon but possible after major surgery | Fever, wound discharge or significant bleeding requires assessment |
| Blood clots | Uncommon but potentially serious | Chest pain or breathing difficulty requires emergency help |
| Positive surgical margin | Found on the final pathology report in some patients | Requires PSA follow-up and sometimes further treatment |
| Need for further treatment | Depends on pathology and PSA results | Radiotherapy, hormone therapy or monitoring may be considered |
| Emotional and relationship effects | Can occur during recovery and rehabilitation | Psychological, continence or sexual-health support may be helpful |
It Can Cause Urinary Incontinence
Urinary leakage is one of the most common concerns after robotic prostate surgery. After your prostate is removed, the bladder and urinary sphincter need time to adjust, which can lead to temporary problems with controlling urine.
You may need to use pads for a period after your catheter is removed while your control improves. Many men experience gradual improvement over weeks or months, although the recovery time can vary from person to person.
For some men, urinary incontinence may continue for longer and affect daily activities such as exercise, work, sleep, and social confidence. Your healthcare team can provide advice on pelvic floor exercises and other support to help improve bladder control.
Urinary Recovery Can Be Unpredictable
Urinary recovery after robotic prostate surgery can vary significantly between individuals. You may find that your bladder control improves quickly, while another person having the same operation may need more time due to factors such as age, previous urinary function, prostate size, pelvic floor strength, and healing.
UCLH patient information explains that for many men, urine leakage improves within around three months, although your recovery timeline may be different. Your surgeon can discuss your personal risk factors and what you can realistically expect before the operation.
The uncertainty during recovery can sometimes feel frustrating. Even when you understand that leakage is a common part of healing, using pads or experiencing unexpected leaks can affect your confidence until your bladder control improves.
Continence statistics vary according to how urinary recovery is defined. Some reports count people using one precautionary pad as continent, while others count only those using no pads. Hospital figures should therefore be used as a guide rather than a guarantee of your individual recovery.
Erectile Dysfunction Is Common
Erection problems are one of the most common concerns after robotic prostate surgery. You may experience changes in erections because the nerves that control erectile function are located very close to the prostate and can be affected during the operation.
Cancer Research UK explains that radical prostatectomy often affects the nerves involved in erections, and many men have difficulty getting erections after surgery. You may notice improvement over time, but recovery depends on factors such as your age, previous erectile function, nerve preservation, and overall health.
Nerve-sparing surgery can improve the chance of preserving erections when it is safe for you. However, it is not always possible, and if your cancer is close to these nerves, your surgeon may need to remove or avoid preserving them to give you the best chance of controlling the cancer.
Erectile Recovery Can Take a Long Time
Even if your surgeon is able to preserve the nerves during robotic prostate surgery, erection recovery may take time. You may not see immediate improvement because the nerves can be bruised, stretched, or temporarily affected during the procedure.
Recovery of spontaneous erections can continue for up to two years or longer, particularly after nerve-sparing surgery. However, recovery is not guaranteed, and some people continue to need tablets, vacuum devices, injections or other treatment.
The recovery process can feel frustrating if you expected changes to happen sooner. You may be offered options such as medication, vacuum devices, injections, or specialist sexual health support, depending on your individual needs and advice from your healthcare team.
Surgery Permanently Changes Ejaculation and Fertility
After radical prostatectomy, you will no longer ejaculate semen because the prostate and seminal vesicles have been removed. Your testicles continue to produce sperm cells, but these are reabsorbed by the body. You may still experience orgasm, although it will be a dry orgasm.
Cancer Research UK explains that after this surgery you will not be able to father a child through sexual intercourse. If future fertility is important to you, sperm banking can be discussed before your operation.
These changes can feel significant, even if you are not currently planning to have children. You should have an open discussion with your healthcare team before surgery so you understand how treatment may affect your sexual function, fertility, and quality of life. You will not be able to cause a pregnancy through sexual intercourse after surgery. If future fertility matters to you, discuss sperm collection and storage before treatment.
Sexual Experience May Feel Different
Robotic prostate surgery can affect more than just erections. You may notice changes in orgasm, sensation, confidence, arousal, your perception of penile length, or how intimacy feels after treatment.
NICE recommends that you should be informed before radical prostate cancer treatment that it can change your sexual experience and may result in a loss of sexual function. Understanding these possible changes beforehand can help you prepare and make informed decisions about your care.
These effects can also impact your partner and your relationship. You may benefit from open communication, honest counselling, and access to sexual recovery support if you need help adjusting after surgery.
Some people experience leakage of urine during orgasm, known as climacturia, or discomfort during orgasm. These effects often improve but should be discussed with the clinical team if they remain troublesome.
You Will Usually Need a Catheter
A urinary catheter is usually needed after robotic prostate surgery to help drain urine while the connection between your bladder and urethra heals. Although it is temporary, having a catheter can be one of the more uncomfortable parts of early recovery.
You may experience bladder spasms, leakage around the catheter, soreness at the tip of the penis, disturbed sleep, or difficulty with clothing and movement while the tube is in place. CUH advises that urine can sometimes bypass the catheter, but if most urine is not draining into the bag, you should seek medical advice as the catheter may be blocked.
The catheter is usually removed once healing has progressed and your healthcare team is satisfied it is safe to do so. You may find this stage challenging, but understanding that the discomfort is temporary can help you manage the early recovery period with more confidence.
A small amount of urine leaking around the catheter can occur because of bladder spasms. However, contact your clinical team promptly if little or no urine is draining into the bag, you develop increasing lower-abdominal pain, the catheter falls out, or large blood clots or debris appear in the tubing.
There Is a Risk of Infection
Like any major operation, robotic prostate surgery carries a risk of infection. You may develop an infection affecting the surgical wounds, urinary tract, chest, bloodstream, or other areas during your recovery.
UCLH lists infection as a potential risk after robotic prostatectomy, including problems such as wound infection and bloodstream infection. Although these complications are not common, you should be aware of the warning signs so they can be treated promptly.
You should seek medical advice if you develop a fever, chills, increasing wound redness, pus from the wound, cloudy or unusually strong-smelling urine, particularly when accompanied by fever, pain, chills or feeling unwell. Early assessment can help ensure infections are managed quickly and effectively.
Bleeding Can Occur
Robotic prostate surgery often involves less blood loss compared with older open surgical approaches, but bleeding is still a possible complication. You should remember that the prostate is surrounded by blood vessels, and some operations can be more complex depending on your individual anatomy and cancer features.
UCLH explains that significant bleeding may occasionally require a blood transfusion, another procedure to control the bleeding, or conversion to open surgery. These situations are uncommon, but your surgical team will be prepared to manage them if they occur.
Your risk of bleeding may be higher if you take blood-thinning medication, have a larger prostate, previous scar tissue, or need more extensive surgery. You will be given specific advice about stopping or restarting medicines before and after your operation to help reduce risks.
Anaesthetic Risks Still Apply
Robotic prostate surgery is usually performed under general anaesthesia, which means you are asleep throughout the operation. During this time, your healthcare team carefully monitors your breathing, circulation, pain control, and fluid balance to keep you safe.
General anaesthesia is considered safe for many people, but it still carries some risks. UCLH patient information estimates the risk of death from serious heart, circulation or respiratory complications at approximately 1 in 1,000. Your own risk may be higher or lower depending on your age, fitness, medical conditions and the complexity of your operation.
Your individual anaesthetic risk depends on factors such as your age, heart and lung health, weight, sleep apnoea, kidney function, diabetes, smoking status, and overall fitness. Before surgery, a pre-operative assessment helps identify any concerns and allows your team to reduce risks wherever possible.
Blood Clots Are a Possible Complication
Major pelvic surgery, including robotic prostate surgery, can slightly increase your risk of developing blood clots in the legs or lungs. Your hospital team will take steps to reduce this risk and support a safer recovery after your operation.
- Increased clot risk after surgery: Major operations can temporarily increase the chance of developing blood clots.
- Preventive measures: Compression stockings, blood-thinning injections and early movement may be used to lower your risk.
- Leg clot symptoms: Pain, swelling, warmth or tenderness in one calf may be signs of a blood clot.
- Lung clot symptoms: Sudden breathlessness, chest pain, coughing blood, dizziness or fainting may indicate a clot has travelled to the lungs.
- When to seek help: Urgent medical advice is needed for new one-sided calf symptoms, while severe breathing problems or chest pain require emergency care.
Following your surgical team’s advice about movement, medication and recovery can help reduce your risk. If you notice any warning signs, seek medical attention promptly rather than waiting for symptoms to improve.
Positioning Can Cause Temporary Problems
During robotic prostate surgery, you are usually placed in a head-down position to help move the bowel away from the pelvis and give your surgeon better access to the prostate. Your healthcare team takes careful steps to protect your arms, legs, nerves, and pressure points throughout the operation.
Despite these precautions, some people may experience temporary symptoms related to positioning, such as numbness, weakness, shoulder discomfort, or pressure-related problems. UCLH notes that eye problems or numbness and weakness affecting the arms or legs can occur as a result of positioning during surgery.
These complications are uncommon, but they highlight that robotic prostatectomy involves more than the surgical procedure itself. Your anaesthetic care, positioning, monitoring, and the wider theatre team all play important roles in keeping you safe during the operation.
Wound Problems Can Happen
Robotic prostate surgery uses several small incisions, but each wound still needs time to heal. You may experience some pain, bruising, swelling, bleeding, infection, or, in rare cases, the wound edges separating during recovery.
UCLH lists possible problems at the incision sites after robotic prostatectomy, including pain, infection, and the development of a hernia in the areas where the cuts were made. Although most wound problems can be treated effectively, they may slow down your recovery.
You should contact your healthcare team if a wound becomes increasingly red, hot, swollen, painful, starts leaking pus, bleeds heavily, or appears to be opening. Early assessment can help prevent minor wound concerns from becoming more serious.
A Hernia Can Develop at an Incision Site
An incisional hernia can develop when tissue from inside the abdomen pushes through a weakened area in the abdominal wall. Although robotic prostate surgery uses small keyhole incisions, a hernia can still occur after this type of operation.
Your risk may be higher if an incision needs to be enlarged to remove the prostate, if healing is delayed, or if there is repeated pressure on the abdominal wall from coughing, constipation, or heavy lifting. Factors such as body weight and previous abdominal surgery may also influence your risk.
This is why following lifting restrictions after surgery is important, even if your skin wounds appear small and are healing well. The deeper tissues need time to strengthen before you return to heavier activities.
Bowel or Rectal Injury Is Rare but Serious
The rectum is located very close to the prostate, so your surgeon works carefully in this area during robotic prostate surgery to avoid injury. Although rare, damage to the bowel or rectum is a possible complication of the procedure.
Cancer Research UK explains that, in very uncommon cases, surgery can injure the lower bowel or rectum, and you may need a temporary colostomy while the bowel heals. Your healthcare team will discuss any specific risks if your individual circumstances increase the complexity of surgery.
This complication is one reason why experience and careful surgical technique are important when performing prostate surgery. Factors such as previous pelvic surgery, radiotherapy, inflammation, or differences in anatomy may make the operation more challenging.
Ureter or Blood Vessel Injury Can Occur
The ureters are the small tubes that carry urine from your kidneys to your bladder. They are not the focus of prostate surgery, but they are located close to the area being treated and must be carefully protected during the operation.
UCLH reports ureteric damage in fewer than one in 100 patients undergoing this procedure. If it occurs, temporary internal or external drainage tubes and further treatment may be required.
These complications are uncommon, but they are important to understand before surgery. Robotic prostate surgery takes place deep within your pelvis, where several important structures are located close together, which is why careful surgical planning and experienced teams are essential.
The Operation May Need to Be Converted
In some situations, a planned robotic prostate operation may need to be changed to another surgical approach. Your surgeon may decide to convert to open surgery or standard keyhole surgery if this is considered the safest option.
UCLH explains that conversion may be needed because of factors such as technical problems with the robot, significant bleeding, scar tissue, or an injury that requires additional treatment. Although this is uncommon, your surgical team will be prepared to make this decision if needed.
A change in surgical approach does not mean the operation has failed. Your surgeon’s main priority is your safety and achieving the best possible outcome, rather than continuing with robotic surgery at all costs.
Robotic Surgery Does Not Guarantee Better Cancer Control
Robotic prostate surgery is a technique used to perform radical prostatectomy, but it does not automatically guarantee better cancer control than other surgical approaches. The success of your treatment depends mainly on factors such as your cancer characteristics, surgical quality, and follow-up care.
Comparative evidence has not shown a clear long-term urinary, sexual or cancer-survival advantage from the robotic platform alone. Robotic surgery may reduce blood loss, transfusion requirements and hospital stay, but outcomes also depend on patient selection, cancer characteristics and surgical expertise.
This does not mean robotic surgery has no benefits. You may still benefit from advantages such as improved visualisation and precision, but it is important not to assume that the word “robotic” always means a better cancer outcome in every situation.
Evidence Note
Comparative studies suggest that robot-assisted prostatectomy may reduce blood loss, transfusion requirements and hospital stay compared with open surgery. However, available randomised evidence has not demonstrated a clear long-term advantage in urinary quality of life, sexual quality of life or cancer survival from the robotic platform itself.
These findings do not mean robotic surgery has no benefits. They mean that the technology should be considered alongside surgeon experience, cancer control, complication management, rehabilitation and your individual treatment priorities.
Positive Surgical Margins Are Still Possible
A positive surgical margin means cancer cells extend to the inked edge of the removed specimen. It increases the probability of a future PSA rise but does not prove that clinically important cancer remains or that recurrence is inevitable.
A positive margin does not always mean your cancer will return. However, you may need closer PSA monitoring and, in some situations, further treatment may be considered based on your follow-up results and overall risk.
Although robotic surgery allows your surgeon to operate with enhanced vision and precision, microscopic cancer spread cannot always be seen during the operation. Your risk of a positive margin depends on factors such as tumour stage, location, grade, and your individual anatomy.
Further Treatment May Still Be Needed
Some men may need additional treatment after robotic prostate surgery. You may be advised to have further treatment if your PSA does not fall as expected, rises during follow-up, cancer is found in the lymph nodes, or your pathology report shows higher-risk features.
EAU follow-up guidance explains that after radical prostatectomy, PSA is expected to become undetectable and that a confirmed rising PSA may indicate recurrence. This is why regular PSA monitoring is an essential part of your care after surgery.
Further treatment options may include radiotherapy, hormone therapy, or other approaches depending on your individual situation. Radical prostatectomy is performed with curative intent and provides lasting cancer control for many people, but it cannot guarantee that further treatment will never be needed.
Follow-Up Can Create Anxiety
After robotic prostate surgery, PSA monitoring becomes an important part of your ongoing follow-up. You may find waiting for PSA results stressful, especially when you are concerned about whether the cancer could return.
EAU guidance highlights the importance of preparing you for different PSA outcomes, as even a small change in PSA levels can sometimes cause worry or uncertainty. Understanding what your results mean can help you approach follow-up appointments with more confidence.
The emotional impact of cancer follow-up is often overlooked. Although surgery removes the prostate, you may still experience anxiety about future results, which is why ongoing support and clear communication with your healthcare team are important.
Recovery Can Take Longer Than Expected
Some men expect a quick recovery because robotic surgery uses smaller incisions, but healing can still take time. You may experience tiredness, catheter discomfort, abdominal soreness, urinary leakage, bowel changes, or emotional ups and downs during the weeks following your operation.
Your return to work, driving, exercise, sexual activity, and normal routines will depend on factors such as your job, fitness level, surgical details, and how your recovery progresses. You should follow your surgical team’s guidance and avoid pushing yourself before your body is ready.
A slower recovery does not always mean there is a problem. However, you should seek medical advice if you develop worsening pain, fever, heavy bleeding, leg swelling, shortness of breath, or problems such as a blocked catheter.
It Can Affect Work and Daily Life
Robotic prostate surgery may require you to take time away from work and your usual responsibilities while you recover. This can be challenging, especially if you are self-employed, provide care for someone else, or have concerns about managing daily commitments.
During the early recovery period, you may need support with tasks such as shopping, lifting, cooking, driving, managing your catheter, and attending follow-up appointments. Planning help in advance can make this period easier and reduce unnecessary stress.
The impact on your daily routine is an important disadvantage to consider before surgery. Alongside the medical risks and benefits, you should think about how recovery may affect your work, home life, and personal responsibilities.
It Can Affect Mental Health and Relationships
Robotic prostate surgery can affect more than your physical health. You may experience changes in how you feel about your body, sexuality, urinary control, and confidence after treatment. While some men feel relieved after cancer treatment, others may experience anxiety, frustration, embarrassment, or low mood.
EAU follow-up guidance highlights that men with prostate cancer can have an increased risk of depression and that mental health should be considered as part of ongoing care. Your emotional recovery is an important part of adjusting after surgery.
Changes in erections, intimacy, and self-confidence can also affect your relationship. Open communication with your partner, emotional support, and access to specialist services can help you manage these changes and improve your quality of life.
Surgeon Experience and Learning Curve Matter
Robotic prostate surgery is a technically complex procedure, and your outcomes can be influenced by your surgeon’s experience, the number of procedures they perform, patient selection, and the wider support team involved in your care.
Certain parts of the operation require particular expertise, including nerve-sparing techniques, bladder neck reconstruction, careful removal of the prostate apex, lymph node removal, and managing challenging anatomy. Although robotic technology provides useful advantages, it does not mean every surgeon will achieve identical results.
Before surgery, you should feel comfortable asking your surgeon about their approach to preserving continence, protecting nerves, maintaining cancer control, and managing complications. The most helpful answers will be specific to your cancer, your health, and your individual treatment goals.
Procedure numbers can provide useful context, but they do not replace discussion of the surgeon’s audited continence, erectile-function, margin and complication outcomes for patients similar to you.
Cost and Access Can Be Limitations
Robotic prostate surgery requires specialist equipment, trained surgical teams, dedicated operating time, and ongoing maintenance. Because of these requirements, access to robotic treatment may vary between hospitals and healthcare settings.
You may need to travel to a specialist centre if robotic surgery is not available locally. In private healthcare settings, factors such as treatment costs and insurance coverage may also influence your options and decision-making.
Access is an important practical consideration, but it should not be the only reason you choose or avoid robotic surgery. The most important question is whether robotic prostatectomy is the right treatment option for your cancer, overall health, and personal priorities.
When to Seek Urgent Help After Surgery
Contact your surgical team or NHS 111 urgently if you develop a fever, worsening wound redness or discharge, persistent vomiting, increasing abdominal pain, very little urine entering the catheter bag, large blood clots in the catheter, inability to pass urine after catheter removal, or rapidly worsening swelling or pain.
Seek urgent medical attention for new one-sided calf pain or swelling. Call 999 or attend A&E if you experience serious breathing difficulty, chest pain, coughing up blood, collapse, severe bleeding, confusion, loss of consciousness or signs of a severe allergic reaction.
How to Weigh the Disadvantages Against the Benefits
The disadvantages of robotic prostate surgery are important to understand, but they do not mean the operation is the wrong choice for everyone. If you are a suitable candidate, the procedure may offer effective cancer control and a clear approach to treating localised prostate cancer.
Making the right decision requires a balanced understanding of both benefits and risks. You should be aware of possible urinary leakage, erectile dysfunction, fertility changes, catheter discomfort, surgical complications, recovery time, recurrence risk, and the possibility of needing further treatment before agreeing to surgery.
The best treatment choice depends on your individual situation. Robotic prostate surgery may be appropriate for you if the potential benefits of cancer control outweigh the possible side effects and you have a clear understanding of what recovery and follow-up may involve.
Clinical Tip
Ask your surgeon for outcomes that are relevant to someone with your age, baseline urinary control, current erectile function, cancer stage and planned nerve-sparing approach. Useful questions include how continence is defined, how many patients use pads at three and twelve months, how often additional continence surgery is required, and what erectile-rehabilitation support is available.
You can also ask about positive-margin rates for your cancer stage, catheter duration, conversion to open surgery, readmission, blood transfusion and the pathway for obtaining urgent advice after discharge.
Key Takeaways
- Robotic prostatectomy remains major surgery despite the smaller external incisions.
- The robot is controlled by the surgeon and does not remove operative risk.
- Urinary leakage and erectile dysfunction are common after surgery.
- Recovery varies, and some urinary or erectile effects can be long-lasting.
- Radical prostatectomy permanently stops ejaculation of semen and prevents natural conception through intercourse.
- A catheter is usually required during early healing.
- Infection, bleeding, blood clots and anaesthetic complications remain possible.
- Rare injuries can affect the bowel, rectum, ureters, blood vessels or nerves.
- Conversion to open or standard laparoscopic surgery may occasionally be required.
- Robotic surgery does not guarantee better cancer control than other properly performed surgical approaches.
- Positive surgical margins and further treatment remain possible.
- Surgeon experience and access to continence and sexual rehabilitation are important.
- The most suitable treatment depends on your cancer, health and personal priorities.
FAQs
1. Is robotic prostate surgery dangerous?
Robot-assisted radical prostatectomy is routinely performed in specialist centres, but it remains major surgery. Suitability and risk depend on your cancer, general health, anatomy and surgical team. Possible risks include urinary leakage, erectile dysfunction, infection, bleeding, blood clots and anaesthetic complications.
2. What is the biggest disadvantage of robotic prostate surgery?
There is no single disadvantage that affects everyone in the same way. Urinary leakage and erectile dysfunction are among the most important concerns, while infertility and dry orgasm are permanent expected consequences.
3. Does robotic prostate surgery always cure prostate cancer?
Radical prostatectomy is performed with curative intent and can provide lasting cancer control for many men. However, it cannot guarantee that prostate cancer will never return. Some men may still need further treatment, such as radiotherapy or hormone therapy, depending on their pathology results and PSA follow-up.
4. How long does urinary leakage last after robotic prostate surgery?
The recovery time varies between individuals. Some men regain bladder control within weeks or months, while others may need longer. Factors such as age, pelvic floor strength, previous urinary function, and the details of your surgery can influence recovery. Seek advice if leakage remains severe, is not improving, or continues to have a major effect on your daily life.
5. Will I have erectile dysfunction after robotic prostate surgery?
Erectile difficulties are a common side effect after robotic prostate surgery because the nerves involved in erections are located close to the prostate. Recovery depends on factors such as your age, erections before surgery, whether nerve-sparing surgery is possible, and your overall health. Even when nerve-sparing is possible, spontaneous erections may not fully recover, and rehabilitation or long-term treatment may be needed.
6. Can I have children after robotic prostate surgery?
After radical prostatectomy, you will no longer ejaculate semen because the prostate and seminal vesicles are removed. You may still experience orgasm, but it will usually be a dry orgasm. You will not be able to conceive through sexual intercourse after radical prostatectomy, so sperm banking should be discussed before surgery if future biological parenthood is important to you.
7. How long does recovery take after robotic prostate surgery?
Recovery differs from person to person. Many men return to normal activities within several weeks, but improvements in bladder control, erections, and energy levels may continue for months or even longer.
8. Does robotic surgery have fewer risks than traditional prostate surgery?
Robotic surgery usually involves smaller incisions and may reduce blood loss, transfusion requirements and hospital stay. However, it does not eliminate major surgical risks, and available evidence has not established a clear long-term urinary, sexual or survival advantage from the robotic platform alone.
9. Can prostate cancer return after robotic prostate surgery?
Prostate cancer can recur after any form of radical prostatectomy. Regular PSA follow-up is therefore essential even when the prostate and visible cancer have been removed.
10. How do I know if robotic prostate surgery is right for me?
The right treatment depends on your cancer stage, PSA level, MRI findings, general health, age, lifestyle priorities, and personal preferences. Discussing all available options with your specialist can help you decide whether robotic prostate surgery is the most suitable choice for you.
Final Thoughts: Understanding the Risks and Benefits of Robotic Prostate Surgery
Robotic prostate surgery can provide effective cancer control for appropriately selected people, but it remains a major operation with potential short- and long-term disadvantages. Urinary leakage, erectile dysfunction, dry orgasm, infertility, catheter discomfort, recovery demands and the possibility of further treatment should all form part of your decision.
The significance of each risk depends on your cancer, age, baseline urinary and sexual function, general health and the planned surgical approach. If you are considering treatment, a consultation with a specialist at a robotic prostate surgery clinic in London can help you compare the available options and understand the outcomes most relevant to your circumstances.
References:
- National Institute for Health and Care Excellence (NICE) (2019, updated 2021; reviewed 2025) Prostate cancer: diagnosis and management (NICE guideline NG131). London: NICE. Available at: https://www.nice.org.uk/guidance/ng131
- University College London Hospitals NHS Foundation Trust (UCLH) (2026) Robotic prostatectomy. Page last updated 4 March 2026. Available at: https://www.uclh.nhs.uk/patients-and-visitors/patient-information-pages/robotic-prostatectomy
- Cambridge University Hospitals NHS Foundation Trust (2024) Robotic radical prostatectomy: pre- and post-operative information. Approved 10 May 2024. Available at: https://www.cuh.nhs.uk/patient-information/robotic-radical-prostatectomy/
- Cancer Research UK (2025) Problems after prostate cancer surgery. Last reviewed 3 September 2025. Available at: https://www.cancerresearchuk.org/about-cancer/prostate-cancer/treatment/surgery/problems-after-prostate-surgery
- Prostate Cancer UK (2024) Surgery: radical prostatectomy. Updated July 2024. Available at: https://prostatecanceruk.org/prostate-information-and-support/treatments/surgery
- British Association of Urological Surgeons (BAUS) (2024) Robotic-assisted radical prostatectomy (RARP). Published March 2024. Available at: https://www.baus.org.uk/patients/information_leaflets/180/roboticassisted_radical_prostatectomy_rarp
- European Association of Urology (EAU) (2026) EAU Guidelines on Prostate Cancer: Follow-up. Arnhem: European Association of Urology Guidelines Office. Available at: https://uroweb.org/guidelines/prostate-cancer/chapter/followup