Frequently Asked Questions

• Which doctor is best for prostate surgery?

  A prostate surgeon who has performed a large number of prostate surgeries most likely will have better results in achieving the trifecta, i.e., cure the cancer, maintain urinary continence and sexual function

• What is the life expectancy after prostate surgery?

  If the cancer is removed successfully, over 95% of the patients go on to live normal lives.

• What is the success rate of prostate surgery?

  In the hands of an experienced urologist, the cancer is cured in over 90-95% of the cases

• Can you still have an erection if your prostate is removed?

  If you have good erections before surgery, there is a very good chance you can still have an erection after the prostate is removed. The nerves responsible for erections are preserved in a procedure called nerve sparing prostatectomy if the cancer is not believed to have spread widely

• How is the prostate removed in robotic surgery?

  The prostate is separated from the adjacent structures in the pelvis and detached from the bladder and urethra. The prostate gland is then put into a plastic bag and then removed in its entirety from one of the holes created in the abdomen. In most cases, the lymph nodes draining the prostate gland are also removed. The bladder is then connected to the remaining stump of the urethra

• Is prostate surgery major surgery?

  It is a major surgery which is done under general anesthesia but with the use of the daVinci robot the procedure is fast and with minimal discomfort

• How many hours does prostate surgery take?

  Many experienced urologists do this procedure in 1- 2 hours.

• What surgeries do urologists perform?

  In addition to prostate cancer related surgeries, they also treat conditions of the kidney such as kidney or bladder stones, enlarged prostate, cancer in the kidney/bladder/testes/penis.

• Is prostate removal the best option?

  The results with prostate removal are far superior to the other treatment options currently offered for prostate cancer.

• How high can PSA levels go?

  The higher the PSA, the greater the chance of harboring prostate cancer. Very high PSA levels in the hundred's or thousands range are rare, but suggests a high probability that the cancer may have spread to other areas of the body

• Can you live a normal life after prostate surgery?

  Other than the immediate post operative period when there is restriction for lifting large or heavy objects, men who undergo prostate cancer surgery can lead a normal life.

• How serious is a Gleason score of 9?

  Gleason score is a range between 6 to 10. Higher score indicates an aggressive cancer and a high likelihood of cancer recurring.

• What PSA indicates metastasis?

  There is no specific cutoff above which there is a certainty of metastasis. However, PSA level, biopsy Gleason score, and rectal exam findings are taken into consideration to offer additional tests such as CT scan and bone scan to rule out metastasis

• Is robotic prostate surgery painful?

  Majority of men are walking the same day as the surgery. Slight amount of pain from the incisions are adequately controlled with pain medication taken orally

• What size of prostate requires surgery?

  There is no size limit to the prostate for undergoing surgery.

• How long do you need a catheter after prostate surgery?

  Usually for 5-7 days.

• What is the average PSA for a 70 year old?

  While a PSA of less than 4 is considered normal, if consecutive PSA's are rising or if a free PSA component is concerning, it warrants a prostate biopsy

• How serious is a Gleason score of 7?

  Gleason score is a range between 6 to 10. Higher score indicates an aggressive cancer and a high likelihood of cancer recurring

• Can you walk after prostate surgery?

  Majority of men are walking the same day as the surgery. Slight amount of pain from the incisions are adequately controlled with pain medication taken orally. The catheter is taped to the leg and should not prevent you from walking.

• At what PSA level should a biopsy be done?

  There is no single PSA cutoff for all men. Younger men have lower threshold for a prostate biopsy, while older men have higher thresholds. Generally, PSA, age adjusted PSA, PSA velocity, free PSA are all taken into consideration. Rectal exam, abnormal MRI finding, or some of the novel genetic tests for prostate cancer are the other components factored into offering a biopsy. A urologist is best qualified to make this decision for you during your annual prostate check

• How long does it take to stop urine leakage after a prostate operation?

  If surgical technique to preserve continence also called "MULP" is performed during prostate cancer surgery, most men are fully continent within a few weeks to 3 months.

• Why does it hurt to pee after prostate surgery?

  The pain is from the reattachment of urethra to the bladder which can be further irritated by urine. This can be well managed with oral pain medication

• Is the urethra cut during prostate surgery?

  Yes, the urethra is cut to remove the prostate. The urethra is then attached to the bladder