Robot-Assisted Prostate Surgery: Potential Risks and Complications

The safety and efficacy of robot-assisted prostate surgery has been well established for selected patients. As with any surgical procedure, there are risks and potential complications. The safety and complication rates are similar when compared to the open surgery.

Bleeding: Blood loss during this procedure is possible and a transfusion may be required in 5 percent of patients.

If you are interested in autologous blood transfusion (donating your own blood) you must let your surgeon know. To make an autologous blood donation, you must first call the Scott & White Blood Center at 254-724-2430. They will assist you in choosing a blood collection facility convenient to you. Please allow at least one to two weeks for the collection, processing and delivery of the donated blood to Scott & White.

Infection: All patients are treated with intravenous antibiotics, prior to starting surgery to decrease the chance of infection from occurring after surgery.

If you develop any signs or symptoms of infection after the surgery (fever [>100.5°F] drainage from incision, urinary frequency/discomfort), pain or anything that you may be concerned about, please contact us immediately.

Leakage of urine at surgical site: After the prostate is removed, the urethra is reconnected to the bladder with absorbable sutures (stitches). This tissue connection is tested for watertightness during the surgery. A catheter is used to internally drain the bladder, and a small plastic drain is left in the abdomen next to the bladder. Despite this, it is possible for a urine leak to develop which could require a prolonged period of catheterization and/or lead to additional scar tissue formation (bladder neck contracture) and additional procedures. Your surgeon may obtain an x-ray of your bladder with contrast (cystogram) to evaluate for urine leaks prior to catheter removal.

Obstruction to urine flow: Early in the postoperative period, this may occur as a result of swelling and might require replacement of the catheter.

Later, scar tissue can develop at the site where the urethra and bladder are connected. This is called a bladder neck contracture and can require additional procedures to relieve obstruction.

Tissue/organ injury: Although uncommon, possible injury to surrounding tissue and organs including bowel, rectum, bladder, ureter, urethra, nerves and vascular structures could require further surgery. Injury could occur to nerves or muscles related to positioning.

Conversion to open surgery: The surgical procedure may require conversion to the standard open operation if difficulty is encountered during the laparoscopic procedure. This could result in a larger than standard open incision and possibly a longer recuperation period.

Pathology: After the surgery, the pathologist will review the specimen in detail. There is no guarantee that the procedure is curative and other treatments may be necessary.

Hernia: As with any surgery, a hernia may form at the surgical site.

Incontinence: (difficulty with urinary control) When your catheter is removed, you can expect to leak urine (incontinence) for approximately three months. During this time, you will use a pad in your undergarment to absorb the leakage.

Although uncommon, persistent severe incontinence can occur in 5 percent of patients. This could require additional procedures to achieve dryness.

Impotence: (difficulty with penile erection) Also, when your catheter is removed, you can initially expect difficulty achieving erections. Although variable, your sexual function often recovers more slowly than continence and may take up to a year. Even with a nerve-sparing technique, it is possible to experience permanent impotence.

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