Robotic Prostate Surgery
The robotic prostatectomy is the newest revolutionary upgrade to the traditional prostatectomy thanks to greatly advanced medical technology. The robotic prostatectomy is known for its benefits of decreased recovery time and scarring, nerve sparing approach and we have consistently demonstrated superior outcomes with respect of cancer control, incontinence and impotence.

• Quicker return to normal activity
• Reduced pain – most patients don’t even need narcotics after surgery
• Shorter hospitalization – most go home the next day
• Reduced risk of urinary or sexual problems
• Virtually no blood loss
• Fewer complications
• Less scarring than traditional open surgery
• Less risk of infection

Screening for prostate cancer has led to increased public awareness and early detection, as well as a decline in mortality rates. Robotic radical prostatectomy (robotic-assisted laparoscopic removal of the prostate gland) is also a contributing factor to these encouraging trends. This state-of-the-art surgical procedure can offer the best chance for complete recovery. Wristed instrumentation, tremor filtration and 3D magnification aid the surgeon in performing one of the most demanding aspects of the procedure – nerve-sparing for preservation of post-operative sexual function and urinary control. Along with cancer control, these are key elements in follow-up for patients undergoing treatment.

You will start on Cialis or Levitra or Viagra 1 week after surgery when your catheter is removed. You can resume sexual activity starting one week after surgery. We recommend having sexual intercourse at least 2 times a week to encourage good penile muscle function and performance. If your erections are not perfect by 6 weeks after surgery, Dr. Gholami will start treatment with stronger medications to ensure normal strong erections. Sexual activity and strong erections are encouraged immediately after surgery to ensure the quickest return to normal function. Although there is no ejaculation, the sensation of climax or orgasm is unchanged. Normal sexual function returns as quickly as a few days after surgery and can improve up to years after the procedure. If you have questions about sexual problems or the da Vinci Robotic Prostatectomy, contact Dr. Gholami.

A catheter will be inserted during surgery. Four to ten days after prostate surgery you will return to Dr. Gholami’s office to have the catheter removed. Bring a protective pad with you. (This is compared to an average of 14-21 days with a catheter after traditional radical prostatectomy.) Upon removal of the catheter, you will need to retrain the muscles that control the flow of urine. Be sure to urinate every three hours when you’re awake to retrain your bladder and as soon as you feel the urge. Walking and Kegel exercises will help strengthen the pelvic floor muscles. Approximately, 300 Kegel exercises a day are recommended until total bladder control is achieved. Kegel muscle exercises are done by stopping your urinary stream/flow or trying to lift your penis up and down. Many patients are dry and do not need pads one week following surgery. However, you may want to wear a bladder control pad in the initial post-operative period to deal with temporary incontinence after prostate surgery. When you begin to regain continence, you will typically remain dry throughout the night at first. The second phase encompasses night and early morning control. Finally, you will remain dry night and day. Drink plenty of water as adequate fluid intake will assist in optimum bladder health. Urinary function also improves for up to two years after prostate surgery. Please remember that overcoming incontinence after prostate surgery will vary from one man to the next. Do your exercises, be patient, and be sure to contact us if you have any questions or concerns about radical prostatectomy incontinence and your progress. At the Northern California Prostate Center, post-operative care and patient satisfaction are critical components of the treatment process.

Surgical results reflect the fine balance between cancer control, urinary continence and erectile function. Studies show that surgical outcomes are greatly affected by the treating surgeon’s level of expertise. Dr. Gholami has over a 99% success rate for patient satisfaction. Dr. Gholami has performed thousands of robotic prostatectomies optimizing techniques for quick urinary and erectile recovery and cancer control with negative surgical margins. Dr Gholami takes care to preserve neurovascular bundles controlling erectile function, however, recovery of function is dependent on the individual and their pre-operative function, type of nerve preservation performed, any difficulties encountered during surgery, and patient compliance with the rehabilitation protocol. Risk of long-term urinary incontinence is less than 3%, erectile dysfunction or sexual dysfunction less than 10% with most symptoms, such as neuropraxis resolving within 3 months after surgery. Patients of Dr Gholami have an overwhelmingly good response and a wealth of treatment options to aid them during recovery.