Robotic simple prostatectomy.
For very large, very obstructive prostates — when medications haven't worked and other surgeries are unlikely to give durable relief, this is the operation that does.
Who needs this operation
Most men with prostate enlargement (BPH) are treated successfully with medications or with one of the smaller minimally-invasive options (such as TURP, HoLEP, GreenLight, UroLift, or Rezum). When the prostate is very large — usually 140 cc (about 140 grams) or greater — those treatments often fall short, and surgically removing the obstructing tissue gives the most reliable, durable relief.
Simple prostatectomy removes the obstructive inner portion of the prostate while leaving the outer "capsule" in place. (It is different from a radical prostatectomy for cancer, which removes the entire prostate.) Robotic simple prostatectomy accomplishes this through small abdominal incisions instead of an open incision.
One more option for very large prostates
Surgery isn't the only route. Prostate artery embolization (PAE) — a minimally invasive procedure that shrinks the prostate by reducing its blood supply, with no incision — is also offered at Fore River Urology and can be a lower-risk choice for some men, particularly those who would rather avoid an operation or aren't ideal surgical candidates. The best way to know which approach fits you is a consultation. Learn about prostate artery embolization at Fore River Urology →
Symptoms that lead to this conversation
- Severe lower urinary tract symptoms (weak stream, hesitancy, straining, frequency, urgency)
- Inability to fully empty the bladder, or chronic urinary retention
- Recurrent urinary tract infections from incomplete emptying
- Bladder stones forming from incomplete emptying
- Episodes of blood in the urine from the prostate
- Failure of medication or prior less-invasive procedures
How it is done
Under general anesthesia, four or five small incisions are made. The inner prostatic adenoma is dissected out from within the prostatic capsule and removed. The bladder is closed, a catheter is left in place for about a week, and most patients go home the same day or the next.
Compared to open simple prostatectomy, the biggest differences are a much shorter hospital stay and far less blood loss — along with less pain and a quicker recovery.
Recovery
- Home the same day or the next
- Catheter: about one week
- Most men return to desk work in 1–2 weeks
- Full activity at 4–6 weeks
- Symptom improvement is dramatic and durable
Risks worth knowing
- Bleeding — uncommon with the robotic approach; occasionally requires transfusion
- Temporary urinary leakage after catheter removal; lasting incontinence is rare (around 0.5%)
- Retrograde ejaculation is common (semen flows backward into the bladder rather than outward) — this does not affect orgasm or sexual function
- Little effect on erections — typically a 0–10% change with this approach
- Bladder-neck contracture — uncommon
- Urinary tract infection
Tried everything for BPH and still suffering?
Bring your records. Dr. Ursiny will tell you honestly which operation fits.
Book a Consultation