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Robotic simple prostatectomy - enucleation

Robotic simple prostatectomy is a keyhole procedure used to treat obstruction of the bladder by overgrowth of the central part of the prostate.  In men with very large prostates who have severe difficulty urinating, medications or the standard procedure of TURP may be insufficient or difficult to perform.  In this case a very good operation to alleviate this problem is RASP.

This involves keyhole surgery under a general anaesthetic.  The procedure involves making a small incision in the bladder and removing the central part of the overgrown prostate tissue to create a large channel to urinate through.  The large pieces of prostate tissue are removed through the keyhole surgery ports. 

The surgery lasts ± 1.5-2 hours and the recovery is usually fairly rapid.  Patients remain in hospital for 2-3 days with a catheter in place and this can be removed on the second or third day.  The procedure uses 5 small incisions in the abdomen which all heal rapidly.  Afterwards the patient usually has a very good urinary stream and the problem is unlikely to recur in their lifetime.

Risks of surgery include bleeding, pain, infection, damage to other organs during the surgery (uncommon), significant bleeding after the surgery and delayed bleeding within the first 6 weeks.  It is rare that the procedure causes leakage and it does not affect the erections.

Dr Pokorny has published the largest series of RASP cases under the mentorship of Professor Mottrie in Belgium who is a world expert in this procedure.  This procedure is usually recommended for very large prostates (>120g).  Prostates smaller than this size can often be shrunk with medication and then treated by standard TURP.