Men’s Health Month: From Prostate Cancer Patient to Survivor and Advocate
Tony Braun was at his urologist’s office one day in 2010 because of a kidney stone when the physician became alarmed. Bloodwork showed Tony’s prostate-specific…

At UF Health, our advanced team of urologic surgeons and oncologists offer robotic radical prostatectomies as one of many possible treatments for prostate cancer.
Radical prostatectomy (prostate removal) is surgery to remove all of the prostate gland and some of the tissue around it. It is done to treat prostate cancer. For almost all prostatectomy surgeries at UF Health, our team utilizes a robotic approach. A robotic radical prostatectomy is a minimally invasive surgical procedure that removes the prostate seminal vesicles and vas deferens, in addition to surrounding lymph nodes in select patients. Sometimes this procedure is called a robotic-assisted laparoscopic prostatectomy, or RALP.
UF Health offers a wide range of robotic technology for prostatectomie. These include:
UF Health will soon offer multi-port robotic surgery using the cutting-edge Da Vinci 5 robotic surgical system.
Beyond radical prostatectomy, UF Health is excited to offer various cutting-edge focal therapy options for select patients. Focal therapy is a type of prostate cancer treatment that targets cancerous tissues while leaving normal prostate tissue and surrounding structures unharmed.
Our surgeons use the most advanced robotic system available to improve precision and control. Older techniques, such as open prostatectomy, are rarely used today.
Using the latest technology and equipment combined with our fellowship-trained urologists’ expertise, our prostate cancer surgical approach offers many benefits, these include:
Utilizing a single-port robotic prostatectomy technique has further advantages:
This technique may be used if the surgeon determines it is the best option for the patient.
Other advantages of robotic prostatectomy include:
With these advantages combined, robotic surgery provides better visualization of the critical structures surrounding the prostate gland. It allows surgeons to operate with the same flexibility and ease as a surgeon has when performing an open prostatectomy while at the same time accomplishing this through smaller incisions with significantly reduced blood loss.
During a multi-port robotic prostatectomy, surgical oncologists carefully insert small, 5-12 millimeter robotic arms—each about the diameter of a dime—into separate small incisions in the patient's abdomen. The arms are equipped with lights, a stereoscopic camera that allows the surgeon and surgical team to view the procedure in three dimensions, and specialized laparoscopic surgical instruments that respond precisely to every movement of the surgeon's hands.
During the procedure, the entire prostate will be removed. Based on the extent and grade of the disease, the surrounding lymph nodes may also need to be removed. Your doctor will discuss this with you before surgery.
The extent of the disease and the location of the cancer with respect to surrounding structures will determine if the robotic radical prostatectomy can be a nerve-sparing procedure, known as a robotic nerve-sparing radical prostatectomy. Utilizing this approach will be discussed before surgery, and the ultimate decision to use a nerve-sparing technique will be made during your surgery.
For patients with clinically localized prostate cancer, nerve-sparing robotic prostatectomy provides patients with a safe and minimally invasive technique for removal of the prostate gland while preserving as much of the surrounding nerve structures responsible for penile erections. Furthermore, various methods can be performed to optimize continence.
Overall this minimally-invasive approach, whether single-port or multi-port, boasts the advantage of smaller incisions, reduced pain, less blood loss, transfusion rates, and reduced hospital stay. In select patients with locally invasive or metastatic cancer, morbid obesity, bleeding tendencies, or severe heart or lung problems, robotic prostatectomy may not be advised.
Robotic prostatectomy is used to treat patients who have clinically localized prostate cancer. In many centers, including at UF Health, the robotic approach is the treatment of choice for the surgical management of clinically localized prostate cancer.
Patients with a history of advanced age, extensive abdominal surgery, radiation, pre-existing heart or lung disease, morbid obesity, or bleeding tendencies may not be the best candidates for robotic prostatectomy. Fortunately, focal therapy or radiation therapy can serve as alternative or additional treatment options.
Patients with known metastatic disease are not candidates for robotic prostatectomy. Patients with recurrent prostate cancer may not be candidates; however, it is best to determine this with your surgeon. Although patients with very large prostate glands can undergo robotic prostatectomy, operative times are generally longer than in patients with smaller prostate gland sizes.
Our robotic surgeons have all received extensive advanced fellowship training in robotic surgery. UF Health has performed and trained surgeons in robotic prostatectomies since 2002. Recently, we also began offering outpatient prostatectomies. This allows eligible patients to return home quicker. UF Health takes a multidisciplinary approach to prostate cancer treatment. This includes urologic surgeons, medical oncologists, radiation oncologists, and physical therapists. We offer a wide array of prostate cancer treatments, including:
Robotic prostatectomy generally takes 2-4 hours, depending on many factors, including the size of the prostate gland, obesity, prior abdominal surgery, and scar tissue. Many of these pre-existing factors mandate a longer operative time. Our surgeons focus on performing a thorough and meticulous surgery, not on the speed of the operation. An additional 2+ hours may be allocated for general anesthesia, setting up the equipment, and coming off of anesthesia.
Although extremely rare, conversion to open prostate cancer surgery may be required if difficulty with dissection or extensive bleeding is encountered during the robotic approach.
Our surgeons are trained in open surgical approaches, laparoscopy, and robotic surgery. They are well-equipped to perform prostate surgery in a laparoscopic or open fashion if necessary.
The prognosis of cancer-free survival includes many factors. This is based in part upon the grade and stage of your cancer and will be discussed with you by your surgeon following surgery during the review of the pathology report.
The timing and extent of return of urinary continence and sexual potency following prostatectomy is a complex process. Some of the factors that influence the success of the return of these quality of life issues include patient factors such as:
In addition, surgical factors such as quality and quantity of nerve preservation can influence outcomes.
For patients 60 years old or younger, who were preoperatively potent with no urinary issues and who received bilateral nerve preservation, at 6 months post-surgery, 80% were continent, and 72% were able to participate in intercourse without the use of medication (known as potent). At 12 months post-surgery, 93% were continent, and 85% were potent.
These results can vary significantly depending on individual circumstances, including the extent of cancer, age, and comorbid medical conditions.
After a period in a recovery room, you will be transported to a hospital room once you are aware and your vital signs are stable. After prostate removal surgery, you may experience:
After being discharged from the hospital, patients can expect the following:
For patients with organ-confined prostate cancer that has not spread beyond the prostate capsule or into the lymph nodes or seminal vesicles, the prognosis remains excellent as most are cured with surgery alone.
In cases where more invasive or metastatic disease is found, additional treatments, such as radiation, chemotherapy, and hormonal therapy, may be required. These options are decided on a case-by-case basis.
UF Health offers a multi-disciplinary meeting for challenging cases of prostate cancer. There are clinical trials with chemotherapy and vaccine therapy that are available at our institution for cases of metastatic prostate cancer that are refractory to conventional treatments. These would be administrated under the advisement of a medical oncologist.
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