• Very good continence
  In addition to tumor removal, another important aspect is maintaining your continence. The "da Vinci" makes it easier for the surgeon to precisely identify the anatomical structures. Our experience with robot-assisted removal of the prostate has so far shown very good results. However, urine leakage can sometimes still occur, particularly in the first few weeks after the operation.

• Preserving potency
  Potency also plays an important role for you as a patient, and we want to preserve it. By using a nerve-sparing procedure, it is possible to preserve the nerve-vessel bundles so that potency can be maintained. However, this depends on the spread of the individual tumor. Even with good potency preservation, it may be necessary to support limb stiffness with medication in the first few months or in the long term.

• No catheter through the urethra
  A catheter is an unpleasant necessity to protect the new connection between the bladder and urethra in the first few days after the procedure. In most cases, we do not use a catheter in the urethra as patients usually find it uncomfortable. Instead, the urine is drained via a thin catheter from the abdominal wall.

• Less pain
  The smallest incisions cause hardly any pain. In the first few days after the operation, however, the abdominal muscles may be sore.

• Short hospital stay
  We decide on the time of your discharge on an individual basis. However, our patients can usually leave the Clinical Department 4 to 5 days after the procedure.

• Quick return to everyday life
  Despite the major procedure, experience has shown that patients feel fit again very quickly after the operation. For most people, everyday life should not be interrupted for long. However, please take it easy for at least 6 weeks - even if you are not in pain and feel healthy.
  
  Cycling, sport and physical work where you are carrying more than 5 - 10 kg should be avoided for the time being.

The inpatient admission takes place one day before the operation. Our surgeons will then give a detailed explanation of the planned operation and talk to an anesthetist about the anesthetic. Our patients also undergo a complete examination. This includes, for example, a blood sample, a general examination, an ultrasound and, if necessary, a urine test. If everything is in order, you will be allocated a room on the ward and can still eat normally on the day of admission.

You will not be allowed to eat on the day of the operation. A transporter will collect you from your bed on the ward and take you to the operating theater. There, an anesthetist will then prepare the anesthesia - the operation will of course be performed under general anesthesia, so that you will not be aware of the procedure itself.

Once everything is prepared, gas is filled into the abdomen and the operating table is tilted to a 30° head-down position. This gives the surgeon the best possible view of the inside of the body. Six small incisions are then made through which the introducer sleeves are inserted into the abdominal cavity. They are the connecting piece to the robot and its arms. Once everything is connected, the operation can begin.

In the first step, the prostate is detached together with the prostatic urethra and the seminal vesicles at the bladder and urethra. It is possible to preserve potency - i.e. to spare the nerves for the stiffness of the penis - but this always depends on the spread of the tumor. This is because the nerves lie directly on the surface of the prostate.

In addition, the lymph nodes along the large pelvic vessels are removed. The pathology laboratory then checks later whether the tumor has spread beyond the capsule - this measure therefore has both a diagnostic and a therapeutic effect if the lymph nodes are already affected.

At the end of the operation, the urethra is reconnected to the bladder with the help of a suture and tested to see whether the new connection (anastomosis) is tight. In order to protect this newly created connection in the first few days after the operation, no catheter is inserted through the urethra, but a so-called building catheter. Many patients find this more comfortable than a urethral catheter.

Finally, the "da Vinci" instruments are removed. The small incisions made at the beginning are sutured and dissolve after a while. Thanks to a special skin adhesive, patients can shower normally the day after the operation.

The patient spends the first few hours after the operation either in the recovery room or in an intensive care unit.

Depending on how you feel, you may be able to get up and move around our ward, take a shower and, of course, eat normally again just one day after the operation.

The MHH also has a social service and psycho-oncologists who will be happy to support you during your recovery. For example, when planning follow-up treatment.

Furthermore, the pathology laboratory will analyze the tissue that was removed during the operation and our surgeons will discuss the histological results with you if they are available before you are discharged. In this way, you will find out on the spot how to proceed with your treatment. For example, whether regular PSA value checks are necessary or whether the treatment may require further measures such as radiation or drug therapy. If the results are not yet available on discharge, they will be sent to the treating urologist as soon as possible.

A few days after the operation, the tightness of the connection between the urethra and bladder will be checked. If everything is in order, you can urinate again as usual and the abdominal catheter is removed - our patients usually leave the MHH without a catheter.

Even if you feel fit for a quick return to everyday life and have no discomfort or pain, you should take it easy and rest in the first few weeks after the operation. Regular sphincter training will help you to control your body as usual.