Hearing the word prostatectomy for the first time can feel abrupt, yet surgeons only place it on the table after they have weighed up your cancer’s stage, your overall fitness, and the life you want to lead once treatment is over.
In this guide, we unpack the main types of prostate surgery, compare robotic-assisted surgery alongside traditional approaches and examine what recent research tells us.
What determines the right prostate surgery for you?
The ideal treatment should be bespoke, taking into account patient factors and the characteristics of the tumour. Localised prostate cancer can usually be cured outright with surgery, while aggressive or locally advanced disease may need a combination of treatments. However, the patient’s age and overall health are important considerations as major surgery demands a certain level of fitness and for men with serious comorbidities, radiotherapy might be a better option.
Long‑term strategy also matters. Having the prostate removed first preserves future treatment options, especially salvage radiotherapy, if the cancer returns. Turning that sequence around is technically far tougher. Finally, some men prefer to avoid the small but documented risk of radiation‑induced secondary cancers, opting instead for the greater certainty of outcome that physical tumour removal brings. Add to these clinical pillars the personal desire to safeguard continence, sexual function and a swift return to work, and the decision starts to take shape.
Different types of prostate surgery
Below we compare the three principal surgical routes to removing the prostate.
Open radical prostatectomy
The original “gold standard” technique, it uses one long incision in the lower abdomen. Surgeons work with direct vision (and the benefit of tactile feedback) to free and remove the prostate, seminal vesicles, and, where necessary, pelvic lymph nodes. For a head‑to‑head analysis, visit our guide to open surgery vs robotic prostatectomy.
Pros: Tried‑and‑tested, familiar to many surgeons, helpful in very large prostates or after past abdominal surgery.
Cons: Longer hospital stay, greater blood loss, more postoperative pain, and a visible scar.
Recovery snapshot: Catheter for 3 weeks; many men need six weeks before driving or desk work.
Laparoscopic radical prostatectomy
Keyhole surgery shrinks that scar to five or six pencil‑sized ports. Long rigid instruments and a camera translate the surgeon’s hand movements inside the pelvis.
Pros: Less bleeding, shorter stay, faster early mobilisation.
Cons: Two‑dimensional vision and fixed‑angle instruments make delicate nerve‑sparing a steeper learning curve.
Recovery snapshot: Overnight admission is common; many men resume full activities inside four weeks.
Robot‑assisted radical prostatectomy (RARP)
Robot-assisted radical prostatectomy (RARP) is a modern evolution of keyhole surgery, using advanced robotic systems to enhance precision, control, and visualisation during the operation. Unlike conventional laparoscopic tools, robotic instruments mimic the movement of the human hand with added stability and magnification, which helps surgeons preserve delicate structures like the neurovascular bundles crucial for continence and sexual function. These advantages often lead to lower blood loss, quicker discharge, and a faster return to daily life.
At Santis Health, the team routinely performs robotic prostatectomy using advanced approaches such as the da Vinci Single Port system, Retzius-sparing access, and intraoperative nerve-sparing techniques.
Pros: 10× magnified 3‑D vision, articulated instruments that move beyond the range of the human hand, tremor suppression, lower blood loss, shorter stays (many patients go home the next morning), and industry‑leading functional outcomes. Continence rates at Santis now top 93% at three months, and potency recovery is running ahead of national averages.
Cons: Not all centres offer robotic surgery, and results depend heavily on the expertise of the surgical team.
Recovery snapshot: Day‑case or one night in hospital; many office‑based patients return to work inside two weeks.
For a deeper dive into surgeries, including the full range of robotic procedures offered at Santis, see the Prostate Surgery overview page.
Radiotherapy as a non‑surgical alternative
Radiotherapy (external‑beam or brachytherapy) kills prostate cancer cells with targeted X‑rays. It suits men who cannot, or would rather not, undergo surgery. Treatment is delivered either as short weekday sessions over a few weeks, or via radioactive seed implants placed directly into the prostate.
When might radiotherapy be considered?
- Men with significant heart or lung disease who may not tolerate anaesthesia.
- Older patients for whom the slower onset of radiation side‑effects is acceptable.
- Cancers that have already broken through the prostate capsule or spread to lymph nodes.
- Patients who prefer to avoid an operation after weighing continence and erectile‑function risks.
Potential downsides include bowel irritation, urinary frequency, radiation-induced pelvic cancers and the fact that salvage surgery after radiation is technically more challenging.
Why so many men choose Santis Health
- A single, named surgeon, Professor Christopher Eden, performs every prostatectomy.
- More than 4,000 surgical procedures completed with outstanding cancer control and functional outcomes.
- First UK centre to adopt the Retzius‑sparing technique and over 1,000 cases completed; leader in neuroSAFE real‑time margin assessment.
- Among the earliest European adopters of the da Vinci Single Port robot for even faster recovery and almost scar‑free results.
- Dedicated support team guiding you from first consultation to long‑term follow‑up.
Make the right choice for you
Whether you favour the time‑honoured visibility of open surgery, the nimble efficiency of laparoscopic keyhole, or the cutting‑edge precision of robotics, modern types of prostate surgery can all deliver excellent cancer control when performed by experts. Where they differ is in the journey home: blood loss, pain, continence, potency, and days away from work all improve as incisions shrink and technology advances.
At Santis Health, decades of innovation and unmatched surgical volume have made robotic prostatectomy the default choice. Pair that with a surgeon who pioneered the method in the UK and an outcome‑driven, patient‑centred culture, and the path becomes clearer.
Ready to explore your options? Get in touch with the Santis team or call the clinic to arrange a consultation.
