You have been diagnosed with prostate cancer and surgery has been recommended. Now comes the part that textbooks don't cover well — what actually happens, day by day, from the moment you agree to surgery until you are back at home feeling like yourself again.
This guide is written for patients, not for medical professionals. It covers the practical reality of robotic radical prostatectomy (RARP) — what to expect, what to prepare, what is normal, and when to call your surgeon.
1. What is robotic prostatectomy (RARP)?
RARP in simple terms
The surgeon sits at a console and controls robotic arms that make 4–5 small incisions in your abdomen. The prostate is removed through these tiny cuts. There is no large open wound. The surgeon sees everything on a 3D screen magnified up to 10 times.
RARP stands for Robot-Assisted Radical Prostatectomy. Radical means the entire prostate is removed — not just part of it. Robot-assisted means the surgeon uses a robotic system (most commonly the Da Vinci system) to perform the operation with greater precision than is possible with human hands alone.
2. The two weeks before surgery
The pre-operative period is not passive waiting — it is active preparation. What you do in the two weeks before surgery significantly affects how smoothly your operation goes and how quickly you recover.
Medical preparation
- Blood tests and ECG — routine checks to ensure you are fit for general anaesthesia
- Bowel preparation — a simple enema is given on the morning of surgery. No special diet or laxatives are required in the days before.
- Medications — inform your surgeon of every medication you take. Blood thinners (aspirin, warfarin, clopidogrel) are typically stopped 5–7 days before. Do not stop any medication without explicit instruction.
- Fasting — nothing to eat from midnight before surgery. As part of our enhanced recovery protocol (ERAS), a carbohydrate drink (apple juice) is given at 5 AM on the morning of surgery. This reduces surgical stress and speeds recovery.
Physical preparation
- Pelvic floor exercises — start these now, before surgery. Squeeze the muscles you would use to stop urine flow, hold for 5 seconds, release. Do 3 sets of 10 daily. Men who do this consistently before surgery regain continence faster afterwards.
- Stop smoking — if you smoke, stopping even 2 weeks before surgery reduces anaesthetic complications and improves wound healing significantly.
- Maintain nutrition — adequate protein intake supports recovery. This is not the time for crash dieting.
Practical preparation at home
- Arrange for someone to drive you home after discharge — you cannot drive for at least 2 weeks
- Prepare a comfortable recovery space at home — a recliner or firm bed, easy access to a bathroom
- Stock loose, comfortable clothing — tracksuit bottoms, not tight waistbands near the incisions
- Buy urinary pads (incontinence pads) — you will need these when the catheter is removed
Inform your team about any recent illness, fever, skin infection, or dental procedure in the two weeks before surgery. These may require postponing the operation. Never attend surgery with an active infection anywhere in your body.
3. The day of surgery
What happens on the day
You are shifted to the OT complex on the morning of surgery. Total time from entering the OT complex to returning to your ward is approximately 5–6 hours — covering anaesthesia preparation, the robotic surgery itself (3–4 hours), and time in the recovery area. Your family can see you in the evening.
You are admitted to hospital the evening before surgery. This allows the team to complete your consent, conduct an anaesthesia review, and administer DVT prophylaxis — an injection that reduces the risk of clots forming in the legs.
On the morning of surgery, after your 5 AM carbohydrate drink, you will be shifted to the OT complex (operation theatre area). Here the anaesthesia team prepares you — intravenous line, monitoring leads, and the anaesthetic itself. Total time in the OT complex from entry to return to ward is approximately 5–6 hours — this includes anaesthesia induction, the robotic surgery itself (3–4 hours), and time in the recovery area before you are moved back to your room.
You will be given a hospital gown and sequential compression devices — pneumatic sleeves placed on your legs that gently inflate and deflate throughout the operation, actively promoting blood flow and preventing clots. An intravenous line (drip) will be placed in your arm.
In the operating theatre, general anaesthesia is administered — you will be completely asleep and will feel nothing. The operation takes 3–4 hours on average, though this varies with complexity.
When you wake up in the recovery room, you will have a urinary catheter in place (a thin tube draining urine from your bladder through the urethra). This is expected and necessary — it allows the join between the bladder and urethra to heal undisturbed.
4. Your time in hospital
Day of surgery — evening
You are on the ward. Pain is controlled with regular medications. You will have a drip, catheter, and a small abdominal drain near the incisions. Sips of water are permitted once the anaesthetic has worn off. Rest.
Day 1 — the most important day
You will be helped to sit up and stand. Most patients walk independently. Early mobilisation is mandatory — it prevents blood clots and speeds recovery. The abdominal drain is removed on this day once drainage is minimal. The drip is also removed. You can eat normally.
Day 2 — discharge
You go home on day 2 with the urinary catheter in place. Before discharge the team explains catheter care, warning signs to watch for, and answers your questions. The catheter is removed at an outpatient visit 7–10 days later. At that same visit, your histopathology report (HPE) is discussed — the detailed laboratory analysis of the removed prostate — and any need for adjuvant (additional) therapy is explained.
Day 7–10 — catheter removal and HPE discussion
You return to the outpatient clinic. The catheter is removed — a brief, simple procedure. Your histopathology report is discussed at this visit — this tells you the final cancer stage, margins, and whether any further treatment may be needed. Some urinary leakage after removal is expected and normal. Pelvic floor exercises are now critical.
5. Recovery at home — week by week
Weeks 1–2
Rest is the priority but complete bed rest is not recommended. Walk around your house every few hours — short, gentle walks prevent clots and maintain circulation. Avoid lifting anything heavier than 2–3 kg. No driving. Shower is fine once the catheter is in place — avoid baths until after catheter removal.
Weeks 3–4
Most patients feel significantly better by week 3. Short walks outside are encouraged — 15–20 minutes, flat ground. Urinary leakage after catheter removal typically improves significantly in this period with consistent pelvic floor exercises. You may return to desk work or light office activity from week 3–4 if you feel comfortable.
Weeks 5–6
Most restrictions lift by 6 weeks. You may drive once you can perform an emergency stop without hesitation — usually 3–4 weeks after surgery, but confirm with your surgeon. Light exercise (swimming, cycling on flat ground) can resume. Avoid heavy lifting or strenuous exercise until 6 weeks.
Beyond 6 weeks
The first PSA test is done at 1 month after surgery. After a successful operation the PSA should be below 0.2 ng/mL — this is what we consider our target. A PSA above this level at 1 month requires careful discussion.
Follow-up schedule: every 3 months for the first 2 years, then every 6 months for the next 3 years, then annually thereafter. Consistent follow-up is not optional — it is how we catch any recurrence early when it is most treatable.
Some degree of urinary leakage after catheter removal is normal in virtually all patients. For most men it improves significantly within 4–8 weeks with pelvic floor exercises. Most patients achieve satisfactory continence within 3–6 months with consistent pelvic floor exercises. If significant leakage continues beyond 6 months, inform your surgeon — there are effective treatments available.
6. Managing the urinary catheter at home
The catheter stays in for 7–14 days depending on your surgeon's preference. It drains urine continuously into a bag attached to your leg (day bag) or a larger bag at night. Most patients find it manageable with some adjustment.
- Keep the catheter clean — wash the area where the catheter exits the urethra twice daily with mild soap and water
- Keep the bag below the bladder — always keep the drainage bag lower than your waist to ensure urine flows by gravity
- Stay hydrated — drink 2–2.5 litres of water daily. This keeps the urine dilute and reduces the risk of infection and blockage
- Watch for signs of infection — fever, cloudy or foul-smelling urine, or pain at the catheter site should prompt a call to your surgeon
The catheter stops draining urine entirely, you develop a high fever above 38.5°C, you notice significant bleeding (bright red urine), you develop severe abdominal pain, or the catheter falls out accidentally.
7. Side effects — what is normal, what is not
Urinary leakage (incontinence)
Normal and expected after catheter removal. Managed with pelvic floor exercises and pads. Improves progressively over weeks to months. Most patients achieve good continence within 3–6 months with regular pelvic floor exercises.
Erectile dysfunction
Erections may be affected after surgery, even with nerve-sparing technique. The nerves controlling erections run alongside the prostate and require time to recover — often 12–24 months. Early rehabilitation with medications helps recovery. This is a sensitive topic that deserves an honest conversation with your surgeon before the operation, not after.
Fatigue
General anaesthesia and surgery cause significant fatigue for 2–4 weeks. This is normal. Do not push through it — rest when your body asks.
Constipation
Common after surgery due to anaesthesia, reduced activity, and pain medications. Increase fluid intake, eat high-fibre foods, and ask your surgeon about a mild laxative if needed. Straining to open your bowels puts pressure on healing tissue — avoid it.
Incision site discomfort
Mild bruising and discomfort around the incision sites is normal for 2–3 weeks. The wounds are small and typically heal well. Increasing redness, warmth, or discharge from any wound site should be assessed.
8. Questions to ask your surgeon before RARP
Take this list to your pre-operative appointment
- Will you attempt nerve sparing — and which nerves, one side or both?
- What is your positive surgical margin rate — how often does cancer reach the edge of what you remove?
- Will lymph nodes be removed — and what is my risk of nodal involvement?
- What continence outcomes do your patients typically achieve — and by when?
- What should I do if the catheter causes problems at home?
- When will I get my first PSA result — and what number are you targeting?
- What happens if the PSA does not become undetectable?
- Can I start pelvic floor physiotherapy before surgery?
In summary
RARP is a major operation that most men recover from well — but recovery is a process, not an event. The patients who do best are those who prepare properly beforehand, follow instructions carefully in the first weeks, and do their pelvic floor exercises consistently.
The cancer operation is one day. The recovery is six weeks. The PSA monitoring is lifelong. All three deserve your full attention.
This article is written for general patient education and reflects standard clinical practice as of 2026. Individual recovery varies significantly based on age, health, cancer characteristics, and surgical findings. All decisions about your care should be made with your urological surgeon based on your specific situation. If you have concerns during recovery, contact your surgical team directly — do not rely on internet resources alone.