Robotic prostate surgery that saves patients from debilitating leaky bladder – and could now change the lives of four in five men

Prostate cancer patients could soon escape debilitating incontinence thanks to a groundbreaking robotic surgery.

The procedure is said to be life-changing for four out of five men who experience leakage after their prostate is removed. Patients often have to wear sanitary pads after the existing invasive surgery, which makes many afraid to leave the house.

But according to a new study, the robotic surgery can reduce the risk of severe incontinence. It is designed to prevent long-term damage to the urethra, the tube that runs through the pancreas.

Research shows that injuries to the urethra are one of the leading causes of incontinence.

So far, only patients at University College London Hospital (UCLH) have had access to the procedure, called radical robot-assisted prostatectomy with complete urethral preservation, as part of a pilot project.

However, experts say it will now be rolled out to hospitals across the NHS. They say it will also lower the risk of erectile dysfunction, a common side effect of prostate removal.

‘The results are remarkable,’ said Professor Greg Shaw, a cancer specialist at UCLH. ‘Men come back after the procedure and don’t need sanitary pads, which is unheard of. The operation even seems to ensure that more men become sexually active again.’

Prostate cancer is the most common form of the disease in men, with 52,000 new diagnoses each year. It occurs in the prostate, the walnut-sized organ located below the bladder that produces semen. The disease kills about 12,000 people every year.

A cancer patient undergoing robot-assisted surgery. The robotic operation could reduce the risk of severe incontinence in prostate cancer patients

Actor Stephen Fry revealed he was forced to wear incontinence pads after surgery for prostate cancer

The majority are men over 65 years old and tend to move slowly. Many patients will never need treatment because the disease does not threaten their health. However, some will need chemotherapy, radiotherapy or tablets to slow its spread.

Around 8,000 people in Britain have their prostate removed every year due to cancer, in a procedure known as a radical prostatectomy.

Normally this involves cutting the prostate and urethra in half. After the prostate is removed, the cut ends of the urethra are stitched back together. However, this often shortens the length of the urethra, which research shows increases the risk of urinary incontinence, where patients are unable to control their bladder movements.

In 2019, actor and comedian Stephen Fry, 67, revealed he was forced to rely on incontinence pads after undergoing prostate cancer surgery last year.

With the new robotic technique, an incision is made along the length of the urethra. This means that the urethra is dissected, but its length does not change. Once the prostate has been removed, the tube is sutured back together.

The results of the pilot study of almost 100 patients showed that six weeks after surgery, 60 percent of patients had no problems urinating – meaning the risk of incontinence halves.

Experts say the procedure could easily be implemented within the NHS. “This will be easy to roll out because surgeons won’t have to learn a new technique from scratch and hospitals won’t need new equipment,” says Professor Shaw.

‘I have already taught this to five other surgeons and we can expect more patients to benefit from this soon.’

The results of the pilot study among almost 100 patients showed that six weeks after surgery, 60 percent of patients had no problems urinating (file photo)

One patient who has already benefited from the groundbreaking surgery is father-of-two Udall Evans, 47, from London.

Udall, who works in the film industry, was diagnosed last year after a blood test as part of a routine GP check-up suggested signs of cancer. Hospital scans showed that he would need urgent surgery to remove his prostate due to the size of the tumor.

“I was quite concerned about the side effects,” Udall says. ‘I was told it could take months, but I didn’t really have a choice.’

Instead of having the standard operation, he was offered the new procedure at UCLH in June.

The robotic surgery was successful and Udall was home the next day. “The team prepared me with sanitary pads anyway, but I didn’t really have any leakage,” he says.

‘I could live a normal life. It was such a relief.’