Less than 10 percent of men experience complications after prostatectomy, and these are usually treatable or short-term. The two most common post-surgery problems are urinary incontinence and erectile dysfunction. Less than 5 percent of men younger than age 50, and less than 15 percent of men age 70 or older, are incontinent after radical prostatectomy. Most men are able to have sex after prostatectomy.
Faster Return to Urinary Continence
We address the incontinence that may result from surgery by carefully reconstructing the support anatomy. We refer to this approach as the Total Reconstruction Technique and the outcomes we have achieved are impressive. 97 percent of these patients are continent after surgery. Most of our patients who are continent before surgery are continent within 18 months post-surgery.
- 88% men not using any pads within 6 weeks
- 90% men not using any pads within 12 weeks
- 95% men not using any pads within a year duration
In addition, with the ART™ technique, patients have been able to benefit from faster convalescence, shorter hospital stays, smaller incisions with less scarring, significantly less blood loss during surgery, and less pain following surgery. The majority of our patients are discharged and return home within 24 hours.
Erectile Function Recovery
The aim of ART™ is to preserve every nerve fiber responsible for the delicate balance between erection, orgasm, and bladder function.
The benefits of the ART™ technique for sexual function are significant. ART™ allows for stronger erections and orgasms, a reduction in penile shrinkage, and a reduction in the risk of climacturia (involuntary release of urine at the moment of orgasm).
Our unique ART™ technique, designed by Dr. Tewari, has proven to result in lower margin rates (less residual cancer) than other robotic techniques being performed by leading robotic surgeons (less than 10% positive margins versus 10% - 30%). Consequently, there is less need for radiation and hormone therapy post-surgery and men have less reason to feel anxious about future increases in their PSA.
Our program is one of the few in the world where pathologists are on stand-by to provide real-time rapid interpretation of the entire prostate margin rather than analysis of small pieces of tissue removed for a frozen tissue biopsy performed after the surgery. This rapid pathology provides an additional element of security that no cancer remains while we are working to preserve the nerves.
In order to protect the delicate nerves involved, which do not tolerate heat, traction, or manipulation well, we use a nerve-sparing, completely athermal and “traction free” technique (no use of cautery or heat energy) during robotic prostatectomy—a technique pioneered by Dr. Tewari and his team.
A majority of our patients who have normal sexual function prior to surgery and are candidates for nerve-sparing return to normal sexual function after ART™ surgical treatment.
Our best-case scenario is when patients are young, the cancer is discovered early and is organ-confined, and baseline sexual functions is very high. Dr. Tewari can perform Grade I nerve-sparing that can achieve excellent potency (ability to have intercourse) with or without the use of oral medications.