Preparing for Robotic Prostatectomy
Preparing for robotic-assisted radical prostatectomy involves more than the operation itself. Learn what happens before surgery, including your pre-operative assessment, medications, pelvic floor exercises, fasting instructions, and how to prepare for your hospital stay.
What Is Pre-operative Preparation?
Preparing for robotic-assisted radical prostatectomy (RARP) involves more than simply arriving at the hospital on the day of surgery. In the weeks leading up to your operation, your healthcare team will perform assessments to ensure you are fit for anaesthesia and surgery while helping reduce the risk of complications.
Most patients will attend a pre-admission or pre-operative clinic where the surgical team reviews your medical history, current medications, previous operations, allergies, and overall health. This is also an opportunity to ask questions about the procedure and your recovery.
Good preparation can help you recover more comfortably, return to normal activities sooner, and feel more confident about the journey ahead. It also helps ensure that any medical conditions or medications that may affect surgery are identified and managed beforehand.
Your Pre-operative Assessment
Several routine assessments may be arranged before surgery. The exact tests depend on your age, medical history, and existing health conditions.
These may include:
- Blood tests
- Urine test to exclude infection
- Electrocardiogram (ECG) to assess heart rhythm
- Chest X-ray if indicated
- Review of your previous operations
- Review of allergies
- Review by an anaesthetist if required
Your surgeon will also review important information about your prostate cancer, including:
- PSA level
- MRI findings
- Prostate biopsy results
- Gleason Grade Group
- Cancer stage
- Any additional imaging if required
These results help confirm that robotic prostatectomy remains the appropriate treatment option.
Reviewing Your Medications
Some medications may need to be stopped or adjusted before surgery.
Common examples include:
Blood-thinning medications
Medicines such as warfarin, apixaban, rivaroxaban, dabigatran, clopidogrel, or aspirin may increase the risk of bleeding during surgery. Your surgeon and physician will advise whether these should be temporarily stopped and when they can be restarted afterwards.
Do not stop these medications unless instructed by your healthcare team.
Diabetes medications
Some diabetes medications may need adjustment during fasting before surgery. You will receive specific instructions based on the medication you take.
Herbal supplements and vitamins
Certain supplements, including fish oil, ginkgo, garlic, ginseng, vitamin E, and some traditional herbal medicines, may increase bleeding risk or interact with anaesthetic medications. Your healthcare team may advise stopping these approximately one to two weeks before surgery.
Always inform your doctor about all prescription medicines, over-the-counter medications, supplements, and herbal products that you take.
Allergies and previous reactions
If you’ve previously experienced a reaction to anaesthesia, antibiotics, latex, or other medications, let your healthcare team know before surgery. This helps the anaesthetist plan your care safely.
Practising Pelvic Floor Exercises Before Surgery
Many men are advised to begin pelvic floor muscle exercises before robotic prostatectomy.
These exercises strengthen the muscles that help control urination and may help you regain urinary control more quickly after surgery.
Learning the correct technique before your operation is often easier than trying to start after surgery.
If recommended, a continence physiotherapist may teach you how to perform these exercises correctly before your procedure.
Staying Physically Active
Maintaining your general fitness before surgery can support recovery afterwards.
Unless advised otherwise, continue regular activities such as:
- Walking
- Gentle cycling
- Light strength exercises
- Stretching
If you smoke, stopping smoking before surgery can reduce the risk of chest infections, improve wound healing, and support recovery after anaesthesia.
Eating and Drinking Before Surgery
Your hospital will provide instructions on when to stop eating and drinking before your operation. Unless instructed otherwise, continue taking fluids normally until your advised fasting time.
In general:
- Solid food usually needs to be stopped several hours before surgery.
- Clear fluids may be allowed until a few hours before your operation, depending on your anaesthetist’s instructions.
Following these fasting instructions carefully helps reduce the risk of complications during anaesthesia.
Preparing Your Home for Recovery
Planning ahead can make the first few weeks after surgery more comfortable.
Consider:
- Preparing easy-to-cook meals in advance
- Having loose-fitting clothing available
- Keeping frequently used items within easy reach
- Place frequently used items at waist height to minimise bending during the first few days after surgery.
- Arranging help with shopping or household chores if needed
- Organising transport home from hospital
Most patients are encouraged to walk regularly after surgery but should avoid heavy lifting during the early recovery period.
What Should You Bring to Hospital?
Your hospital may provide a checklist, but useful items often include:
- Identification documents
- Hospital admission paperwork
- Previous imaging or reports if requested
- Current medication list
- Comfortable loose-fitting clothes
- Slippers with non-slip soles
- Toiletries
- Mobile phone and charger
Leave valuables and unnecessary jewellery at home whenever possible.
Questions to Discuss With Your Surgeon
Many patients find it helpful to clarify any remaining questions before the day of surgery.
Examples include:
- How long is the operation expected to take?
- Will lymph nodes need to be removed?
- How long will I stay in hospital?
- How long will the urinary catheter remain in place?
- When can I return to work?
- When can I drive again?
- What should I expect during recovery?
Writing down your questions beforehand can help ensure they are addressed during your consultation.
The Day of Surgery
On the day of surgery, you will usually:
- Arrive at the hospital at your scheduled admission time.
- Meet members of the surgical and anaesthetic teams.
- Have your identity, planned procedure, and consent confirmed.
- Change into a hospital gown.
- Have an intravenous (IV) line inserted.
- Be taken to the operating theatre once everything is ready.
The operation is performed under general anaesthesia, so you will be asleep throughout the procedure.
Good Preparation Supports Recovery
Good preparation before robotic prostatectomy extends beyond the day of surgery. Understanding what to expect, following medication and fasting instructions, maintaining physical activity where appropriate, and learning pelvic floor exercises can all contribute to a smoother recovery.
Your healthcare team will provide personalised advice based on your medical history and planned procedure.
Frequently Asked Questions
Should I shave before robotic prostatectomy?
Unless specifically instructed by your hospital, avoid shaving the surgical area yourself. If necessary, hair removal will be performed safely in hospital to reduce the risk of skin irritation and infection.
Can I continue exercising before surgery?
In most cases, yes. Light to moderate exercise such as walking and gentle cycling is encouraged unless your doctor advises otherwise.
Will I need bowel preparation?
Routine bowel preparation is not required for most patients undergoing robotic prostatectomy. Your surgeon will advise if any special preparation is necessary.
When should I stop eating before surgery?
Your hospital will provide exact fasting instructions. It is important to follow these carefully to ensure safe anaesthesia.
Should I stop all my medications?
No. Some medications should be continued, while others may need temporary adjustment. Always follow the instructions provided by your surgeon, anaesthetist, or physician.
Can I drive myself home after surgery?
No. You will need someone to take you home when you are discharged from hospital.
Do I need to stop smoking before robotic prostatectomy?
Stopping smoking before surgery is strongly recommended. Smoking increases the risk of chest infections, slows wound healing, and may increase the risk of complications after anaesthesia. Even stopping a few weeks before surgery can be beneficial.
Can I drink alcohol before my operation?
Moderate alcohol intake should generally be reduced in the days leading up to surgery. Excessive alcohol consumption may affect anaesthesia, wound healing, and recovery. If you drink heavily, let your healthcare team know so they can advise you appropriately.
Why are pelvic floor exercises recommended before surgery?
Learning pelvic floor exercises before surgery allows you to become familiar with the correct technique while you are still continent. This may make it easier to restart the exercises after surgery as part of your recovery
What happens if I develop a fever or become unwell before surgery?
If you develop a fever, cough, urinary tract infection, COVID-19, influenza, or any other significant illness before your scheduled operation, contact your surgeon or hospital as soon as possible. In some cases, surgery may need to be postponed until it is safe to proceed.
Preparing for Robotic Prostatectomy?
Every patient’s diagnosis and treatment plan is different. If you have been advised to undergo robotic prostatectomy, discussing your individual situation with your urologist can help you understand the benefits, potential risks, expected recovery, and the preparation required before surgery.