Robotic surgery: preserving erectile function and urinary control

Robotic surgery for prostate cancer is increasingly preserving erectile function and urinary control compared to conventional procedures, according to one of South Africa’s top urologists.

Dr Lance Coetzee, from The Urology Hospital, Pretoria – the first hospital in the country to acquire a robotic surgical system in 2013 – says robotic prostatectomies (removal of a cancerous prostate gland) has improved a host of side effects related to prostate cancer surgery.

Just over 4% of all South African men will develop prostate cancer in their lifetime and more than   4 300 are newly diagnosed each year. On average, five South African men die from prostate cancer every day. Side effects from the surgical removal of a cancerous prostate include possible erectile dysfunction and incontinence.

Coetzee has undertaken just over 550 of 1 200 robotic procedures at The Urology Hospital. His data shows that the preservation of erectile function in patients with good potency before the operation is over 80%, while incontinence is being preserved in over 95% of cases. This is in line with research showing improved erectile function and urinary continence compared to open surgery.

In addition to prostatectomies, robotic surgery is being used in SA for partial nephrectomies, (removal of cancerous parts of the kidney), cystectomies (removal of the bladder) and colorectal surgery. It may in future be applied to gynaecological and female incontinence procedures, he added.

The Urology Hospital is the only specialised hospital of its kind in SA, comprising 23 urologists, 10 of whom are trained in robotic surgery – the highest concentration of robotic surgeons under one roof in the country.

“Robotic assisted surgery is fast becoming the global norm in many procedures due to its significantly improved patient outcomes. We expect it to continue growing in South Africa and we’re proud to have pioneered it in this country,” said the hospital.


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