Prostate cancer patients could soon escape debilitating incontinence thanks to a pioneering robotic operation.
The procedure would change the lives of four in five men who experience leaks after having their prostate removed. Patients often have to wear sanitary pads after the existing invasive operation, making many afraid to leave the house.
But according to a new study, robotic surgery can dramatically reduce the risk of severe incontinence. It is designed to prevent long-term damage to the urethra, the urine tube that runs through the prostate.
Research shows that urethral injuries are one of the leading causes of incontinence.
So far, only patients at University College London Hospital (UCLH) have been able to access the procedure, called robotic-assisted radical 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 reduce the risk of erectile dysfunction, a common side effect of prostate removal.
“The results are remarkable,” says Professor Greg Shaw, a cancer specialist at UCLH. ‘Men return after the procedure without needing pads, which is unheard of. “The surgery even seems to help 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 that lies below the bladder and produces semen. The disease kills about 12,000 people each year.
A cancer patient undergoing robotic-assisted surgery. Robot operation could reduce risk of severe incontinence in prostate cancer patients
Actor Stephen Fry revealed he had been forced to rely on sanitary pads for incontinence after prostate cancer surgery.
Most affect men over 65 years of age and tend to be slow. Many patients will never need treatment because the disease does not threaten their health. However, some will need chemotherapy, radiotherapy or tablets to stop its spread.
Around 8,000 people are removed each year in the UK as a result of cancer, in a procedure known as radical prostatectomy.
Typically, this involves cutting the prostate and urethra in half. Once the prostate has been 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, when patients cannot control bladder movements.
In 2019, actor and comedian Stephen Fry, 67, revealed that he had been forced to rely on pads for incontinence after undergoing surgery for prostate cancer the previous year.
The new robot-guided technique consists of making the cut along the urethra. This means that the urethra is dissected but the length does not change. Once the prostate is removed, the tube is sewn back together.
Results from the pilot study involving almost 100 patients found that six weeks after the operation, 60 percent of patients had no problems urinating, meaning the risk of incontinence is halved.
Experts say the procedure can be easily adopted across the NHS. “This will be easy to implement as it does not require surgeons to learn a new technique from scratch or hospitals needing new equipment,” Professor Shaw says.
“I have already taught this to five other surgeons and we can expect more patients to benefit from this soon.”
Results from the pilot study involving almost 100 patients found that six weeks after the operation, 60 percent of patients had no problems urinating (file photo)
One patient who has already benefited from this pioneering surgery is Udall Evans, 47, a father of two from London.
Udall, who works in the film industry, was diagnosed last year after a blood test carried out as part of a routine medical check-up suggested signs of cancer. Hospital scans revealed he would need urgent surgery to remove his prostate due to the size of the tumour.
“I was quite worried about the side effects,” Udall says. “I had been told it could last months, but I really had no choice.”
Instead of undergoing the standard operation, he was offered the new procedure at UCLH in June.
The robot operation was successful and Udall was home the next day. “Anyway, the team prepared sanitary pads for me, but I didn’t really have any leaks,” he says.
‘I was able to lead a normal life. “It has been a great relief.”