By Mr Neil Haldar, Consultant Urological Surgeon — Buckinghamshire, Berkshire, Oxfordshire and the Thames Valley
Key facts at a glance
Recovery after robotic radical prostatectomy is usually measured in weeks for physical recovery and months for continence and erectile function recovery.
Typical milestones are:
- Hospital stay: usually 24–48 hours.
- Catheter: usually 7–10 days.
- Desk-based work: often 2–3 weeks.
- Manual work: usually 4–6 weeks, depending on the job.
- Driving: usually around 2–3 weeks, once safe and insured.
- Light exercise: gradually from the first few weeks.
- Heavy lifting/contact sport: usually avoided until at least 6 weeks.
- Continence recovery: usually gradual over weeks to months.
- Erectile function recovery: can continue for 12–24 months, especially after nerve-sparing surgery.
- First PSA check: usually no earlier than 6 weeks after surgery.
The two most useful things you can do to support recovery are to engage with specialist pelvic floor physiotherapy and to follow a structured, clinician-led plan for sexual rehabilitation where appropriate.
Robotic radical prostatectomy is keyhole surgery to remove the prostate and seminal vesicles, usually with the aim of curing localised prostate cancer. It is commonly performed using the da Vinci robotic system.
One of the questions men most often ask before surgery is:
“What will recovery actually be like?”
The honest answer is that recovery happens in stages. Many men are walking the day after surgery and back to desk-based work within a few weeks. However, urinary control, sexual function, confidence and energy levels recover more gradually.
This guide explains what to expect after robotic prostate surgery, week by week, including the catheter, pain, walking, driving, work, continence, erections, PSA follow-up and when to seek help.
I see men for robotic prostatectomy and prostate cancer consultations across Buckinghamshire, Berkshire, Oxfordshire, West Hertfordshire and the Thames Valley, including Great Missenden, High Wycombe, Windsor, Beaconsfield, Gerrards Cross, Slough, Maidenhead, Amersham and Aylesbury.
Days 0–2: in hospital after robotic prostate surgery
When you wake up after a robotic prostatectomy, you will usually have:
- a urinary catheter draining the bladder;
- several small keyhole wounds across the lower abdomen;
- dissolvable stitches, glue, dressings or clips depending on the closure used;
- sometimes a small surgical drain, which is usually removed before you go home.
The catheter is there to protect the join between the bladder and urethra while it heals. This join is called the anastomosis.
Most men are encouraged to sit out of bed and start walking soon after surgery. Early movement helps reduce the risk of blood clots, supports breathing and helps the bowel begin working again.
Pain is usually manageable. Many men describe discomfort, bloating or tightness rather than severe pain. Bloating is common because gas is used to create working space during keyhole surgery. Shoulder-tip discomfort can also occur and usually settles.
What I usually recommend in the hospital
During the first 24–48 hours, the priorities are:
- walking short distances regularly;
- drinking enough fluid, unless advised otherwise;
- eating lightly at first;
- avoiding constipation and straining;
- learning how to manage the catheter;
- understanding wound care and discharge instructions.
Before discharge, you should know how to empty the catheter bag, when to change from a day bag to a night bag, who to contact if the catheter stops draining, and when your catheter removal appointment is planned.
Week 1: early recovery at home
Most men go home with the catheter still in place. This is normal.
The first week is about gentle movement, rest, catheter care, wound healing and avoiding strain. You should not expect to feel completely normal. Tiredness is common and can be surprisingly noticeable.
What is normal in week 1?
Common experiences include:
- mild abdominal discomfort;
- bruising around the wounds;
- bloating or wind pain;
- blood-stained urine, especially after walking;
- small amounts of leakage around the catheter;
- bladder spasms or a strong urge to pass urine despite the catheter;
- tiredness and disrupted sleep.
These symptoms usually improve gradually.
What to do in week 1
During the first week:
- walk several times daily, increasing gently;
- avoid heavy lifting;
- avoid straining on the toilet;
- keep stools soft with fluid, fibre and prescribed medication if needed;
- shower as advised, but avoid baths and swimming until wounds are healed;
- avoid driving;
- rest when tired.
Do not start strenuous pelvic floor exercises while the catheter is still in place unless your specialist physiotherapist or surgical team has specifically advised this. Many men learn the technique before surgery and then restart properly after catheter removal.
Catheter removal: usually 7–10 days
The catheter is commonly removed around 7–10 days after robotic prostatectomy, although the exact timing depends on the operation, healing and your surgeon’s pathway.
Catheter removal is usually quick. Some men pass urine well immediately. Others notice urgency, frequency or leakage at first.
Leakage after catheter removal
Urinary leakage immediately after catheter removal is common. It can be significant for the first few days and does not mean you will be permanently incontinent.
Before surgery, the prostate contributes to urinary control. Once it has been removed, the external sphincter and pelvic floor muscles need time to take over more of the work.
This is why pelvic floor rehabilitation is so important.
Weeks 2–3: regaining confidence
By weeks 2–3, many men are walking more comfortably, sleeping better and beginning to feel more independent.
This is often when men ask about driving, work and normal daily activities.
Driving
Many men return to driving around 2–3 weeks after surgery, but only when:
- they can sit comfortably;
- they are no longer taking strong painkillers;
- they can perform an emergency stop safely;
- they feel mentally alert;
- their insurer confirms they are covered.
Do not drive just because a fixed number of days has passed. You must be safe, comfortable and insured.
Returning to work
For desk-based work, many men return at around 2–3 weeks. Some return earlier if they work from home and can rest, while others need longer.
For manual work, operating, lifting, prolonged standing, travel-heavy roles or physically demanding jobs, 4–6 weeks is more realistic.
If your job involves long commutes, heavy lifting or high-pressure clinical or professional duties, it is sensible to plan a phased return.
Weeks 3–6: building activity
Between weeks 3 and 6, the focus shifts from simple recovery to rebuilding strength and routine.
You can usually continue to increase your walking distance and daily activities. Light household tasks are usually possible. Many men feel much more like themselves by this stage, but heavy lifting and intense exercise should still be avoided until cleared.
Exercise
A typical approach is:
- walking from the first few days;
- gentle stretching as comfort allows;
- light gym or stationary bike only once wounds are healed, and you feel ready;
- avoid abdominal strain, heavy weights, and contact sports until at least 6 weeks;
- build gradually rather than testing yourself.
The operation is keyhole, but the internal healing is more substantial than the external wounds suggest.
Continence recovery after robotic prostatectomy
Urinary leakage is one of the main worries after prostate removal.
The important point is that recovery of continence is usually gradual. Some men regain control quickly. Others improve over several months. A smaller group have longer-lasting leakage that may require specialist help.
What affects continence recovery?
Recovery depends on:
- age;
- baseline urinary function;
- prostate size;
- anatomy;
- cancer position;
- surgical findings;
- previous prostate surgery;
- weight and general fitness;
- pelvic floor strength;
- adherence to pelvic floor rehabilitation.
Pelvic floor physiotherapy
Specialist pelvic floor physiotherapy can help men regain control faster. Ideally, men should learn the correct technique before surgery and restart after catheter removal.
A good programme usually includes:
- identifying the correct muscles;
- avoiding breath-holding and abdominal bracing;
- practising short and long contractions;
- using different positions such as lying, sitting and standing;
- gradually building endurance;
- applying the pelvic floor before coughing, standing or lifting.
A leaflet is helpful, but many men benefit more from supervised physiotherapy because incorrect technique is common.
If leakage persists beyond the expected recovery period, further assessment is warranted. Options such as pads, sheaths, clamps in selected circumstances, physiotherapy, medication for urgency, male sling or artificial urinary sphincter may be discussed depending on the pattern and severity.
Erectile function recovery after prostatectomy
Erectile dysfunction is common after prostate cancer surgery, even when nerve-sparing surgery is performed.
This can be one of the most difficult parts of recovery emotionally. Men may feel shocked by how sudden the change is, especially if they had good erections before surgery.
Why do erections take time to recover
The nerves responsible for erections run very close to the prostate. If the cancer position allows, nerve-sparing surgery may be performed. Even then, the nerves can enter a temporary state of shock called neuropraxia.
Nerve recovery is slow. It is measured in months rather than weeks.
Typical erectile recovery timeline
A realistic pattern is:
- first few weeks: erections usually absent or very weak;
- around 3 months: some early signs of recovery may begin in selected men;
- 6–12 months: more meaningful recovery may occur;
- 12–24 months: further recovery can continue, particularly after nerve-sparing surgery.
Recovery depends heavily on age, erections before surgery, diabetes, vascular health, smoking, medication, whether nerve-sparing was possible and whether rehabilitation is used.
Penile rehabilitation
Penile rehabilitation aims to maintain oxygenation and blood flow to the erectile tissue while nerve recovery takes place.
A programme may include:
- a PDE5 inhibitor such as sildenafil or tadalafil, if suitable;
- a vacuum erection device;
- penile injections in selected men;
- psychosexual support where confidence, anxiety or relationship strain are important.
The exact plan should be personalised. These treatments are not suitable for every man, and the choice of medication depends on other conditions and medications.
It is important to be realistic: rehabilitation may help with assisted erections and sexual confidence, but it cannot guarantee full natural recovery. The earlier conversation is often as important as the treatment itself, because it sets expectations and avoids months of uncertainty.
Bowel function and diet
Constipation is common after surgery because of anaesthetic, painkillers, reduced mobility and changes in routine.
Straining should be avoided, particularly in the early weeks.
Helpful measures include:
- drinking enough fluid;
- eating fibre-rich foods such as vegetables, fruit and wholegrains;
- using prescribed stool softeners if needed;
- walking daily;
- reducing constipating painkillers when safe.
Caffeine, alcohol, fizzy drinks and spicy foods can worsen urgency or bladder irritation in some men during early recovery. This does not mean they are forbidden permanently, but moderation is sensible at first.
Fatigue and emotional recovery
Fatigue after robotic prostatectomy is common. It may last several weeks.
Many men focus on the physical operation but underestimate the emotional recovery. A cancer diagnosis, major surgery, catheter care, leakage and sexual changes can all affect mood, confidence and relationships.
It is normal to have good days and bad days.
Support can come from:
- your specialist nurse;
- your surgeon’s team;
- your GP;
- pelvic floor physiotherapy;
- psychosexual counselling;
- Prostate Cancer UK;
- Macmillan Cancer Support;
- your partner, family or trusted friends.
Asking for help is not a sign of weakness. It is part of recovering well.
PSA follow-up after robotic prostatectomy
After the prostate has been removed, PSA should fall to a very low or undetectable level.
The first PSA is usually checked no earlier than 6 weeks after surgery. It is then monitored regularly, often at 3, 6, and 12 months, and at least annually, depending on your cancer risk and local follow-up pathway.
The exact PSA result should be interpreted in context. Different laboratories may use different assays, and very low “ultrasensitive” PSA readings can cause anxiety if not explained properly.
A confirmed rise in PSA after surgery may require further assessment, but a single result should usually be interpreted alongside the trend, pathology findings, and timing after surgery.
When to contact your surgical team urgently
Most recovery is uncomplicated, but some symptoms should not be ignored.
Contact your surgical team, GP, NHS 111 or emergency services, depending on severity, if you develop:
- temperature above 38°C or rigors;
- worsening abdominal or pelvic pain;
- heavy bleeding;
- wound redness, swelling, discharge or opening;
- catheter not draining;
- inability to pass urine after catheter removal;
- new calf pain or swelling;
- breathlessness or chest pain;
- severe vomiting or inability to keep fluids down;
- feeling suddenly or seriously unwell.
Chest pain, severe breathlessness, or symptoms suggestive of a blood clot should be treated as an emergency.
Recovery timeline at a glance
| Recovery phase | Typical timeframe | What to expect |
|---|---|---|
| Hospital stay | 1–2 days | Walking early; catheter in place |
| Catheter removal | 7–10 days | Leakage common at first |
| Desk-based work | 2–3 weeks | Earlier for some, longer for others |
| Driving | Around 2–3 weeks | Only if comfortable, safe and insured |
| Manual work | 4–6 weeks | Depends on lifting and physical demand |
| Light exercise | 3–6 weeks | Build gradually |
| Heavy lifting/contact sport | Usually after 6 weeks | Only when cleared and comfortable |
| Continence recovery | Weeks to months | Gradual improvement; physiotherapy helps |
| Erectile recovery | 3–24 months | Depends on age, baseline function and nerve-sparing |
| PSA monitoring | From 6 weeks onward | Regular follow-up according to risk |
How to optimise your recovery
The men who recover best tend to be those who take recovery seriously without rushing it.
1. Start pelvic floor preparation early
Learning pelvic floor exercises before surgery makes it easier to restart after catheter removal.
2. Walk every day
Walking is the safest early exercise. It helps circulation, bowel function, energy and confidence.
3. Avoid constipation
Constipation and straining are common but avoidable problems after surgery.
4. Follow a sexual rehabilitation plan
If erections matter to you, discuss this before surgery or soon after catheter removal. Do not wait months before asking for help.
5. Build gradually
Feeling well does not mean internal healing is complete. Increase activity steadily.
6. Keep perspective
Recovery is not linear. A difficult week does not mean the final outcome will be poor.
Private robotic prostatectomy recovery advice across the Thames Valley
I see men before and after robotic prostate cancer surgery from across Buckinghamshire, Berkshire, Oxfordshire, West Hertfordshire and the Thames Valley.
My clinic locations include:
- The Chiltern Hospital, Great Missenden — convenient for Amersham, Aylesbury, Chesham, Wendover, Beaconsfield and the Chilterns.
- The Shelburne Hospital, High Wycombe — convenient for High Wycombe, Marlow, Beaconsfield, Maidenhead, Gerrards Cross and South Buckinghamshire.
- The Princess Margaret Hospital, Windsor — convenient for Windsor, Slough, Maidenhead, Ascot, Berkshire and West London.
Patients also commonly travel from Stoke Poges, Denham, Henley, Thame, Watlington, Hemel Hempstead, Berkhamsted, Rickmansworth, and the surrounding M40, M4, and M25 areas.
If you are still deciding on treatment, you may also wish to read my guide to prostate cancer second opinions or my page on robotic radical prostatectomy.
Book a consultation
If you have been diagnosed with prostate cancer and would like to discuss whether robotic prostatectomy is right for you — or if you are already approaching surgery and would like to plan your recovery — my secretary can arrange a consultation. NHS referrals to my service at Buckinghamshire Healthcare NHS Trust can be made through your GP.
Contact: Emma Stacey, 07841 048975
Frequently asked questions
How long does it take to recover from robotic prostate surgery?
Most men are discharged 24 to 48 hours after robotic prostatectomy and return to desk-based work within 2 to 3 weeks. Manual work and full physical activity are usually possible by 6 weeks. Functional recovery is longer: continence typically improves over 6 to 12 months, while erectile function recovery can continue for 12 to 24 months. The catheter is removed at 7 to 10 days post-operatively.
How long does the catheter stay in after a robotic prostatectomy?
The urinary catheter typically stays in place for 7 to 10 days after robotic prostatectomy. It is removed at the first follow-up appointment, either by the surgical team or by a community continence nurse. Some urinary leakage immediately after catheter removal is normal and does not indicate permanent incontinence; it reflects the time the continence muscles need to take on the work the prostate previously shared.
When can I drive after a robotic prostatectomy?
Most men can resume driving 2 to 3 weeks after robotic prostate surgery, provided they are comfortable, no longer taking strong analgesia, and able to perform an emergency stop. You should always confirm cover with your motor insurer before driving after surgery, as some policies have specific requirements following major operations.
When can I return to work after robotic prostate surgery?
Most men return to desk-based work 2 to 3 weeks after robotic prostatectomy. Manual or physically demanding work usually requires 4 to 6 weeks of recovery. Light gym work is generally possible from around 4 weeks once wounds are fully healed, while heavy lifting and contact sport should be deferred until at least 6 weeks.
When does urinary continence return after robotic prostatectomy?
Continence recovery is gradual rather than sudden. Most men progress from using two or three pads daily in the first week after catheter removal to one or no pads by week 6. By 12 months, around four out of five men are pad-free or using only a small security pad. Continence continues to improve slowly out to 2 to 3 years for some men. Supervised pelvic floor physiotherapy significantly accelerates recovery.
When does erectile function return after robotic prostatectomy?
Erectile function recovery is slower than continence recovery and depends on age, baseline function, and whether nerve-sparing surgery was possible. Partial recovery typically begins around 3 months, substantial recovery between 6 and 12 months, and full recovery (where it occurs) may take up to 2 years. Between 30% and 70% of men with good erectile function before surgery recover erections adequate for intercourse by 12 months, often with the help of medication.
What pelvic floor exercises should I do after prostatectomy?
Aim for three daily pelvic floor sessions performed lying, sitting, and standing, with 15 repetitions of contractions held for 2 to 10 seconds and equal rest. Progress the hold by 1 second per week up to a maximum of 10 to 20 seconds. Continue for at least 6 months after surgery. The single most important factor is supervision by a specialist pelvic floor physiotherapist — unsupervised exercises are far less effective than supervised training.
What is penile rehabilitation after prostatectomy?
Penile rehabilitation is a structured programme to maintain blood flow to erectile tissue while the nerves recover after surgery. It typically combines a regular low-dose PDE5 inhibitor (such as tadalafil or sildenafil), a daily vacuum erection device, and sometimes intracavernosal injections. The evidence supports starting as soon as the catheter is removed. Combination therapy can achieve up to 80% assisted erectile function recovery at two years in men with good baseline function.
What PSA level is normal after robotic prostatectomy?
PSA should drop to below 0.1 ng/mL after radical prostatectomy. PSA is monitored at 6 weeks, then at 3, 6, and 12 months, and annually thereafter for at least 5 years. A confirmed rise above 0.2 ng/mL is generally considered biochemical recurrence and warrants further investigation. PSA should not be checked earlier than 6 weeks after surgery, as residual prostatic tissue activity can give a misleadingly elevated reading.
When should I contact my surgeon during recovery?
Contact your surgeon’s team, your GP, or your nearest A&E promptly if you experience: a temperature above 38 °C; worsening abdominal or pelvic pain; heavy bleeding or wound discharge; inability to pass urine after catheter removal; a catheter that stops draining; or calf pain, swelling, breathlessness, or chest pain (possible signs of a blood clot). Most recovery is uncomplicated and follows a predictable trajectory.
About the author
Mr Neil Haldar is a Consultant Urological Surgeon specialising in robotic prostatectomy, uro-oncology and paediatric urology.
He has over 25 years’ experience and treats patients across the UK and internationally for complex urological conditions, minimally invasive surgery and expert second opinions.
This article is intended for general information only and does not replace individual medical advice. Every patient’s recovery is different and depends on cancer characteristics, baseline function, surgical findings, and other clinical factors. Treatment decisions and post-operative care should always be discussed with your specialist team.
Further Information
BAUS robotic-assisted radical prostatectomy leaflet
Prostate Cancer UK support after treatment
Macmillan prostate cancer surgery recovery information
Mr Neil Haldar is a UK Consultant Urological Surgeon specialising in prostate cancer, robotic surgery, uro-oncology and paediatric urology. He offers expert diagnosis, treatment and second opinions for complex urological conditions.