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Any experience with Robotic assisted simple prostatectomy (RASP)?

Posted by lizziew @lizziew, Nov 20, 2025

Hi everyone,

Has anyone had experience with having RASP? Robotic assisted simple prostatectomy?
Outpatient surgery? Incontinence issues afterward? Recovery ease?
Hubby is scheduled for surgery January 12th. Just curious to hear how other’s did with the simple prostatectomy?
Also, was tissue from the procedure sent to pathology? If so, did your Gleeson score change?

Thank you.

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lizziew | @lizziew | Mar 13 4:15pm
In reply to @heavyphil "@lizziew So he basically had a TURP on steroids - which is taking out all the..." + (show)
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@lizziew So he basically had a TURP on steroids - which is taking out all the innards but leaving the capsule. Were there external incisions or all done thru urethra?
His Gleason 3+3 is the lowest score you can get - some would argue even borderline cancer - and the small percentage they found is extremely GOOD as far as any future treatment is concerned.
I don’t know why radiation is even being brought up at this point but maybe just to temper any expectations…take the WIN and go home!
Phil

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@heavyphil

Hi there! Thank you for your response.
RASP is similar to TURP, as it is a de-bulking procedure. However, unlike TURP, the point of entry is five incisions in the abdomen.
Hubby’s prostate was huge! 160cc. The RASP is primarily used on very large prostates with BPH.
Hubby has cancer, so that is why he will need radiation to address the possibility of cancer cells in the capsule.

I messaged hubby’s urologist regarding the pathology report. Stating that we were happy to see a downgrade in the Gleason score. She said his cancer is not downgraded, and that the tissue removed isn’t completely reliable. So here we are…

Thanks, Phil.

Thank you, Phil.

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heavyphil | @heavyphil | Mar 14 7:06am
In reply to @lizziew "@heavyphil Hi there! Thank you for your response. RASP is similar to TURP, as it is..." + (show)
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@heavyphil

Hi there! Thank you for your response.
RASP is similar to TURP, as it is a de-bulking procedure. However, unlike TURP, the point of entry is five incisions in the abdomen.
Hubby’s prostate was huge! 160cc. The RASP is primarily used on very large prostates with BPH.
Hubby has cancer, so that is why he will need radiation to address the possibility of cancer cells in the capsule.

I messaged hubby’s urologist regarding the pathology report. Stating that we were happy to see a downgrade in the Gleason score. She said his cancer is not downgraded, and that the tissue removed isn’t completely reliable. So here we are…

Thanks, Phil.

Thank you, Phil.

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@lizziew Thank you for the clarification, but has your surgeon told you what the point of doing a RASP as opposed to a RARP??
It sounds like an incomplete RARP! Why leave the capsule in, if there’s cancer in or near it and then need radiation?
Traditionally, surgeons try to remove as much cancer as possible and then only use radiation if necessary.
I am speaking as a layman here so I am sure the surgeon did this for a good reason; any ideas on that?
Thanks again,
Phil

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lizziew | @lizziew | Mar 14 8:42am

Good morning, Phil,

Hubby’s urologist said he wasn’t an optimal candidate for RALP given his age(73), very large size of his prostate, and the large amount of his urethra which would be removed along with the prostate. These factors increase his risk for permanent incontinence, or a delayed recovery to continence. Not to mention, nerve sparing might be impossible. His urologist said with higher risk patients, tri-modal therapy may be required anyway. Even those who choose radical prostatectomy may need XRT ADT as well.
So, the RASP removes the core, leaves the capsule, spares the nerves, and the ureter. Hubby and I discussed all the options, and felt RASP was the best choice for us. Not thrilled about radiation, but if he had had RALP or RARP, he might very well have radiation anyway.
Hubby has his follow up appointment and first PSA testing in June.
I will be sure and let all you wonderful men of the forum, know what transpired.

Have a good weekend, Phil.

Lizzie

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