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For years now, robotic prostate cancer surgery has been reducing side effects and speeding up recovery time for more men undergoing the procedure.

Now, a new technique, in combination with robotic surgery, seems to be further easing post-surgical discomfort. It eliminates the use of a penile urinary catheter – a tube connected to the bladder used for the passage of urine and seminal fluid post-surgery during recovery.

While it is a fear most men in need of surgery get over, sometimes concerns about a catheter can impact treatment decisions.

"There was a patient, who in his earlier life, for some reason needed a catheter when he was young. And according to him, the two days of catheter was the worst time he had experienced," said Dr. Ashutush Tewari. "And he was literally not going to have surgery just because he was afraid of the catheter."
Doctors report patients with penile catheters experience pain and discomfort up to nine-times greater than those without.

A new technique developed at New York Presbyterian/Weill Cornell Medical Center, which surgeons call "catheter-less", re-directs urine from the bladder using a small tube that comes out of the stomach.

When given a choice, Peter McGovern, 65, chose the catheter-less option.

"I thought, 'Oh, this is good, because the only thing that concerned me was walking around with discomfort on me,'" said McGovern. "And by doing what the doctor said, I was very comfortable and felt no discomfort at all. And, even immediately after the surgery, I was able to do normal activities."

The speedy recovery time was a relief to his wife, as well.

"Dr. Tewari came to find me in the waiting room. He came in, and was smiling," said Peter's wife, Carolyn McGovern. "And he said, with this surgery there was not one nerve damaged. We had heard from people about long recovery. There was no long recovery. He was walking in and out, and couldn't wait to get back to work."

While this procedure is yet another advance, Dr. Tewari warns that it may not be for everyone.

"Large prostates, obese patients, patients with some major bleeding going on in that area, are not candidates for the catheter-less procedure," he said.

But for those who are candidates, Tewari says in the future, the new approach may also be used for non-robotic prostate removal, as well..