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Cancer Control. Continence. Potence.
Dr. Koushik Shaw has helped diagnose and successfully treat men with prostate cancer from the Austin, Texas area and beyond using the Shaw Advanced Robotic Prostatectomy (SHARP) Technique. Dr. Shaw’s advanced technique helps to beat prostate cancer, while preserving erectile function and urinary continence.
The SHARP Technique robotic prostatectomy has reduced surgical times to two hours in most cases and a vast majority of patients are in the hospital for 24 hours or fewer. Studies show that reduced operative time and shorter hospital stays can lead to lower complications and faster recovery.
The SHARP Technique allows Dr. Shaw to perform the surgery in a manner that optimizes prostate cancer control, nerve-sparing for preservation of potency, and maximizing urethral length and pelvic floor preservation to optimize urinary control. We call this the “Trifecta of Success.” Cancer Control. Continence. Potence.
We will start with a phone or video consultation to review your case. This includes review of your PSA, your prostate biopsy results, family and medical, surgical history, and your continence and potency expectations.
If you are found to be a good surgical candidate, we will reserve you a surgical date, typically performed on Tuesdays. We will have you fly or drive into Austin on a Friday before your surgery for an in-person visit, as well as coordinating MRI imaging studies if needed, which will assist us with intraoperative mapping of the prostate to optimize nerve sparing for preservation of continence, potency, and optimizing a cancer-free outcome.
We will also coordinate pelvic-floor biofeedback therapy, to help identify and strengthen your pelvic floor musculature prior to surgery. Practicing these Kegels exercises preoperatively and postoperatively will help maximize postoperative urinary continence. We are proud to have over 95% continence within a few weeks of surgery with our patients.
If flying into Austin, we are happy to coordinate car-service from the airport to one of several nearby hotels within three miles of the Austin Urology Institute, with whom we have negotiated affordable rates.
We typically remove the foley catheter that is placed intra-operatively 7-10 days after surgery. It is at that time that we review the pathology report, and do a postoperative check. Most individuals can fly home or drive home two weeks postoperatively. The first PSA check should be done with us, or at the patient’s home town six weeks postoperatively. Using our telemedicine capabilities, we can also perform postoperative checks and follow ups remotely.
We often recommend use of daily 5mg Cialis postoperatively to help with accelerated recovery of the nerves for regaining erectile function.
Dr. Koushik Shaw has practiced for more than a decade, performing hundreds of robotic cases including robotic prostatectomy, robotic cystectomy (bladder removal) as well as advanced robotic cases involving kidney cancer (robotic partial nephrectomy) and robotic da Vinci pyeloplasty (reconstruction of the kidney to optimize drainage).
Dr. Shaw is proud to be part of the St. David’s North Austin Medical Center and the Texas Institute for Robotics Surgery, one of the largest centers for daVinci Robotic Surgery in the world and winner of the prestigious Malcolm Baldridge Award for operational excellence. That, along with our 5-star rated, world-class Austin Urology Institute facilities, recognized for friendly, patient-centered care, is the reason that patients find us to be the doctor and facility of choice for treatment of their prostate cancer.
While robotic prostatectomy is performed routinely, it is still a relatively major surgery that will take some time and effort to recover from, so stay positive, you can get through this.
All patients will be discharged from the hospital with a urinary catheter in place. This catheter is known as a Foley catheter and is held in place by a balloon inside the bladder. It allows continuous drainage of the bladder into a small external collection bag which is emptied as needed. Do not try to remove this catheter on your own. It must stay in place until you heal enough that it is no longer needed.
Since you will not be cleared to drive yourself, you will need someone to drive you home.
Immediately after surgery, your abdomen will be slightly bloated so you may have trouble fitting into your regular clothes. For comfort, wear loose fitting clothing such as sweatpants or other pants with elastic (not button) waistbands. You will probably need to do so initially anyway to accommodate the catheter and collection bag.
You may now start showering the day of your discharge. The catheter collection bag may be removed during showering. Gently pull the colored catheter straight off of the clear plastic tubing from the bag and allow urine to run into the shower. After showering, gently pad the suture sites (do not rub or otherwise irritate them) with a towel.
The sutures were utilized which will dissolve on their own, there is no need to have them removed. Skin glue is often used, and should gradually flake off like a sunburn. A small amount of redness at the edges of the incision sites, as well as a small amount of clear or bloody leakage from the wound, is acceptable. Drainage of sufficient quantity to soak dressings, or redness greater than 1/2 inch from the incision should be reported to the physician.
Abdominal Distention, Constipation or Bloating: Make sure you are taking your stool softener as directed, and drinking prune juice or milk of magnesia. If you still haven’t had a bowel movement 48 hours after surgery, you may take an over-the-counter suppository such as Dulcolax.
Bladder Spasms: Bladder spasms are typically associated with a sudden onset of lower-abdominal discomfort, a strong urge to urinate, or with sudden leakage of urine from around the catheter. If they are a big problem, contact the office, as we can prescribe a medication for you.
Bloody drainage around the Foley catheter or in the urine: Under stress, such as during physical activity or bowel movement, this is not uncommon immediately after surgery. This should improve if you cease activity and rest for a short while. If it does not, or if you see clots in your urine, or have no urine output for two hours, contact your physician.
Bruising around the port sites: This is not uncommon, and should not worry you. They will go away as you heal.
Lower legs/ankle swelling: This is not abnormal and is not cause for serious concern. The swelling should go away in a week or two. Elevating your legs while sitting will help.
Perineal Discomfort (pain between your rectum and scrotum): This may last for several weeks after surgery, but it should resolve on its own. If you are suffering significant pain despite pain medication, contact your physician. You might also try elevating your feet on a small stool when you have a bowel movement, applying hemorrhoid ointment, and increasing the fiber and water intake in your diet.
Scrotal/Penile Swelling and Bruising: This is not abnormal and is not cause for serious concern. You might notice scrotal/penile swelling anywhere from immediately after surgery to 5 days later. It should go away on its own in a week or two. You might try elevating your scrotum on a small rolled up towel when you are sitting or lying down to reduce swelling. Also, wearing supportive underwear (briefs, not boxer shorts) is advisable.