Robotic Prostatectomy London | Harley Street Prostate Cancer Surgeon — dsri.co.uk

Robotic Prostatectomy · Central London · Marylebone W1

Robotic-Assisted Radical Prostatectomy in London

Nerve-sparing prostate cancer surgery performed at HCA Princess Grace Hospital, Marylebone — steps from Harley Street, in the heart of Central London.

Mr Sri holds his Central London prostatectomy practice at Princess Grace Hospital, W1. Same-week consultation appointments are routinely available. Surgery is scheduled at your convenience with no waiting list.

Book a Consultation Prostate cancer overview →

1 dayMedian hospital
stay

>80%Continent
(all patients)

>90%Continent
(nerve-sparing)

6 wksDry at night &
safety pad by day

2–4 wksReturn to normal
activity

Robotic Prostatectomy · Central London

World-class prostate cancer surgery at Harley Street's doorstep

HCA Princess Grace Hospital sits at 18 Devonshire Street, Marylebone — one minute from Harley Street and directly accessible from across Central, North, and East London. For patients in the City, Islington, Camden, Hackney, the West End, or visiting from abroad, it eliminates the need to travel south of the river while offering the same robotic surgical programme available at Mr Sri's other private hospitals.

Princess Grace is HCA Healthcare's flagship London facility, operating a dedicated robotic theatre with the da Vinci system. It is widely used by consultants from London's major teaching hospitals for their private practice and has an established international patient pathway — concierge service, interpreter support, and close proximity to major hotels and transport hubs.

Consultations, pre-operative assessments, catheter removal, and post-operative follow-up appointments can all be held at this location, minimising disruption to working life in the city.

Second opinion · Harley Street area

Patients who have received a prostate cancer diagnosis elsewhere and wish to seek a surgical opinion before committing to radiotherapy or active surveillance are seen at Princess Grace. No GP referral is required. Mr Sri's practice includes a significant second opinion workload from patients across Central and North London and internationally. Second opinion information →

Surgical venue · Central London

HCA Princess Grace Hospital

Address

18 Devonshire Street
Marylebone, London W1G 7AF

Telephone

020 3797 7248

Parking

Valet parking available. NCP Marylebone Road 5 min walk.

Transport

Great Portland St (2 min)

Regent's Park (4 min)

Marylebone (7 min)

Patients who typically attend this location

City of London Islington Camden Hackney Westminster Kensington Mayfair Hampstead Canary Wharf International

Patients from South West London and Surrey may prefer Mr Sri's Wimbledon or Cheam locations. All locations offer identical surgical standards — the choice is purely about convenience.

The procedure

What is a robotic radical prostatectomy?

Robotic-assisted radical prostatectomy (RARP) is the surgical removal of the entire prostate gland and seminal vesicles for clinically localised or locally advanced prostate cancer. Robotic surgery is now the dominant technique — offering greater precision than open or conventional laparoscopic approaches, with particular advantages for nerve preservation and accurate reconstruction of the bladder-urethra join.

The procedure is performed using the da Vinci system through six small keyhole incisions. The surgeon operates at a console with three-dimensional magnified vision and wristed instruments delivering precision beyond the unassisted hand. The prostate is dissected from surrounding structures, the bladder neck is rejoined to the urethra, and a catheter remains in place for approximately one week while the anastomosis heals.

The principal goals are complete cancer removal with negative surgical margins, while preserving the structures responsible for urinary continence and — where oncologically safe — erectile function. For localised prostate cancer, robotic surgery and radiotherapy offer equivalent cancer control; the choice between them is personal, and discussed openly at consultation. NICE guidance (NG131) sets out the current UK recommended pathway.

Nerve-sparing prostatectomy

The neurovascular bundles running alongside the prostate are responsible for erectile function. Nerve-sparing technique preserves these structures where oncologically safe.

Whether nerve-sparing is possible depends on the MRI appearance, biopsy result, and PSA. Where cancer is close to the nerve bundle, removing it safely must take priority.

Robotic precision allows nerve-sparing surgery more reliably than open approaches — magnification and wristed instruments enable careful dissection in a confined anatomical space.

Structured penile rehabilitation starting early post-operatively significantly improves long-term erectile function recovery where nerve-sparing was performed.

Continence outcomes

What to expect with urinary control

Temporary urinary leakage following catheter removal is expected and normal. The rate and completeness of recovery depend on age, baseline function, and surgical technique. The key target to aim for at 6 weeks is to be dry at night and using a single safety pad during the day.

Pelvic floor exercises — starting before surgery and restarting the moment the catheter is removed — are the single most impactful thing a patient can do to influence their recovery.

All patients — continent or minimal leak at 1 year>80%

Personal series. Does not bother the patient.

Nerve-sparing patients — continent or minimal leak at 1 year>90%

Personal series. Bilateral nerve-sparing performed.

Recovery week by week

Timeline

Before op

Pelvic floor training begins

4–6 weeks of daily exercises before surgery. Referral to specialist pelvic floor physiotherapist arranged.

Day of op

Surgery and early recovery

Mobile the same day. Eating and drinking within hours. Median discharge within 24 hours.

Week 1

Catheter removal

Catheter removed at clinic at 7–10 days. Pelvic floor exercises restart immediately. Tadalafil started for penile rehabilitation.

Weeks 2–4

Returning to normal

Desk work by 2–3 weeks. Driving when safe. Leakage improving week by week.

6 weeks

Key milestone

Expectation: dry at night, single safety pad during day. First PSA check. Referral for vacuum pump.

3–12 months

Ongoing improvement

Continence and erectile function continue improving. Regular PSA monitoring.

The most important thing you can do before surgery

Pelvic floor preparation — start before your operation

Pre-operative pelvic floor training is one of the most evidence-based and impactful things a patient can do before prostatectomy. Patients who begin exercises before surgery recover continence significantly faster than those who start only after the catheter comes out.

Mr Sri refers all prostatectomy patients for specialist pelvic floor physiotherapy before their operation. Exercises should begin at least four to six weeks before the planned surgery date.

Find the correct muscles

Tighten the muscles used to stop urine mid-flow. Do not engage thighs, buttocks, or abdomen. Correct technique is essential.

Begin 4–6 weeks before surgery

A consistent daily programme — ideally supervised by a specialist physiotherapist — builds the baseline strength needed for recovery.

Restart immediately after catheter removal

The window immediately after catheter removal is the most critical. Exercises restart the same day — this is non-negotiable.

Continue throughout the first year

Pelvic floor exercises remain beneficial at every stage of recovery, and even years later for persistent leakage.

Patient resources from Prostate Cancer UK — the UK's leading prostate cancer charity:

Prostate Cancer UK

Pelvic floor muscle exercises — complete guide for men after prostate treatment

Prostate Cancer UK

Surgery for prostate cancer — what to expect before, during, and after

Life after surgery

Survivorship — the long view

The goal of treatment is not just cancer control — it is getting back to living well. Mr Sri's approach places equal emphasis on excellent oncological outcomes and quality of life in the years following surgery.

PSA monitoring

PSA should become undetectable after prostatectomy. Regular monitoring detects any sign of recurrence early. A rising PSA does not necessarily mean spread — early detection opens the window for salvage radiotherapy or other interventions.

Continence recovery

Most patients achieve good continence within the first year. Those with persistent leakage beyond 12 months are assessed for further interventions — including a male sling or artificial urinary sphincter where necessary. Pelvic floor resources →

Erectile function

Erectile recovery after nerve-sparing prostatectomy is gradual — typically 6–18 months. Structured penile rehabilitation from the early post-operative period significantly improves long-term outcomes. Mr Sri works with specialist andrology colleagues for this aspect of care.

What happens during surgery

The operation — step by step

Pre-operative assessment

Anaesthetic review, blood tests, any additional staging imaging. Pelvic floor physiotherapy referral made. Informed consent obtained at Princess Grace or by telephone.

General anaesthetic and robot setup

Da Vinci robot docked via five small port incisions in the lower abdomen. Patient positioned head-down so bowel falls away from the pelvis.

Prostate dissection and nerve-sparing

The prostate is carefully dissected from the bladder, urethra, and — where oncologically safe — the neurovascular bundles. The seminal vesicles are removed with the specimen.

Anastomosis — rejoining bladder to urethra

Bladder neck sutured to urethra with absorbable sutures. Catheter placed through the join, which heals over approximately one week.

Recovery and discharge

Mobile on the day of surgery. Median discharge within 24 hours. Most patients return home to Central or North London the following morning. Pathology results reviewed at the first post-operative appointment.

Common questions

Frequently asked questions

Full information on the prostate cancer page.

No. Mr Sri performs robotic-assisted radical prostatectomy at HCA Princess Grace Hospital, 18 Devonshire Street, Marylebone — two minutes from Great Portland Street tube and steps from Harley Street. Pre-operative assessment, surgery, catheter removal, and post-operative follow-up can all take place in Central London. Patients from the City, Islington, Camden, Hackney, Kensington, and internationally do not need to travel to South West London for treatment.

In most cases there is time to consider your options fully — a few weeks to understand the alternatives and seek a second opinion will not compromise your outcome. Mr Sri will advise clearly if there is any clinical reason to act with greater urgency. Rushing a decision of this magnitude is never recommended when it can be avoided.

No. The majority of patients achieve social continence within the first year. At 6 weeks, the realistic expectation is dry at night and a single pad during the day for security. Pelvic floor exercises before and after surgery are the most important factor influencing recovery speed.

A PSA rise after prostatectomy — biochemical recurrence — does not necessarily mean the cancer has spread. Management depends on the timing, rate of rise, and pathological features. Options include active surveillance, salvage radiotherapy to the prostate bed, and systemic treatment. All decisions are made through the MDT with full patient involvement.

Both offer equivalent cancer control in most risk categories. Surgery's primary risks relate to urinary continence and erectile function; radiotherapy's primary risks relate to bowel and bladder irritation and long-term erectile dysfunction. The right choice depends on your cancer characteristics, general health, and personal priorities. Mr Sri discusses both openly and refers directly to clinical oncology colleagues where radiotherapy is preferred. NICE NG131 sets out the current decision framework.

Further information

Condition overview

Prostate cancer — staging, treatment pathway, and all options

Prostate cancer →

Second opinion · London

Considering your options before radiotherapy or active surveillance? Second opinion consultations at Princess Grace

Second opinion →

Surrey location

Prefer a Surrey or South West London location? Mr Sri also operates at Spire St Anthony's, Cheam

Prostatectomy Surrey →

Mr Denosshan Sri

MA Cantab | MB BChir | FRCS Urol | Consultant Urological Surgeon

Mr Sri performs over 200 robotic procedures annually at St George's University Hospital, where he leads the RCS-accredited robotic surgical fellowship. He is Principal Investigator of the ELLIPSE trial (RARP vs RARP with lymph node dissection for high-risk prostate cancer). His prostatectomy practice emphasises nerve-sparing technique, pre-operative pelvic floor preparation, and structured post-operative survivorship follow-up. He holds his Central London private practice at HCA Princess Grace Hospital, Marylebone.

Full profile → Patient reviews →