"Robotic prostatectomy experience was poor"

About: University College Hospital

Anything else?

Discussed robotic assisted laparoscopic prostatectomy only to find the consent process requires agreement to switch to open surgery at any time without further patient consent. No option to limit this as robotic assistance was only allowed if the full consent form was signed,

All nurse specialists were female and therefore total embarrassment in discussing continence and erection problems at every clinic and every follow up appointment, The nurses were not able to relate to dry orgasm issues, and other sensitivities.

Erection problems were advised to resolve in up to 18 months but the truth is that they may never return. This was common of all risks. At first I was told things would get better only to concede when challenged that some issues may be permanent.

Poor advice, lack of honesty, poor empathy and lack of patient involvement was a common thread of all my time with the hospital.

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Responses

Response from University College Hospital

During robotic assisted laparoscopic surgery there is a risk of complications arising which may necessitate switching to open surgery in order to complete the procedure. This is a small but inherent risk of this type of surgery and as such it is appropriate that this is fully covered in the consent process. It would no be in the interest of the patient to proceed with this operation if a patient was unhappy with the possibility of having to have an open procedure. This is standard practice for all laparoscopic procedures and is clearly stated in the patient information which every patient should be given prior to admission. .

Initial counselling for surgery is given by a Consultant Urologist with back up and access to the specialist nurses (CNS). All of our CNS's have undertaken the advanced communication skills course required for all clinicians working with cancer patients and level 2 psychological assessment. The contact details for our CNSs are in the patient information booklet given to all our patients. Our current team of CNS's includes both Male and Female nurse specialists and consultation with a male CNS could have been arranged upon request. It is possible that we should ask patients if they are comfortable discussing personal issues with female members of staff prior to engaging in that part of the service.

If you wish to discuss things further please do not hesitate to contact our Patient Advice and Liaison Service (PALS) on 020 3447 3042 or PALS@uclh.nhs.uk

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