If you are facing prostate surgery, you have probably heard the word robotic a lot. Maybe your surgeon recommended it. Maybe a friend told you to insist on it. Maybe your hospital offers only one option and you are wondering if you are getting second best.
It is a fair question, because leakage afterward is one of the biggest worries men have. So what does the newest research actually say?
What a 2025 Study Compared
Researchers in Poland followed 182 men through prostatectomy and a structured pelvic floor rehab program. 76 had robot-assisted surgery and 106 had conventional laparoscopic surgery. Everyone got the same rehab. [1]
They then asked two separate questions:
- Where did each man start when rehab began?
- How much did each man improve during rehab?
The answers were not the same.
Three Findings Most Headlines Miss
1. Robotic patients tended to start drier
Men who had robotic surgery were more likely to begin rehab with milder leakage. They were also more likely to be fully dry by the final visit, about six months after the catheter came out. The difference was clearest in men with moderate to severe leakage.
2. Surgery type did not predict how much men improved
Once rehab started, the type of surgery did not predict how much a man’s leakage improved.
The authors were direct about this. The robotic advantage mostly reflected a better starting point, not a bigger response to rehab. They also cautioned that details they did not measure may explain part of the gap, such as nerve-sparing technique, bladder neck preservation and surgeon experience.
3. Your cancer grade did not decide it either
Many men assume a more aggressive cancer means worse leakage. In this study, tumor grade and spread beyond the prostate were not linked to how much men improved, or to whether they ended up dry.
Surgery date on the calendar?
The Pre-Surgery Preparation Class is a live, 60-minute small-group session that teaches you the right technique before your operation. It works best 2 to 8 weeks out.
Reserve the Pre-Surgery Class — $149
So What Did Predict Improvement?
Two things you can actually influence:
- Training before surgery. Men who had pre-surgery pelvic floor sessions were more likely to move down to a milder level of leakage during rehab. [1]
- Starting supervised rehab sooner. The longer the wait after surgery, the less men tended to improve. [1]
An Honest Caveat A second analysis from the same team did not find a significant pre-surgery effect. [2] These are observational studies, not randomized trials. Still, starting pelvic floor training before surgery is what the American Urological Association already recommends. [3]
What This Means for You
- Choose your surgeon and approach with your urology team. Ask about their experience and their continence results. That conversation belongs to you and your surgeon.
- Don’t treat your surgery type as your destiny. Whichever approach you have, how you prepare and how soon you start rehab are still in your hands.
- Learn the technique before you need it. Many men squeeze the wrong muscles or hold their breath. It is much easier to fix that before surgery than while you are sore and leaking.
Prepare for Whichever Surgery You’re Having
The Pre-Surgery Preparation Class walks you through what happens during a prostatectomy, why leakage occurs, the correct pelvic floor technique, a bladder plan for your first day home, and an honest talk about sexual function. You leave with a personal home exercise program.