Mr Pras Satasivam FRACS
Urologist, Uro-Oncologist and Robotic Surgeon
Pras Satasivam is a highly qualified and experienced urologist with expertise in the treatment of urological cancers. He holds a Fellowship of the Royal Australasian College of Surgeons and is a Member of the Society of Urologic Oncology.
Pras grew up in Melbourne and attended Haileybury College, where he graduated as Dux of the School in 1998. He then went on to study at the University of Melbourne Medical School, where he was accepted with the top tertiary entrance rank of 99.95. After completing his postgraduate surgical training in Victoria, he was offered a Fellowship in Urologic Oncology at Memorial Sloan-Kettering Cancer Center in New York. This gave him the opportunity to receive specialized training from world-renowned experts in his field.
Pras offers a range of general urologic services, with a focus on the latest surgical techniques for treating urological cancers. Click here to learn more about his background, qualifications, and services.
Please click above for detailed descriptions of common operations, including robotic prostatectomy, robotic partial nephrectomy, TURP, HOLEP, prostate steam ablation, inflatable penile prosthesis, vasectomy, stone surgery, testis cancer surgery, and more.
Please click below for detailed descriptions of common operations, including robotic prostatectomy, robotic partial nephrectomy, TURP, HOLEP, prostate steam ablation, inflatable penile prosthesis, vasectomy, stone surgery, testis cancer surgery, and more.
Prostate Cancer
Should you have a PSA test? How do we diagnose and treat prostate cancer? How do we manage the side-effects of treatment?
Benign Enlarged Prostate
What are the symptoms of having an enlarged prostate? What treatment options are available?
Kidney Cancer
What is the role of biopsy in kidney cancer? Do all kidney tumours need surgery? When can we watch a kidney tumour?
Kidney Stones
What causes kidney stones and what can I do to prevent them? How do we treat kidney stones?
Bladder Cancer
What causes bladder cancer? When must we remove the entire bladder with surgery?
Testis Cancer
What are the symptoms of testis cancer? How is it treated and can it be cured?
TURP
TURP (Transurethral Resection of the Prostate) is the traditional operation for urinary symptoms caused by an enlarged prostate. It involves removing obstructing prostate tissue through a telescope placed in the urethra, and is a reliable, well-established procedure for men with moderate-sized prostates. CLICK HERE
TURP Comparison
Bleeding risk: Medium
Hospital stay: 2 days
Catheter: 2 days
Loss of ejaculation: 65-75%
Large prostates: No
Retreatment rate: 5-15%
HoLEP
HoLEP (Holmium Laser Enucleation of the Prostate) is a minimally invasive laser procedure for men with urinary symptoms caused by an enlarged prostate. Compared with TURP and Rezum, HoLEP is more effective for larger prostates and provides more durable, long-term symptom relief. CLICK HERE
HoLEP Comparison
Bleeding risk: Low
Hospital stay: 1 day
Catheter: 1 day
Loss of ejaculation: 70-90%
Large prostates: Yes
Retreatment rate: 1-2%
Rezūm
Rezum is a minimally invasive treatment that uses steam to shrink prostate tissue and improve urine flow. It is performed as a day procedure and preserves sexual function. Symptom improvement occurs gradually over several weeks, and it is best suited to men with mild to moderate prostate enlargement. CLICK HERE
Rezūm Comparison
Bleeding risk: Very low
Hospital stay: Day case
Catheter: 5 to 7 days at home
Loss of ejaculation: 5%
Large prostates: No
Retreatment rate: 15%
The "Hood Technique"
Pras utilises the “Hood Technique” for robotic radical prostatectomy for prostate cancer (1). This approach combines elements of both the traditional “anterior” and newer “Retzius-sparing” techniques to enable early return of continence without compromising surgical margin rates.
Early continence recovery
In a recent audit of the last 50 cases using the Hood Technique, we found that 37% of our patients achieved continence (0 pads or 1 security pad) within 2 weeks of surgery, and 57% within 3 months. Few studies have looked at continence this early after surgery, however one large systematic review reported 3-month continence rates ranging from 25% to 90% (2).
Excellent cancer control
In a recent audit of the last 50 cases using the Hood Technique, we achieved superior cancer control rates with a negative margin rate of 100% for organ-confined cancer (stage pT2) and 82% for locally-advanced cancer (stage pT3). For comparison, in one large systematic review the average negative margin rate was 91% for pT2 and 63% for pT3 cancers (3).
(1) Wagaskar et al. European Urology, Volume 80, Issue 2, August 2021, Pages 213-221.
(2) Ficarra et al. European Urology, Volume 62 Issue 3, September 2012, Pages 405-417.
(3) Novara et al. European Urology, Volume 62 Issue 3, September 2012, Pages 382-404.