Hi Kimpy,
I'm in the US, but I had Retzius Sparing Robotic RP exactly 4 weeks ago today. I was stage T3aN0M0 (cancer broke through the capsule, PNI in right nerve bundle, but no SV invasion). PSA 12.7. My Gleason was 4+5 (w/ cribriform) at biopsy but was downgraded to 4+3 after the post RP histology report. My surgeon removed roughly 25 ~ 30% of my right nerve bundle, left side was fully spared. Despite all that, I have NO ED issues AT ALL post surgery. I'm not even using any pills (Cialis, Viagra). Don't need 'em. Don't want 'em. As far as continence goes, I was 99% continent the day my catheter came out and at this point am not using any pads around the house (except overnight). I do wear one when I go out just in case. The only time I leak (and it's very little when I do) is during any straining like a hard cough or passing wind. I will also mention that I returned to my office job last week (at week 3 post surgery). I go in 3 days a week.
If you are considering surgery, I would say, the two most important factors (aside from degree of cancer) are 1) Your age and overall general health and 2) The experience and skill of the surgeon. I was fortunate to have a very experienced surgeon who performs over 300 robotic surgeries per year. I am also relatively young (51) and am in good physical shape. My surgeon said that with regards to incontinence, he usually sees greater post-op issues in men that are overweight going into surgery. He also mentioned that the "Retzius sparing" technique helps patients to recover continence more quickly. I don't know if the Retzius sparing technique is considered par for the course nowadays or not but it might be something to ask about. He actually did expect me to have some degree of erectile dysfunction after surgery but assured me that there are enough therapeutic options available that I would be ok in the long run. And as it turns out, I beat even his expectations! So maybe I just got lucky, but I'm doing fine.
Another tidbit you might want to ask about with regards to surgical technique being you are T3b is whether or not the surgeon is able to check the margins of the tissue removed from you DURING THE PROCEDURE. If you've been reading through this forum you will see that when you get your post-op histology report, they check the tissue removed to see if there are any areas where the cancer spreads all the way to the edge. If so, this is considered a "positive margin" and means there is a high probability that some cancerous tissue was left behind. At some facilities (at least here in the US), if a lab exists onsite, the surgeon can freeze the tissue removed from you (while you are still on the operating table) and shave off some of the outer edges and have the lab take a quick look to see if the margins are clear or not. If not, the surgeon can then remove more tissue from you where the cancer went out to the edge giving better odds of getting it all out. In all the research I did online when I was trying to decide between surgery and radiation, I never read anything about this. But in my final appointment with him pre-surgery, my surgeon mentioned very nonchalantly that he does this at his hospital. This really boosted my confidence going in and it did in fact result in me walking away with clear margins. Again, I'm in the US, but having never heard of this before I asked the doctor if this was common practice or not and he seemed to indicate that in fact it is relatively common these days.
Finally, keep in mind, that no matter which route you go (radiation or surgery), there are likely going to be some side effects, some healing time and NEITHER can guarantee you won't have recurrence. There is no right or wrong answer, but if you are fit enough and willing to go through surgery, at least you will still have the radiation option in your back pocket as another weapon to fight the beast with, should it return.
Best of luck to you,
-Mike