OBJECTIVES: The advent of robotic surgery to prostate cancer treatment has been justified by improved convalescence, fewer medical complications and decreased morbidity in comparison with traditional operating techniques. Furthermore, robotic surgery has been claimed to achieve better results concerning urinary continence and sexual factors. Our aim was to find out whether these claims are realized in an unselected material of a large university hospital. METHODS: An ongoing observational follow-up study in the real-world setting of a university hospital using the 15D generic health-related quality of life (HRQoL) instrument. Patients entering for treatment of prostate cancer were asked to fill in the HRQoL questionnaire at baseline and 3, 6, 12 and 24 months after entering treatment. RESULTS: So far, 123 patients have undergone surgery: 76 in the robot-assisted laparoscopic prostatectomy group (RALP, mean age 60.6 years) and 47 in the open surgery group (OS, mean age 61.5 years).  The baseline prognostic Gleason score did not differ in a statistically significant manner between the groups (6.91 vs. 6.98, p=0.593). The mean HRQoL score in the OS group was slightly lower at baseline than that in the RALP group (0.940 vs. 0.920), but the difference was not statistically significant. During the two-year follow-up the HRQoL score remained slightly lower in the OS group at all follow-up points, but none of the differences was statistically significant. At the three-month follow-up the RALP group fared statistically significantly better on the dimensions of “excretion” (p<0.05) and “sexual activity” (p<0.01), but at the subsequent follow-up points the statistically significant difference had disappeared. The dimension of “vitality” did not differ between the groups at any of the follow-up points. CONCLUSIONS: The benefit from robot-assisted prostate surgery was in our material so small that it probably does not offset the high cost associated with the robotic approach.