Prehabilitation for men undergoing radical prostatectomy: a multi-centre, pilot randomized controlled trial

Area of Science:

• Oncology
• Urology
• Rehabilitation Medicine
• Exercise Science

Background:

• Prehabilitation, focusing on preoperative health behaviors like exercise, is an emerging field.
• The preoperative period offers a unique window to foster health behavior adherence for improved surgical outcomes.
• No prior studies have investigated prehabilitation for men with prostate cancer undergoing radical prostatectomy.

Purpose of the Study:

• To determine the feasibility of a full-scale randomized controlled trial (RCT) of prehabilitation versus usual care.
• To estimate effect sizes for key outcomes to inform sample size calculations for future studies.
• To investigate the potential of prehabilitation to optimize postoperative recovery in this patient population.

Main Methods:

• A multi-center pilot randomized controlled trial involving 100 men undergoing radical prostatectomy.
• Participants were randomized to either a prehabilitation program (exercise, pelvic floor training, lifestyle guide) or usual care.
• Feasibility was assessed via recruitment rates, adherence, attrition, and safety, with efficacy outcomes measured pre- and post-operatively.

Main Results:

• The study assessed feasibility metrics including recruitment, adherence, attrition, and safety.
• Efficacy outcomes such as fatigue, quality of life, urinary incontinence, and physical fitness were measured.
• This pilot trial provides preliminary data on the impact of prehabilitation on recovery.

Conclusions:

• This is the first study to examine a structured presurgical exercise program for men undergoing radical prostatectomy for prostate cancer.
• The findings will guide the design of future, adequately powered RCTs in prehabilitation for prostate cancer patients.
• Prehabilitation may offer a valuable strategy to enhance postoperative recovery and reduce complications.