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Prehabilitation for radical prostatectomy: A multicentre randomized controlled trial.

Daniel Santa Mina1, William J Hilton2, Andrew G Matthew3

  • 1Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, Ontario, Canada; Cancer Rehabilitation and Survivorship, University Health Network, Toronto, Ontario, Canada; Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.

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Prehabilitation, a home-based exercise program before surgery, is feasible and safe for men undergoing radical prostatectomy. It shows promising benefits for physical and psychological well-being post-surgery.

Keywords:
ExercisePrehabilitationProstate cancerRadical prostatectomySurgery

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Area of Science:

  • Urology
  • Exercise Science
  • Surgical Recovery

Background:

  • Preoperative fitness predicts surgical recovery.
  • Prehabilitation's effects on radical prostatectomy recovery are understudied.
  • This study investigates prehabilitation feasibility and outcomes in men undergoing radical prostatectomy.

Purpose of the Study:

  • To assess the feasibility of a prehabilitation program for men undergoing radical prostatectomy.
  • To examine the effects of prehabilitation on perioperative and postoperative outcomes.
  • To evaluate prehabilitation's impact on physical function, quality of life, and psychological well-being.

Main Methods:

  • Feasibility randomized controlled trial (RCT) comparing prehabilitation (PREHAB) to a control group (CON) in 86 men.
  • PREHAB involved home-based, moderate-intensity exercise; both groups had pelvic floor training.
  • Outcomes included feasibility metrics (recruitment, adherence), surgical complications, length of stay, 6-min walk test, strength, quality of life, psychosocial well-being, and urologic symptoms.

Main Results:

  • Recruitment rate was 47%, with 69% adherence to PREHAB and no serious adverse events.
  • PREHAB participants showed reduced anxiety and body fat pre-surgery.
  • Postoperatively, PREHAB improved 6-min walk test scores at 4 weeks and grip strength and anxiety levels at 26 weeks.

Conclusions:

  • Prehabilitation is a feasible and safe intervention for men undergoing radical prostatectomy.
  • Prehabilitation demonstrates potential benefits for physical and psychological well-being during the perioperative period.
  • The findings support prehabilitation as a valuable strategy to enhance recovery after radical prostatectomy.