Association of Prehabilitation in the Precystectomy Pathway in Patients With Bladder Cancer on Postoperative Outcomes

Prehabilitation in patients with bladder cancer recommended for cystectomy has the potential to improve functional status and outcomes after cystectomy. Prior research has shown that increasing exercise preoperatively can improve strength and quality of life, but research has not yet investigated the impact on length of stay, readmissions, complications and mortality.

We compared historical controls (2021-2022) for patients with bladder cancer who underwent radical cystectomy at a major academic center to those referred for prehabilitation consultation (2023) on postoperative outcomes, namely hospital length of stay, 30 and 90 day readmission rates, postoperative complications and 90-day mortality.

In total, 16 patients received prehabilitation consultation and were compared to 175 patients who did not receive consultation. There were no significant differences in hospital length of stay or 30 or 90 day readmission rates. There were differences in the incidences of some postoperative complications, although not statistically significant.

In this study, prehabilitation consultation did not improve length of stay, 30 or 90 day readmission rates or some postoperative complications, but was limited by low rate of referral. Further research is needed regarding the implementation of prehabilitation programs for bladder cancer.