Prehabilitation and Patient Optimization for Cystectomy

Prehabilitation is often defined as the process of enhancing or optimizing a patients' functional capacity preoperatively to improve tolerance of perioperative physiologic stressors. This is accomplished beginning with a standardized risk assessment using laboratory values, imaging, and validated questionnaires. Following this risk assessment, patients are referred to a team of multidisciplinary providers with a goal of optimizing nutritional status, exercise capacity, cessation of smoking, and enabling psychiatric preparedness for the stressors of radical cystectomy. Herein, we provide a critical evaluation of the key components of the prehabilitation process and offer insights into directions for future research endeavors.