MS-N312 · Exercise and rehabilitation · Pelvic-floor care · Nutrition · Surgery · Human evidence · Appraised 12 November 2026
Does four weeks of multimodal prehabilitation improve early recovery after robotic-assisted radical prostatectomy?
Evidence at a glance
- Evidence label: Single-center randomized trial; early patient-reported benefit with attenuation over time
- Benefit: At one month, global health status was 15 points higher and urinary incontinence scores were better; no advantage was detected for physical performance or erectile function.
- Certainty: Moderate for early patient-reported outcomes, lower for long-term benefit and broader generalizability.
- Risk: The abstract described the program as feasible but did not provide adverse-event counts; pelvic-floor, physical and nutritional components require individual assessment.
What was studied
Design: A prospective single-center trial randomized 100 men scheduled for robotic-assisted radical prostatectomy; 95 were analyzed (53 prehabilitation, 42 usual care).
Program: Four weeks of physical and pelvic-floor muscle training, nutritional counselling and psychological support before surgery. The primary endpoint was change in EORTC QLQ-C30 global health status from baseline to one month after surgery; follow-up continued to six months.
What the evidence found
At one month, adjusted global health status favored prehabilitation by 15 points on a 0–100 scale (95% CI 7–22; P<.001). The ICIQ-UI Short Form urinary-incontinence score favored prehabilitation by 2.7 points (P=.032).
No between-group difference was detected in physical performance or erectile function. The global-health difference diminished to 4.5 points by six months, while selected quality-of-life, mental-health and continence differences persisted.
Adverse-event counts, adherence and missing-data detail were not reported in the accessible abstract and are therefore not assumed.
How to interpret it
The early quality-of-life difference is potentially meaningful, but the multicomponent design cannot tell us which part produced the effect. The attenuation by six months and single-center setting temper claims of routine effectiveness.
This study evaluated recovery, not tumor control. A better recovery score cannot be interpreted as lower recurrence risk or longer survival.
Practical safety context
Pelvic-floor technique, baseline continence, cardiovascular and musculoskeletal conditions, and perioperative nutrition should be assessed. Overtraining immediately before surgery or restrictive diets that worsen intake are counterproductive.
People using anticoagulants, with hernia symptoms, severe pain, acute urinary infection or rapidly changing symptoms should obtain individualized clearance.
Questions for the care team
- Can a pelvic-floor physiotherapist check technique before surgery?
- Which element—conditioning, continence, nutrition or anxiety support—is most relevant for me?
- How will the plan change immediately after surgery and catheter removal?
Funding and conflicts
Funding and conflict-of-interest statements were not available in the abstract and were not verified from the paywalled full text.
Sources
Last literature search: 12 November 2026. Record appraisal: 12 November 2026. Only the journal abstract and bibliographic record were accessible; unavailable details are labeled rather than inferred. This page is educational and does not replace individualized medical advice. These supportive-care outcomes do not establish tumor shrinkage, delayed recurrence or longer survival.
