Prehabilitation models in patients undergoing radical prostatectomy: A scoping review.

Abstract

Prehabilitation, defined as the preoperative optimisation of physical, nutritional, and psychological status, has emerged as a promising strategy to improve postoperative recovery in surgical oncology. However, its application in patients undergoing radical prostatectomy (RP) remains poorly characterised. This scoping review aimed to systematically map existing evidence on prehabilitation models for patients scheduled for RP, with particular focus on delivery formats, intervention components, and outcome measures. Following the Arksey and O'Malley framework and reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines, a comprehensive search of nine electronic databases was conducted from inception to 1 December 2025. Thirteen studies from eight countries were included, comprising randomised controlled trials (RCTs), quasi-experimental studies, and prospective cohort studies. Three distinct delivery formats were identified: digital remote interventions via mobile applications (n = 4), non-digital remote interventions via booklets and telephone follow-up (n = 4), and in-person hospital-based programmes (n = 5). Pelvic floor muscle training (PFMT) was the most consistently implemented component (n = 11), complemented by aerobic exercise, resistance training, nutritional support, psychological interventions, and health education. Outcome measures spanned six domains: urinary continence and sexual function, physical function, perioperative clinical outcomes, psychological status, health-related quality of life (HRQoL), and nutritional status. Considerable heterogeneity was observed across intervention content and outcome assessment instruments. Prehabilitation appears feasible and acceptable across diverse delivery formats; however, the current evidence base is constrained by methodological heterogeneity and inconsistent outcome measurement. High-quality RCTs are warranted to establish standardised multimodal prehabilitation protocols and consensus-based core outcome sets for this population.