REVIEW PAPER
Prehabilitation as an element of comprehensive perioperative care in selected pelvic surgeries
1
Doctoral School, Medical University of Lublin
2
Department of Pediatric Rehabilitation and Physiotherapy, Chair of Rehabilitation and Physiotherapy, Faculty of Health Sciences, Medical University of lublin
3
Szkoła Doktorska, Uniwersytet Medyczny w Lublinie, Polska
4
Zakład Rehabilitacji i Fizjoterapii, Katedra Rehabilitacji i Fizjoterapii, Wydział Nauk o Zdrowiu, Uniwersytet Medyczny w Lublinie, Polska
KEYWORDS
TOPICS
ABSTRACT
Introduction and objective:
Prehabilitation is a key element in preparing patients for surgery, aimed at improving their overall health, reducing the risk of postoperative complications, accelerating the recovery process and shortening the hospitalization time. The aim of the study was to broaden the understanding of pre-rehabilitation, as well as to analyze and compile research on the impact of perioperative preparation in the form of targeted physical activity, pelvic floor muscle training, psychological support, dietary and educational support of the patient on the postoperative condition, quality of life and frequency of complications in the area of selected pelvic surgery.
Review methods:
A review of scientific publications from 2012–2025 was conducted based on PRISMA guidelines, using the search engines of PubMed and Scopus to obtain a comprehensive understanding of the topic under consideration.
Brief description of the state of knowledge:
Research suggests that prehabilitation can improve postoperative outcomes, such as urinary continence and erectile function after radical prostatectomy, as well as pelvic floor muscle strength and quality of life after pelvic surgery. Physical activity before hysterectomy can reduce postoperative pain, especially in older patients.
Summary:
Research indicates that comprehensive prehabilitation programmes can enhance patients› preoperative condition by improving their nutritional status, physical fitness, and mental well-being. Although prehabilitation reduces treatment costs, further research is needed to fully understand the clinical benefits.
Prehabilitation is a key element in preparing patients for surgery, aimed at improving their overall health, reducing the risk of postoperative complications, accelerating the recovery process and shortening the hospitalization time. The aim of the study was to broaden the understanding of pre-rehabilitation, as well as to analyze and compile research on the impact of perioperative preparation in the form of targeted physical activity, pelvic floor muscle training, psychological support, dietary and educational support of the patient on the postoperative condition, quality of life and frequency of complications in the area of selected pelvic surgery.
Review methods:
A review of scientific publications from 2012–2025 was conducted based on PRISMA guidelines, using the search engines of PubMed and Scopus to obtain a comprehensive understanding of the topic under consideration.
Brief description of the state of knowledge:
Research suggests that prehabilitation can improve postoperative outcomes, such as urinary continence and erectile function after radical prostatectomy, as well as pelvic floor muscle strength and quality of life after pelvic surgery. Physical activity before hysterectomy can reduce postoperative pain, especially in older patients.
Summary:
Research indicates that comprehensive prehabilitation programmes can enhance patients› preoperative condition by improving their nutritional status, physical fitness, and mental well-being. Although prehabilitation reduces treatment costs, further research is needed to fully understand the clinical benefits.
REFERENCES (41)
1.
Molenaar CJ, Papen-Botterhuis NE, Herrle F, et al. Prehabilitation, making patients fit for surgery – a new frontier in perioperative care. Innov Surg Sci. 2019;4(4):132–138.
2.
Aguila-Gimeno O, Jareño-Vicens A, Recasens CT. Pelvic floor rehabi-litation before radical prostatectomy: a systematic review. BMC Urol. 2025;25(1):224.
3.
van der Velde M, van der Leeden M, Geleijn E, et al. What moves patients to participate in prehabilitation before major surgery? A mixed methods systematic review. Int J Behav Nutr Phys Act. 2023;20(1):75.
4.
Carli F, Silver JK, Feldman LS, et al. Surgical prehabilitation in patients with cancer: state-of-the-science and recommendations for future research from a panel of subject matter experts. Phys Med Rehabil Clin N Am. 2017;28(1):49–64.
5.
Espiño-Albela A, Castaño-García C, Díaz-Mohedo E, et al. Effects of Pelvic-Floor Muscle Training in Patients with Pelvic Organ Prolapse Approached with Surgery vs. Conservative Treatment: A Systematic Review. J Pers Med. 2022;12(5):806.
6.
Zhou L, Chen Y, Yuan X, et al. Preoperative pelvic floor muscle exercise for continence after radical prostatectomy: a systematic review and meta-analysis. Front Public Health. 2023;11:1186067.
7.
Palma S, Hasenoehrl T, Jordakieva G, et al. High-intensity interval training in the prehabilitation of cancer patients-a systematic review and meta-analysis. Support Care Cancer. 2021;29(4):1781–1794.
8.
Gillis C, Wischmeyer PE. Pre-operative nutrition and the elective surgical patient: why, how and what? Anaesthesia. 2019;74:27–35.
9.
Levett DZ, Grimmett C. Psychological factors, prehabilitation and surgical outcomes: evidence and future directions. Anaesthesia. 2019;74:36–42.
10.
Durrand J, Singh SJ, Danjoux G. Prehabilitation. Clin Med (Lond). 2019;19(6):458–464.
11.
Jurys T, Dzierzawa M, Kwiecień A, et al. Fizjoterapeutyczne leczenie nietrzymania moczu u mężczyzn po radykalnej prostatektomii. Med Og Nauk Zdr. 2019;25(3):144–148.
12.
Santa Mina D, Hilton WJ, Matthew AG, et al. Prehabilitation for radical prostatectomy: a multicentre randomized controlled trial. Surg Oncol. 2018;27(2):289–298.
13.
Hughes MJ, Hackney RJ, Lamb PJ, et al. Prehabilitation Before Major Abdominal Surgery: A Systematic Review and Meta-analysis. World J Surg. 2019;43(7):1661–1668.
14.
Au D, Matthew AG, Lopez P, et al. Prehabilitation and acute postoperative physical activity in patients undergoing radical prostatectomy: a secondary analysis from an RCT. Sports Med Open. 2019;5(1):18.
15.
Ploussard G, Kesch C, Calleris G, et al. From an On-site Program to a Mobile App for Prehabilitation and Rehabilitation for Robotic Radical Prostatectomy: Lessons Learned from 5 Years of Experience, the COVID-19 Outbreak, and Comparison with Nationwide Data. Eur Urol Oncol. 2024;7(2):297–299.
16.
Mungovan SF, Carlsson SV, Gass GC, et al. Preoperative exercise in-terventions to optimize continence outcomes following radical prosta-tectomy. Nat Rev Urol. 2021;18(5):259–281.
17.
Donovan JL, Hamdy FC, Lane JA, et al. Patient-reported outcomes after monitoring, surgery, or radiotherapy for prostate cancer. N Engl J Med. 2016;375(15):1425–1437.
18.
Carrier J, Edwards D, Harden J. Men,s perceptions of the impact of the physical consequences of a radical prostatectomy on their quality of life: a qualitative systematic review. JBI Database System Rev Implement Rep. 2018;16(4):892–972.
19.
Min Q, Zepeng J, Bijun L, et al. The impact of pelvic floor muscle exer -cise training mode on the rehabilitation of urinary incontinence after robot-assisted laparoscopic radical prostatectomy. Acad J Second Mil Univ. 2020;41:114–118.
20.
Hodges PW, Stafford RE, Hall L, et al. Reconsideration of pelvic floor muscle training to prevent and treat incontinence after radical prostatectomy. Urol Oncol. 2020;38(5):354–371.
21.
Chang JI, Lam V, Patel MI. Preoperative Pelvic Floor Muscle Exercise and Postprostatectomy Incontinence: A Systematic Review and Meta-analysis. Eur Urol. 2016;69:460–467.
22.
Hsu LF, Liao Y, Lai FC, et al. Beneficial effects of biofeedback-assisted pelvic floor muscle training in patients with urinary incontinence after radical prostatectomy: a systematic review and metaanalysis. Int J Nurs Stud. 2016;60:99–111.
23.
Singh F, Newton RU, Taaffe DR, et al. Prehabilitative versus rehabilitative exercise in prostate cancer patients undergoing prostatectomy. J Cancer Res Clin Oncol. 2023;149(18):16563–16573.
24.
Nelson CJ, Scardino PT, Eastham JA, et al. Back to baseline: erectile function recovery after radical prostatectomy from the patients› perspective. J Sex Med. 2013;10(6):1636–1643.
25.
Nicolai M, Urkmez A, Sarikaya S, et al. Penile Rehabilitation and Treat ment Options for Erectile Dysfunction Following Radical Prostatectomy and Radiotherapy: A Systematic Review. Front Surg. 2021;8:636974.
26.
Goonewardene SS, Gillatt D, Persad R. A systematic review of PFE pre-prostatectomy. J Robot Surg. 2018;12(3):397–400.
27.
Feng D, Tang C, Liu S, et al. Current management strategy of treating patients with erectile dysfunction after radical prostatectomy: a systematic review and meta-analysis. Int J Impot Res. 2022;34(1):18–36.
28.
Vanderhaeghe D, Albersen M, Weyne E. Focusing on sexual rehabilitation besides penile rehabilitation following radical prostatectomy is important. Int J Impot Res. 2021;33(4):448–456.
29.
Safavy S, Kilday PS, Slezak JM, et al. Effect of a Smoking Cessation Program on Sexual Function Recovery Following Robotic Prostatectomy at Kaiser Permanente Southern California. Perm J. 2017;21:1–5.
30.
Schoentgen N, Califano G, Manfredi C, et al. Is it Worth Starting Sexual Rehabilitation Before Radical Prostatectomy? Results From a Systematic Review of the Literature. Front Surg. 2021;8:648345.
31.
Pauls RN, Crisp CC, Novicki K, et al. Impact of physical therapy on quality of life and function after vaginal reconstructive surgery. Female Pelvic Med Reconstr Surg. 2013;19(5):271–277.
32.
Nyhus MØ, Mathew S, Salvesen Ø, et al. Effect of preoperative pelvic floor muscle training on pelvic floor muscle contraction and symptomatic and anatomical pelvic organ prolapse after surgery: randomized controlled trial. Ultrasound Obstet Gynecol. 2020;56(1):28–36.
33.
McClurg D, Hilton P, Dolan L, et al. Pelvic floor muscle training as an adjunct to prolapse surgery: a randomised feasibility study. Int Urogynecol J. 2014;25(7):883–891.
34.
Kearney R, Wagg A, Bower W, et al. How Can We Improve the Assessment and Indifferent Outcomes From Pelvic Organ Prolapse Management From Conservative and Surgical Therapies? Neurourol Urodyn. 2026.
35.
Schachar JS, Devakumar H, Martin L, et al. Pelvic floor muscle weakness: a risk factor for anterior vaginal wall prolapse recurrence. Int Urogynecol J. 2018;29(11):1661–1667.
36.
Choi JB, Kang K, Song MK, et al. Pain Characteristics after Total Laparoscopic Hysterectomy. Int J Med Sci. 2016;13(8):562–568.
37.
Carli F, Brown R, Kennepohl S. Prehabilitation to enhance postoperative recovery for an octogenarian following robotic-assisted hysterectomy with endometrial cancer. Can J Anaesth. 2012;59(8):779–784.
38.
Björkström LM, Wodlin NB, Nilsson L, et al. The Impact of Preoperative Assessment and Planning on the Outcome of Benign Hysterectomy – a Systematic Review. Geburtshilfe Frauenheilkd. 2021;81(2):200–213.
39.
Vonk Noordegraaf A, Anema JR, van Mechelen W, et al. A personalised eHealth programme reduces the duration until return to work after gynaecological surgery: results of a multicentre randomised trial. BJOG. 2014;121(9):1127–1135.
40.
Szymański JK, Starzec-Proserpio M, Słabuszewska-Jóźwiak A, et al. Is PREHAB in Pelvic Floor Surgery Needed? A Topical Review. Medicina (Kaunas). 2020;56(11):593.
41.
Crişan I, Slankamenac K, Bilotta F. How much does it cost to be fit for operation? The economics of prehabilitation. Curr Opin Anaesthesiol. 2024;37(2):171–176.
| eISSN: | 2084-4905 |
| ISSN: | 2083-4543 |
We process personal data collected when visiting the website. The function of obtaining information about users and their behavior is carried out by voluntarily entered information in forms and saving cookies in end devices. Data, including cookies, are used to provide services, improve the user experience and to analyze the traffic in accordance with the Privacy policy. Data are also collected and processed by Google Analytics tool (more).
You can change cookies settings in your browser. Restricted use of cookies in the browser configuration may affect some functionalities of the website.
You can change cookies settings in your browser. Restricted use of cookies in the browser configuration may affect some functionalities of the website.
