Mental Health

Perioperative mental health needs in urological and genitourinary surgery: a scoping review.

TL;DR

Perioperative psychological distress in urological and genitourinary surgery follows a provisional staged pattern across preoperative, early postoperative, and longer-term phases, with heterogeneous and largely observational evidence identifying candidate components for future perioperative mental health pathway development.

Key Findings

A scoping review of 44 studies identified a provisional staged pattern of perioperative mental health concerns in urological and genitourinary surgery.

  • 44 studies were included in total.
  • Six databases were searched: PubMed, Embase, Web of Science, ScienceDirect, PsycINFO, and CINAHL.
  • Studies published from January 2000 to May 2026 in English were eligible.
  • The review was conducted in accordance with PRISMA extension for Scoping Reviews.
  • Observational designs predominated, and most evidence came from adult oncological populations.

Preoperative mental health concerns in this surgical population centered on uncertainty and fear.

  • Preoperative concerns were identified as the first stage in the provisional staged pattern.
  • Uncertainty and fear were the primary preoperative psychological themes identified across included studies.
  • This stage was part of a three-phase provisional framework synthesized descriptively using evidence mapping.

Early postoperative mental health concerns were primarily related to pain, sleep disturbance, and device adaptation.

  • Early postoperative concerns constituted the second stage of the provisional staged pattern.
  • Pain, sleep, and device adaptation were the dominant themes in the early postoperative period.
  • This phase was distinct from both preoperative concerns and longer-term adjustment concerns.

Longer-term psychological distress was concentrated in selected subgroups and linked to multiple functional and social factors.

  • Longer-term concerns comprised the third stage of the provisional staged pattern.
  • Distress was commonly linked to urinary diversion, incontinence, sexual dysfunction, altered genital anatomy, and body-image concerns.
  • Social constraints, limited support, self-perceived burden, and prior mental health vulnerability were also identified as contributing factors.
  • Longer-term distress was described as concentrated in 'selected subgroups' rather than uniformly distributed across patients.

Multiple categories of supportive interventions were reported across the included studies.

  • Reported supportive approaches included prehabilitation, structured education, multidisciplinary or pathway-based care, digital and virtual reality strategies, transcutaneous electrical acupoint stimulation, multimodal analgesia, and opioid stewardship.
  • No single intervention was identified as dominant; the range reflects the heterogeneity of the evidence base.
  • Interventions spanned both pharmacological (multimodal analgesia, opioid stewardship) and non-pharmacological modalities.

The available evidence was characterized as heterogeneous and largely observational, limiting conclusions about causal relationships or intervention efficacy.

  • The authors note the evidence 'remains heterogeneous and largely observational.'
  • Findings were synthesized descriptively using evidence mapping rather than meta-analysis.
  • The staged pattern described was explicitly termed 'provisional,' indicating it requires prospective validation.

The review identified candidate components for future perioperative mental health pathway development in urological and genitourinary surgery.

  • Candidate components identified included repeated assessment, structured education, family-inclusive support, and referral mechanisms.
  • The authors called for prospective evaluation of perioperative mental health pathways.
  • The scoping review framed its findings as mapping the evidence base to guide future pathway development rather than providing definitive practice recommendations.

What This Means

This research suggests that patients undergoing urological and genitourinary surgeries — such as bladder, prostate, or kidney procedures — experience distinct psychological challenges at different points in their surgical journey. Before surgery, patients commonly face fear and uncertainty. Shortly after surgery, concerns shift to managing pain, sleep problems, and adapting to medical devices. Over the longer term, some patients — particularly those dealing with changes to urinary function, sexual function, genital anatomy, or body image — may experience ongoing emotional distress, especially if they have limited social support or a history of mental health difficulties. The review, which synthesized findings from 44 studies published over more than two decades, found that a range of supportive strategies have been reported, including patient education programs, multidisciplinary care teams, digital tools, virtual reality, nerve stimulation techniques, and approaches to managing pain without relying heavily on opioids. However, because most of the available studies were observational in nature and varied widely in their methods and populations, it is not yet possible to draw firm conclusions about which interventions work best or for whom. This research matters because it highlights that psychological care in urological surgery is not a single-point concern but an ongoing need that changes over time. The authors suggest that future care pathways should include repeated mental health screening throughout the surgical journey, structured patient education, involvement of family members, and clear referral routes to mental health support — particularly for patients at higher risk of longer-term distress. These findings provide a foundation for designing and testing more systematic approaches to supporting the emotional wellbeing of patients undergoing these procedures.

Have a question about this study?

Citation

Wang Q, Lv D, Zhou H, Wang Z, Li J, Guo Z, et al.. (2026). Perioperative mental health needs in urological and genitourinary surgery: a scoping review.. Frontiers in public health. https://doi.org/10.3389/fpubh.2026.1904213