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

Thirteen studies from eight countries were identified examining prehabilitation models for patients undergoing radical prostatectomy, comprising RCTs, quasi-experimental studies, and prospective cohort studies.

• A comprehensive search of nine electronic databases was conducted from inception to 1 December 2025.
• The review followed the Arksey and O'Malley framework and was reported in accordance with PRISMA-ScR guidelines.
• Study designs included randomised controlled trials (RCTs), quasi-experimental studies, and prospective cohort studies.
• Studies originated from eight different countries, indicating international scope of prehabilitation research in this population.

Three distinct delivery formats for prehabilitation were identified: digital remote interventions, non-digital remote interventions, and in-person hospital-based programmes.

• Digital remote interventions via mobile applications accounted for 4 of the 13 studies (n=4).
• Non-digital remote interventions via booklets and telephone follow-up also accounted for 4 studies (n=4).
• In-person hospital-based programmes were the most common format with 5 studies (n=5).
• Prehabilitation was described as feasible and acceptable across all three diverse delivery formats.

Pelvic floor muscle training (PFMT) was the most consistently implemented prehabilitation component across studies.

• PFMT was implemented in 11 of the 13 included studies (n=11).
• PFMT was complemented by aerobic exercise, resistance training, nutritional support, psychological interventions, and health education.
• The predominance of PFMT reflects its established relevance to urinary continence outcomes following radical prostatectomy.
• Considerable heterogeneity was observed across intervention content across studies.

Outcome measures across the included studies spanned six distinct domains.

• The six outcome domains identified were: 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 outcome assessment instruments used across studies.
• Inconsistent outcome measurement was identified as a key limitation constraining the current evidence base.
• The breadth of outcome domains reflects the multimodal nature of prehabilitation interventions targeting physical, nutritional, and psychological status.

Prehabilitation is defined in this review as the preoperative optimisation of physical, nutritional, and psychological status, and has emerged as a promising strategy in surgical oncology.

• The application of prehabilitation in patients undergoing radical prostatectomy was characterised as 'poorly characterised' prior to this review.
• The scoping review aimed to systematically map existing evidence with particular focus on delivery formats, intervention components, and outcome measures.
• Prehabilitation was described as a 'promising strategy to improve postoperative recovery in surgical oncology.'
• The review identified that high-quality RCTs are warranted to establish standardised multimodal prehabilitation protocols and consensus-based core outcome sets.

Methodological heterogeneity and inconsistent outcome measurement were identified as key constraints on the current prehabilitation evidence base for radical prostatectomy patients.

• Considerable heterogeneity was observed across both intervention content and outcome assessment instruments.
• The authors concluded that 'high-quality RCTs are warranted to establish standardised multimodal prehabilitation protocols and consensus-based core outcome sets for this population.'
• The lack of standardised protocols was highlighted as a barrier to synthesising evidence across studies.
• The call for consensus-based core outcome sets suggests current studies measure different outcomes, making cross-study comparison difficult.