Design: Systematic review and meta-analysis of randomised trials
Population: 1,542 men having radical prostatectomy in 16 trials
Primary outcome: Urinary incontinence, erectile function and quality of life over 12 months
Effect: Incontinence OR 0.58 at 1 month (0.39-0.84), 0.52 at 6 months (0.28-0.96); none at 12 months

A systematic review and meta-analysis pooled 16 randomised trials (1,542 men) of preoperative rehabilitation training before radical prostatectomy.

Prehabilitation reduced urinary incontinence at 1 month (OR 0.58, 95% CI 0.39-0.84) and 6 months (OR 0.52, 0.28-0.96), with a borderline effect at 3 months and none at 12 months. Incontinence severity and erectile function did not improve. Quality of life was better at 3 months (SMD -0.70) and 6 months (SMD -0.45) but not clearly at 12 months.

The early months after prostatectomy are when incontinence most affects work and confidence. A few sessions of preoperative training shorten that period for many men.

It does not change the long-term result, so it should be presented as faster recovery rather than better final continence.

Refer men to pelvic floor training before, not only after, radical prostatectomy.
Tell them it speeds early recovery of continence rather than changing the final outcome.
Do not promise better erectile function from prehabilitation.
Use the waiting time for surgery to deliver it.

Why it matters

It turns the waiting time for surgery into faster early recovery for men most troubled by incontinence.

The statistics, in plain English

Odds ratios around 0.5 to 0.6 mean roughly 40-50% lower odds of incontinence in the early months. The 6-month interval nearly reaches 1.0, so that estimate is less secure. Loss of effect by 12 months is expected because most men regain continence by then regardless.