- Design
- Single-centre randomised controlled trial
- Population
- 95 men undergoing robotic-assisted radical prostatectomy
- Primary outcome
- Change in EORTC QLQ-C30 global health status at 1 month
- Effect
- +15 points (95% CI 7-22); +4.5 points at 6 months
This single-centre randomised trial assigned 100 men scheduled for robotic-assisted radical prostatectomy to four weeks of multimodal prehabilitation — physical and pelvic floor muscle training, nutritional counselling and psychological support — or usual care. Ninety-five were analysed.
One month after surgery, global health status on the EORTC QLQ-C30 was 15 points higher with prehabilitation (95% CI 7-22, on a 0-100 scale). Several quality-of-life domains, mental health and urinary continence (ICIQ-UI SF difference -2.7) were also better. Physical performance and erectile function did not differ.
The global difference narrowed over time, to 4.5 points at six months, but continence and mental health gains persisted. The trial was single-centre and unblinded, as such trials must be.
A four-week window often exists between diagnosis and surgery. Using it for structured pelvic floor training, exercise and support is a low-risk way to improve the early weeks after prostatectomy.
- Offer structured pelvic floor training before robotic prostatectomy, not only after.
- A four-week programme raised one-month global health status by 15 points.
- Continence and mental health benefits persisted to six months.
- Erectile function and physical performance did not change.
- Use the wait between diagnosis and surgery for exercise, nutrition and psychological support.
Why it matters
The early weeks of incontinence and low mood after prostatectomy are what men fear most, and this targets them with time that is usually wasted.
Don't overread it
The overall quality-of-life gain largely faded by six months; it is an early-recovery benefit.
The statistics, in plain English
A 15-point difference on a 100-point quality-of-life scale is clinically meaningful; differences of about 10 points are often regarded as noticeable to patients. By six months the gap was smaller, so the main benefit is in early recovery.
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