Is It Worth the Sweat? Prehabilitation in Uro-oncology: A Mini Review

• Published in: European urology focus 2024-01, Vol.10 (1), p.29-31
• Main Authors: Sigg, Silvan, Zeidler, Kristin, Fankhauser, Christian Daniel
• Format: Article
• Language: English
• Subjects: Prehabilitation; Preoperative exercise; Urological surgical procedures
• ISSN: 2405-4569; 2405-4569
• DOI: 10.1016/j.euf.2023.10.022

Preoperative exercise initiatives might improve short-term functional results and reduce hospital length of stay and the incidence of postoperative complications after uro-oncological surgeries. However, further investigations are warranted. In several surgical specialities, exercise as part of a prehabilitation program enhances recovery. However, for uro-oncological patients, evidence up to 2020 did not demonstrate significant benefits in terms of postoperative complications or hospital length of stay (LOS). We reviewed the literature from 2020 to 2023 and screened 205 reports, of which four full texts were included. Two retrospective cohort studies, despite having potential confounding risks, indicated that preoperative exercise might reduce LOS. One of these studies also suggested a lower likelihood of complications. Present evidence hints at the potential benefits of embedding exercise in prehabilitation for uro-oncological patients, particularly for short-term functional results. However, evidence on a direct effect on postoperative complications and LOS is still inconclusive. Future research should prioritise identification of specific exercises (eg, anaerobic vs aerobic, strength training, endurance, or respiratory exercises) that yield the most cost-effective benefits. Recent studies suggest that exercising before surgery might help people with urological cancers to improve their short-term fitness. More research is needed to see if exercise before surgery shortens hospital stays or reduces complications.