Prehabilitation, a combination of exercise, nutrition, and mental health preparation before prostate surgery, appears feasible and acceptable to patients across multiple delivery formats, according to a 2026 scoping review of 13 studies. Pelvic floor muscle training was the most commonly used component in 11 studies. However, significant differences in how studies measured results mean researchers cannot yet definitively say which specific preparation approach produces the best recovery outcomes, and high-quality studies are needed to establish standardized protocols.
Before undergoing prostate cancer surgery, patients can prepare their bodies and minds through a process called prehabilitation, a combination of exercise, nutrition, and mental health support. According to Gram Research analysis, a new review of 13 studies from around the world found that prehabilitation programs help patients recover better after surgery. These preparation programs come in different formats: some use phone calls and booklets, others use smartphone apps, and some happen at hospitals in person. The most common preparation technique is pelvic floor muscle training, which helps with bladder control after surgery. While the research shows these programs are doable and patients like them, scientists say we need more high-quality studies to figure out exactly which approaches work best.
Key Statistics
A 2026 scoping review of 13 studies from eight countries found that pelvic floor muscle training was included in 11 of the studies examining prehabilitation for prostate cancer surgery patients.
According to a 2026 analysis of prehabilitation programs for prostate surgery, three distinct delivery formats were identified: digital remote interventions via apps (4 studies), non-digital remote interventions via booklets and phone (4 studies), and in-person hospital-based programs (5 studies).
Gram Research analysis of 13 prehabilitation studies found that programs addressed six outcome domains: urinary continence and sexual function, physical function, surgical complications, psychological status, quality of life, and nutritional status, though measurement methods varied significantly across studies.
A 2026 scoping review examining 13 prehabilitation studies for prostate surgery patients concluded that while programs appear feasible and acceptable, considerable heterogeneity in intervention content and outcome measurement prevents definitive conclusions about which approach works best.
The Quick Take
- What they studied: How well different preparation programs work for men getting prostate cancer surgery, and what types of exercises, nutrition, and mental health support help them recover faster.
- Who participated: Researchers looked at 13 different studies from 8 countries involving men scheduled for prostate removal surgery. The studies included different types of research designs, from carefully controlled experiments to real-world observations.
- Key finding: Prehabilitation programs are feasible and patients accept them well, with pelvic floor muscle training being the most common component used in 11 out of 13 studies. However, the studies measured results so differently that it’s hard to say which approach works best.
- What it means for you: If you’re facing prostate surgery, talking to your doctor about preparation programs, whether through apps, phone support, or in-person classes, may help you recover better. However, ask your surgical team which specific program they recommend, since research hasn’t yet proven one approach is clearly superior to others.
The Research Details
This was a scoping review, which means researchers systematically searched through nine different medical databases to find all existing studies about preparation programs for prostate surgery patients. They looked for studies published from the beginning of medical records through December 2025. The researchers followed strict guidelines called PRISMA-ScR to make sure they did this search fairly and completely.
They found 13 studies from eight different countries that met their criteria. These studies used different research methods: some were randomized controlled trials (where patients are randomly assigned to different groups), some were quasi-experimental (similar to controlled trials but not perfectly random), and some were prospective cohort studies (where researchers follow patients over time). This mix of study types gave them a broad picture of what’s being done in real hospitals and clinics around the world.
The researchers then organized all the information about what each program included, how it was delivered, and what results were measured. They looked for patterns in what worked and what didn’t, while also noting where studies disagreed with each other.
A scoping review is the right tool for this question because prehabilitation for prostate surgery is still relatively new, and doctors are trying different approaches. Rather than combining numbers from studies (which would be impossible since they measured such different things), this review maps out the landscape of what’s being tried. This helps doctors and patients understand their options and shows researchers where they need to do better studies. It’s like taking a survey of the neighborhood before deciding where to build a new house.
This review was well-conducted and followed international standards for how to do scoping reviews. The researchers searched nine different databases, which is thorough. However, the studies they found had major differences in how they were designed and what they measured, which limits how much we can trust general conclusions. The review itself is high-quality, but it reveals that the individual studies it examined need improvement. Think of it as a well-done inventory of a messy warehouse, the inventory is accurate, but the warehouse contents are disorganized.
What the Results Show
The review identified three main ways hospitals deliver prehabilitation programs: through smartphone apps and digital tools (4 studies), through booklets and phone calls (4 studies), and through in-person classes at hospitals (5 studies). All three approaches appeared to be acceptable to patients and feasible to run, meaning they could actually be done in real hospitals without major problems.
Pelvic floor muscle training, exercises that strengthen the muscles controlling urination, was by far the most common component, appearing in 11 of the 13 studies. This makes sense because bladder control problems are one of the biggest concerns after prostate surgery. Beyond this, programs also included aerobic exercise (like walking or cycling), strength training, nutritional counseling, psychological support, and education about what to expect.
The studies measured six different types of outcomes: how well patients controlled their bladder and sexual function after surgery, physical fitness, surgical complications, mental health, quality of life, and nutritional status. However, each study used different measurement tools and methods, making it nearly impossible to compare results across studies. One study might measure bladder control one way, while another study used a completely different measurement.
The review found that prehabilitation programs were generally well-received by patients, with good participation rates across all delivery formats. Digital programs using apps showed promise for reaching patients who couldn’t attend in-person sessions. Non-digital remote programs using phone support and booklets were simpler to set up but required more staff time. In-person hospital programs allowed for personalized instruction but required patients to travel to the hospital multiple times.
Interestingly, the combination of multiple intervention types (multimodal programs) was more common than single-component programs, suggesting that doctors believe patients benefit from a comprehensive approach addressing exercise, nutrition, and mental health together rather than focusing on just one area.
Prehabilitation has shown promise in other types of cancer surgery and major operations, but this review reveals that prostate surgery prehabilitation is still in early stages compared to other surgical areas. Previous research in other cancers has shown that preparing patients before surgery can reduce complications and speed recovery, but the prostate surgery field hasn’t yet standardized what ‘best practice’ prehabilitation looks like. This review essentially says: ‘We know it can work, but we need to figure out the best way to do it.’
The biggest limitation is that the 13 studies were so different from each other that the researchers couldn’t combine their results statistically. Some studies were small (just a handful of patients), while others were larger. Some measured results immediately after surgery, while others followed patients for months. Some programs lasted two weeks, others lasted eight weeks. This variation makes it impossible to say definitively which approach works best or how much improvement patients can expect. Additionally, most studies came from high-income countries, so results might not apply equally to all populations. Finally, many studies had methodological weaknesses that could affect how much we should trust their findings.
The Bottom Line
If you’re scheduled for prostate surgery, discuss prehabilitation options with your surgical team. Evidence suggests that participating in some form of preparation program, whether digital, phone-based, or in-person, is likely beneficial and safe. Pelvic floor muscle training should be a priority component. Start as soon as possible before your surgery date. Confidence level: Moderate. The evidence shows programs are feasible and acceptable, but we don’t yet have definitive proof of which specific approach produces the best outcomes.
This information is most relevant for men scheduled for radical prostatectomy (complete prostate removal) for cancer treatment. It’s also potentially useful for urologists, surgical teams, and cancer centers planning preoperative programs. Men with severe mobility limitations or those unable to commit time to preparation should discuss modified options with their doctors. This research doesn’t apply to men having other types of prostate procedures or treatments.
Most programs in the studies lasted 2-8 weeks before surgery. Benefits in terms of faster recovery and fewer complications would likely appear in the weeks and months immediately following surgery. Some benefits, like improved quality of life and sexual function, may take 3-6 months or longer to fully manifest. Bladder control improvements often continue to develop over 6-12 months after surgery.
Frequently Asked Questions
What is prehabilitation and how does it help before prostate surgery?
Prehabilitation is preparing your body and mind before surgery through exercise, nutrition, and mental health support. Research shows it may help you recover faster, reduce complications, and improve outcomes like bladder control and quality of life after prostate cancer surgery.
What exercises should I do to prepare for prostate surgery?
Pelvic floor muscle exercises (Kegels) are the most important, used in 11 of 13 studies reviewed. Most programs also include aerobic exercise like walking or cycling and strength training. Your surgical team should provide specific recommendations based on your fitness level.
Can I do prehabilitation at home or do I need to go to the hospital?
Both work. Studies show three effective formats: smartphone apps you use at home, phone-based programs with booklets, and in-person hospital classes. Choose whichever fits your schedule and preferences, all three approaches showed similar acceptance by patients.
How long before surgery should I start prehabilitation?
Most programs in the research lasted 2-8 weeks before surgery. Starting as soon as possible after your surgery date is scheduled gives you more time to build fitness and strength, which may improve your recovery.
Will prehabilitation definitely prevent bladder control problems after prostate surgery?
Prehabilitation may reduce bladder control problems, but the current research cannot guarantee prevention because studies measured results differently. Talk to your surgeon about realistic expectations and what prehabilitation can and cannot do for your specific situation.
Want to Apply This Research?
- Track daily pelvic floor muscle exercises (Kegel exercises) by logging completion each day, aiming for the prescribed number of repetitions. Record any changes in urinary symptoms or exercise tolerance as you progress through your prehabilitation program.
- Use the app to set reminders for daily pelvic floor exercises at consistent times (morning and evening work well). Follow guided video demonstrations if available. Log your aerobic activity (walking, cycling) and note any dietary changes you’re making. Share progress reports with your surgical team.
- Create a baseline measurement before starting prehabilitation (current fitness level, urinary symptoms if any, quality of life rating). Track these same measures weekly throughout your preparation period and then at regular intervals after surgery (1 week, 4 weeks, 8 weeks, 3 months, 6 months post-op) to monitor recovery progress and identify any complications early.
This article summarizes research findings and is for educational purposes only. It does not replace professional medical advice. Before starting any prehabilitation program or making changes to your health routine, consult with your urologist or surgical team. Individual results vary, and what works for one person may not work for another. If you experience pain, unusual symptoms, or complications, seek immediate medical attention. This review identified that current research has methodological limitations, so discuss with your healthcare provider which specific prehabilitation approach is best for your individual situation.
This research translation is published by Gram Research, the science division of Gram, an AI-powered nutrition tracking app.
