Perioperative Rehabilitation After Radical Prostatectomy: A Narrative Review

Abstract

Background. Prostate cancer is one of the most frequently diagnosed malignancies in men worldwide. Radical prostatectomy is the standard treatment for localized disease, providing excellent oncological control. However, postoperative complications, including urinary incontinence, erectile dysfunction, impaired physical function, and psychological distress, significantly reduce quality of life. Evidence indicates that perioperative rehabilitation improves functional recovery and facilitates return to daily activities. Aim. To summarize evidence on perioperative rehabilitation after radical prostatectomy, focusing on pelvic floor muscle training, physical exercise, erectile dysfunction management, nutritional optimization, psychological support, and multimodal prehabilitation, and their effects on functional outcomes and quality of life. Materials and Methods. A narrative literature review was conducted using PubMed, Scopus, Web of Science, and Google Scholar. Original studies, systematic reviews, meta-analyses, and international guidelines on perioperative rehabilitation were included. Results. Preoperative pelvic floor muscle training accelerates urinary continence recovery. Multimodal prehabilitation, including exercise, nutritional counseling, and psychological support, improves physical fitness and may reduce postoperative complications. Early mobilization, structured rehabilitation, and individualized erectile dysfunction management enhance functional recovery and support sexual function. Multidisciplinary care and patient education further improve postoperative outcomes. Conclusions. Perioperative rehabilitation should be integral to radical prostatectomy care. Early implementation of evidence-based strategies improves functional recovery and quality of life, while further high-quality randomized controlled trials are needed to establish standardized protocols.