Prehabilitation and rehabilitation in patients operated on for bladder cancer
DOI: 10.22591/magyurol.2024.2.szonyim.79
Authors:
Szőnyi Márta dr.1, Fazekas Fruzsina dr.2,
Bíró Krisztina dr.3, Beöthe Tamás dr.2
1Somogy Vármegyei Kaposi Mór Oktató Kórház, Onkológiai Centrum, Kaposvár
(centrumvezető: Lakosi Ferenc dr.)
2Dél-pesti Centrumkórház, Péterfy Sándor Kórház-Rendelőintézet és Manninger Jenő
Országos Traumatológiai Központ, Urológiai Osztály, Budapest (osztályvezető: Buzogány István dr.)
3Országos Onkológiai Központ, Urogenitális Tumorok és Klinikai Farmakológiai Osztály,
„Kemoterápia C” (osztályvezető: Géczi Lajos dr.)
Summary
Endoscopic or radical surgery is an important step in the treatment of malignant bladder tumours. Both preoperative preparation and postoperative care improve surgical outcomes. Good prehabilitation practice prepares the patient physically and psychologically for the surgical insult, thus reducing stress response. The most important elements of prehabilitation are achieving adequate nutrition, smoking cessation, cognitive reinforcement, stress reduction and increasing physical activity. Important outcomes are shorter hospital stay and promoting postoperative recovery. For elderly and frail patients, individualised prehabilitation strategies are of particular importance.
Postoperative rehabilitation aims to restore the highest possible level of physical, social, psychological and professional function for the patient. The cornerstones of rehabilitation are structured exercise, physiotherapy, psychosocial support and restoration of sexual function. In bladder cancer patients’ appropriate rehabilitation programmes have led to significant improvements in physical fitness, daily activity levels and other quality of life indicators, as well as reduced anxiety, fatigue and depression.
Bladder cancer is overrepresented in the elderly, frail, lower socioeconomic status patient and smokers, making prehabilitation and rehabilitation a priority in this patient population.