Prehabilitation in gynecological surgery? What do gynecologists know and need to know

• Published in: Archives of gynecology and obstetrics Vol. 297; no. 1; pp. 27 - 31
• Main Authors: Ebner, Florian, Schulz, Sebastian Viktor Waldemar, de Gregorio, Amelie, Volz, Sophia, Steinacker, Jürgen Michael, Janni, Wolfgang, Otto, Stephanie
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 2018; Springer Nature B.V
• Subjects: Elective Surgical Procedures; Endocrinology; Female; Gynecologic Surgical Procedures; Gynecology; Health Knowledge, Attitudes, Practice; Human Genetics; Humans; Literature reviews; Medicine; Medicine & Public Health; Obstetrics/Perinatology/Midwifery; Outcome Assessment (Health Care); Physicians; Postoperative Care - rehabilitation; Preoperative Care - methods; Review; Exercise; Prehabilitation; Gynecology; Surgery; PFMT; Recovery; Obstetrics; ERAS
• ISSN: 0932-0067; 1432-0711
• DOI: 10.1007/s00404-017-4565-8

Background/aims
The self-quantification of patients is extending beyond the daily routine. More and more patients ask about the ‘optimal’ physical condition for an elective surgery. As the hysterectomy is one of the most common surgeries, a literature review was conducted to answer the question for the optimal surgical self preparation (prehabilitation).
Methods
A literature review with the search terms ‘physical activity’ or ‘physical exercise’ or ‘sport’ or ‘prehabilitation’ and ‘hysterectomy’ was conducted in the National Library of Medicine database (PubMed) and Web of science. The search was limited to English or German language and publishing date after 2000. Two independent researchers (SO, FE) reviewed the results and excluded irrelevant or double articles.
Results
After excluding irrelevant articles, five publications were left for review. One article published a study protocol and one a case report. Three articles reported study results. The numbers of patients reported are low. Prehabilitation programs differ depending on the primary study outcome. There seems to be a benefit for earlier discharge if patients undergo prehabilitation.
Conclusion
Unlike other disciplines where prehabilitation has been studied, a gynecologic viewpoint still needs establishing and further studies are needed to clarify the benefit for the patients.