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Addition of a surgery-specific module to a perioperative, telemedicine program for improving functional outcomes after radical prostatectomy: a prospective, multicenter, non-randomized study

Prostate Cancer and Prostatic Diseases (2025)Cite this article

Subjects

Abstract

Background

Digital perioperative programs offer promising solutions to overcome organizational constraints of traditional prehabilitation, potentially improving recovery while reducing healthcare burden and costs. We aimed to assess the impact of adding a surgery-specific module to an optimized digital perioperative program on improving functional outcomes after radical prostatectomy (RP).

Methods

This was a multicentre, prospective, comparative, non-randomized trial including consecutive robot-assisted RP. Intervention was the implementation of the Betty (Better Surgery) coaching program combined with the activation of a RP-specific pre- and rehabilitation module. The primary endpoint was continence recovery, defined as “0 or 1 safety pad per day” at 6 weeks after surgery. Secondary endpoints were mid-term continence, need for postoperative physiotherapy, erectile function, complications, and readmissions.

Results

A total of 177 and 156 RP cases were included in the control and experimental groups. Baseline and pathological variables were statistically comparable between groups. The mean patient age and PSA were 65.3 years and 11 ng/ml, respectively. At 6 weeks after RP, 83.3% of patients following the digital program were continent, as compared with 68.4% in the control group (p = 0.002). The need for postoperative physiotherapy for persistent incontinence was significantly reduced in the digital program group (27.5%, versus 58.8%, p < 0.001). Patients who followed the digital program experienced lower complications although not statistically significant (p = 0.1), unplanned visits (p = 0.025), reoperation rates (p = 0.025), more same-day discharge surgery (p = 0.030), and higher satisfaction (9.4/10 versus 8.3/10, p < 0.001). The main limitation was the absence of randomization.

Conclusions

Besides the benefits provided by the perioperative digital program, the addition of a pre- and rehabilitation module, including surgery-specific content, significantly improved functional recovery after RP and perioperative outcomes.

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Data availability

Data is available on reasonable request from the corresponding author.

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Acknowledgements

Association Française d’Urologie for its support.

Author information

Authors and Affiliations

  1. Urology Department, La Croix du Sud Hospital, Quint Fonsegrives, Nantes, France

    Alessandro Uleri, Benjamin Pradère, Jean-Baptiste Beauval & Guillaume Ploussard

  2. Urology Department, Clinique Urologique Nantes Atlantis, Nantes, France

    Eric Potiron

  3. Urology Department, Hôpitaux du Sud Manche, Avranches, France

    Naoufel Miaadi

  4. Urology Department, Clinique Tivoli, Bordeaux, France

    Gilles Pasticier

  5. Urology Department, Cincinnati, OH, USA

    Alberto Martini

  6. Institut d’Urologie d’Auxerre, Polyclinique Sainte Marguerite, Auxerre, France

    Nordine Deffar

  7. Urology Department, Clinique Saint-Augustin, Bordeaux, France

    Nam-Son Vuong & Jean Rouffilange

  8. Urology Department, CHU de Pointe-à-Pitre, Univ Antilles, Univ Rennes, Inserm, EHESP, Irset (Institut de Recherche en Santé, Environnement et Travail) - UMR_S 1085, Pointe-à-Pitre, France

    Gilles Gourtaud & Laurent Brureau

  9. Methodology and Statistics Department, Digital Médical Hub, Hotel-Dieu Hospital, Paris, France

    Lara Mroueh

  10. Urology Department, Institut Universitaire Cancer, Toulouse, France

    Bernard Malavaud & Guillaume Ploussard

  11. Urology Department, North Hospital, Aix-Marseille University APHM, Marseille, France

    Michaël Baboudjian

  12. Urology Department, HEGP, APHP, Paris, France

    Charles Dariane

  13. Urology Department, CHU Henri Mondor, APHP, Créteil, France

    Alexandre de la Taille

Authors
  1. Alessandro Uleri
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  2. Eric Potiron
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  11. Bernard Malavaud
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  15. Laurent Brureau
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  16. Guillaume Ploussard
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  18. Alexandre de la Taille
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Contributions

AU: Project development, data collection, data analysis, and manuscript drafting; EP: data collection, critical revision of the manuscript; NM: data collection, critical revision of the manuscript; GP: data collection, critical revision of the manuscript; AM: data collection, critical revision of the manuscript; ND: data collection, critical revision of the manuscript; NSV: data collection, critical revision of the manuscript; GG: data collection, critical revision of the manuscript; BP: data collection, critical revision of the manuscript; LM: data collection, critical revision of the manuscript; BM: data collection, critical revision of the manuscript; MB: data collection, critical revision of the manuscript; JBB: data collection, critical revision of the manuscript; JR: data collection, critical revision of the manuscript; LB: data collection, critical revision of the manuscript; GP: project development, critical revision of the manuscript; CD: project development, critical revision of the manuscript; ADLT: project development, critical revision of the manuscript.

Corresponding author

Correspondence to Alessandro Uleri.

Ethics declarations

Competing interests

Jean-Baptiste Beauval and Guillaume Ploussard have ownership in AIMED2 company.

Ethical approval

This study was approved by the local ethics committee of the Croix du Sud hospital and was conducted in line with the principles of the Declaration of Helsinki and nformed consent have been obtained.

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Uleri, A., Potiron, E., Miaadi, N. et al. Addition of a surgery-specific module to a perioperative, telemedicine program for improving functional outcomes after radical prostatectomy: a prospective, multicenter, non-randomized study. Prostate Cancer Prostatic Dis (2025). https://doi.org/10.1038/s41391-025-01026-y

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