Research Protocol: Prehabilitation for Holmium Laser Enucleation of the Prostate (HoLEP)

Surgery causes a physiological and psychological stress response which can lead to a decline in functional capacity (1). The adoption of prehabilitation into existing pathways can improve postoperative outcomes. HoLEP (Holmium laser enucleation of the prostate) is a minimally invasive surgical treatment for men with benign prostatic hyperplasia. We aim to assess the feasibility of providing multimodal prehabilitation to patients with an ASA score of 2 or more. The prehabilitation interventions include supervised cardiopulmonary exercise, muscle conditioning, dietary/lifestyle advice and exploration of psychosocial needs. Patients will also receive a medication review by a specialist pharmacist. Compliance is to be assessed with a phonecall 2 weeks into the program and 6 weeks post procedure. Viability of the project will be determined by the ability of the organisation to deliver and sustain the program. The data to be collected will include project costs, time spent, patient satisfaction, length of stay, early and later surgical complications and daycase rate. This project will assess feasibility of perioperative optimisation programmes for non-oncology surgical pathways for maximal patient benefit.