Pelvic Health and Physical Therapy to Improve Lives of Prostate Cancer Patients

This is a prospective, randomized, non-blinded, research study undergoing robotic-assisted laparoscopic prostatectomy at the University of Missouri/Ellis Fischel Hospital. Participants will be randomized in a 1:1 fashion. Data also will be tracked on those who are post-operatively stratified by cancer grade and addition of radiation therapy (XRT) as XRT after surgery is dependent on participant pathology therefore would not be able to be determined in advance.

The study will be broken up into four phases, as described in detail below:

Phase 1:

• Urologic oncology team will consist of a urologic oncologist/surgeon, urologic nurse, and oncology nurse navigator practicing in a specialty oncology hospital which is part of a large regional hospital network in the Midwest section of the United States. A pelvic health physical therapist will be an additional member of this team practicing primarily in outpatient based clinics affiliated with a with the same large regional hospital network.
• Enrollment will be offered during first hospital visit with urologic oncology team confirming diagnosis of prostate cancer in and decision for robotic radical prostatectomy. Enrollment goal will be at least 40 men but caps at 100.
• The capture of participants for enrollment will be limited to a 12 month period.
• Consent is obtained and the participant is enrolled
• At the time of enrollment, all participants will have baseline measurements taken to obtain baseline physical assessment, complete baseline quality of life questionnaires, and receive education on exercises to begin as prehabilitation protocol prior to surgical intervention.

o Baseline questionnaires include:

1. International Prostate Symptom Score (IPSS)
2. International Index of Erectile Function (IIEF)
3. National Institute of Health Chronic Prostatitis Symptom Index (NIH-CPSI)
4. Pain Visual Analog Scale (VAS)
5. Beck's Depression Index (BDI)
6. Bristol Stool Form Scale (BSFS)

• After obtaining written consent, subjects will be randomized to receive post-operative pelvic health physical therapy (Rehab group) or no post-operative intervention (control).
• Both groups will be given pre-operative prehabilitative exercise program and education of continence behavioral training.
• At the time of enrollment, all participants the will receive the same educational packet and home exercise program education from the urologic oncology team.