Perioperative mental health needs in urological and genitourinary surgery: a scoping review.

INTRODUCTION

Perioperative psychological distress may affect surgical recovery, yet evidence specific to urological and genitourinary procedures remains fragmented. These procedures can affect urinary control, sexual function, genital integrity, body image, and long-term self-management. This scoping review mapped reported mental health problems, associated risk factors and supportive interventions, and examined their implications for perioperative care pathways.

METHODS

This scoping review was reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews. PubMed, Embase, Web of Science, ScienceDirect, PsycINFO, and CINAHL were searched for English-language studies published from January 2000 to May 2026. Two reviewers independently screened the studies and charted the data, and the findings were synthesized descriptively using evidence mapping.

RESULTS

Forty-four studies were included. Most evidence came from adult oncological populations, and observational designs predominated. The heterogeneous evidence could be organized into a provisional staged pattern comprising preoperative concerns related to uncertainty and fear, early postoperative concerns related to pain, sleep, and device adaptation, and longer-term concerns related to urinary, sexual, body-image, and social adjustment. Longer-term distress was concentrated in selected subgroups and was commonly linked to urinary diversion, incontinence, sexual dysfunction, altered genital anatomy, body-image concerns, social constraints, limited support, self-perceived burden, and prior mental health vulnerability. Reported supportive approaches included prehabilitation, structured education, multidisciplinary or pathway-based care, digital and virtual reality strategies, transcutaneous electrical acupoint stimulation, multimodal analgesia, and opioid stewardship.

DISCUSSION: The available evidence remains heterogeneous and largely observational. These findings identify candidate components for the future development and prospective evaluation of perioperative mental health pathways, including repeated assessment, structured education, family-inclusive support, and referral mechanisms.