Endourological Training Using 3D-Printed Bladder Phantoms: Development and Prospective Evaluation.

To create and evaluate a realistic, anatomically accurate, and user-friendly bladder phantom for reproducible endourological training purposes and endoscope mastery. The anatomy of full bladders was mapped from human computed tomography datasets. After a 3D model development process, content evidence and response process evidence (RPE) of the phantom were evaluated using the system usability scale (SUS), 5-point Likert scale questionnaires, and task execution of experienced urologists (U) and endoscopy-naive medical students (MS) in two training sessions (first second). Required validation cohort sizes (1:10) of the evaluating urologists ( = 12) and students ( = 115) were precalculated. Time measurements were recorded. Students were additionally evaluated by a validated global psychomotor assessment score (GPSS). Group comparisons were calculated by the Mann-Whitney test. All tests were two sided with  < 0.05 considered statistically significant. Content evidence was assessed by urologists with an "excellent" SUS score of 89.4 ± 5.9 and an average "agreement" of ≥4 pts in the Likert scale questionnaires. RPE was assessed by intra- and intergroup time comparison for the execution of endoscopic tasks (cystoscopy [CY], guidewire insertion, and tumor biopsy). For CY, U: first 17.6 ± 4.4 seconds second 12.4 ± 2.0 seconds,  = 0.002; MS: first 56.6 ± 28.2 seconds second 28.6 ± 14.7 seconds,  < 0.001; U MS: first U 17.6 ± 4.4 seconds first MS 56.6 ± 28.2 seconds,  < 0.001, second U 12.4 ± 2.0 seconds second MS 28.6 ± 14.7 seconds,  < 0.001. Significant time differences were documented for all tasks and sessions ( < 0.001). Additionally, significant GPSS differences were recorded between the sessions (GPSS: first 20.4 ± 5.1 pts second 24.7 ± 4.0 pts,  < 0.001). Our low-fidelity 3D-printed bladder, called BladCap, is an easy-to-assemble, inexpensive, and robust phantom. We present data, which establish construct validity to support use as a clinical training device.