Simulation models and training curricula for training in endoscopic enucleation of the prostate: A systematic review from ESUT.

The introduction of endoscopic anatomical enucleation of the prostate created a new educational field. We investigated the current literature for simulators, phantoms, and other training models that could be used as a tool for teaching urologists alone or within the boundaries of a course or a curriculum. A systematic review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses statement and the European Association of Urology Guidelines office's recommendations for conducting systematic reviews. Seven out of 51 studies met our inclusion criteria and are presented in the current review. The VirtaMed UroSim HoLEP (Holmium Laser Enucleation of the Prostate) Simulator achieved excellent scores for face, content, and construct validity, and participants agreed that it could be used for training. In addition, this simulator offers the opportunity for morcellation training. The Kansai University model for HoLEP does not support morcellation simulation and has only demonstrated face and content validity. The CyberSim (Quanta System, Solbiate Olona, VA, Italy) has not been yet evaluated, but it seems that it can be used for training without tutoring. Only one training curriculum was revealed from the search. The Holmium User Group-Mentorship Program has been proposed since 2005 for training urologists for HoLEP. Simulators and courses or curricula based on a simulator could be valuable learning and training tools. The existent models seem efficient but have not been widely evaluated and accepted yet. It seems that the training field for transurethral enucleation of the prostate will be rapidly developed soon.