Endoscopic simulators in benign prostatic hyperplasia surgical training: a scoping review.

Abstract

Introduction: Simulation-based training (SBT) is designed to mimic real-life surgeries and help surgeons develop skills they can transfer to the operating room in a risk-free environment. With the emergence of numerous surgical therapies for benign prostatic hyperplasia (BPH), a need has developed for new learning tools in addition to standard clinical exposure. In this scoping review, we aimed to provide a comprehensive and updated outline of available endoscopic BPH simulators.

Methods: We conducted a scoping review in accordance with the Joanna Briggs Institute methodology. References were identified through searches of MEDLINE, Embase, Web of Science, and CINAHL from inception to March 2025. A search of Google Scholar was also conducted to identify grey literature references. Keywords searched included those related to simulators, medical education and BPH surgeries. Studies included were original articles on simulators used for endoscopic BPH surgery. Data pertaining to simulator validity, acceptability and feasibility were collected.

Results: Forty-five records were included, with one reference consisting of a multi-modality curriculum used for simulating two BPH surgeries. Thirty studies assessed transurethral resection of prostate (TURP) simulators, six studies for GreenLight laser prostatectomy (PVP), eight studies for anatomic endoscopic enucleation of the prostate (AEEP) procedures, and two articles for Urolift. For TURP simulators, four bench-top models, nine virtual reality simulators, two food-based phantoms, and one porcine model were identified. For HoLEP simulators, three bench-top models, two VR simulators, and one human cadaver prostate model were assessed. Furthermore, virtual simulation was the only modality tested for PVP (two simulators), ThuLEP (one simulator), and Urolift (one simulator).

Conclusion: Our results suggest a need for developing SBT models other than TURP. Future iterations of BPH surgical models should be evaluated using the modern definition of validity with the goal of integration into surgical curriculum.