Laser enucleation of the prostate (LEP) has become a standard treatment for benign prostatic obstruction, yet its adoption is limited by a steep learning curve and a lack of validated training models. This study aimed to evaluate the face and content validity of a bench-top simulator specifically developed for LEP training within the framework of the European School of Urology (ESU) Lower Urinary Tract Endoscopy Working Group.
Fourteen expert endourologists assessed the simulator during the European Urology Residents Education Programme (EUREP) 2025. Face and content validity were evaluated using 4-point Likert questionnaires, structured using the ESU validation framework. Descriptive statistics and content validity indices (I-CVI, S-CVI/Ave, S-CVI/UA) were calculated to assess agreement across anatomical, procedural, and educational domains.
Face validity scores were high across all items (mean 3.57-3.86; ≥90% agreement). The overall S-CVI/Ave was 0.85 and S-CVI/UA 0.47. Domain-specific analysis showed strong content validity for procedural steps (S-CVI/Ave = 0.89) and educational/global domains (0.95), moderate validity for essential anatomy (0.81), and lower ratings for intraoperative conditions (0.69), primarily due to the absence of bleeding simulation. When restricted to core domains (procedural + educational), S-CVI/Ave improved to 0.91.
The simulator demonstrated strong face and content validity. Expert ratings indicated favorable perceptions of its realism, procedural similarity, and educational utility. These findings suggest that the simulator may be a useful component of a structured transurethral procedural training curriculum, although further construct validation is needed.
World journal of urology. 2026 May 06*** epublish ***
Tarik Emre Sener, Tiago Ribeiro de Oliveira, Engin Denizhan Demirkiran, Davide Perri, Sergio Pereira, Juan Pablo Caballero, Luis Osorio, Ioannis Goumas Kartalas, Marijn Goossens, Bernhard Schoensee, Laurian Dragos, Domenico Veneziano, Chandra Shekhar Biyani, Bhaskar Somani, Evangelos Liatsikos
Department of Urology, School of Medicine, Marmara University, Istanbul, Türkiye. ., Department of Urology, Armed Forces Hospital, Lisbon, Portugal., Department of Urology, School of Medicine, Zonguldak Bülent Ecevit University, Zonguldak, Türkiye, Turkey., Department of Urology, Azienda Socio Sanitaria Territoriale Lariana, Como, Italy., Department of Urology, Lisbon Medical Academic Centre, Lisbon, Portugal., Department of Urology, University General Hospital, Alicante, Spain., Department of Urology, Lusíadas Porto Hospital, Porto, Portugal., Department of Urology, Istituto Clinico Beato Matteo, Vigevano, Italy., Department of Urology, OLV Hospital Aalst, Aalst, Belgium., Department of Urology, Urologie Berlin Adlershof, Berlin, Germany., Department of Urology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK., Department of Urology, Smith Institute for Urology, Northwell Health, New York, USA., Department of Urology, St James's University Hospital, Leeds, UK., Department of Urology, University Hospital Southampton NHS Foundation Trust, Southampton, UK., Department of Urology, University Hospital Patras, Patras, Greece.