Feasibility and user perception of a hydrogel-based platform for introductory LEP training

Mitchell Hoestermann^*, Regan Merkin, Scott O. Quarrier, Ashley Li, Yadong Lu, Rajat Kumar Jain, Jean Joseph, Thomas Osinski
Department of Urology, University of Rochester Medical Center, 601 Elmwood Ave, Rochester, NY, USA
* Corresponding Author: Mitchell Hoestermann. Email: email
(This article belongs to the Special Issue: Prostatic Enucleation: Current Evidence and Contemporary Practice)

Canadian Journal of Urology https://doi.org/10.32604/cju.2026.078662

Received 05 January 2026; Accepted 07 July 2026; Published online 29 July 2026

Download PDF

Abstract

Background: Laser enucleation of the prostate (LEP) remains underutilized despite strong guideline support, partly because of its steep learning curve and limited access to realistic simulation tools. We developed a hydrogel model incorporating a penis, prostate, distensible bladder, and pelvis, and conducted a pilot feasibility study to evaluate usability and face validity during a hands-on workshop. Methods: This prospective, single-session pilot study was conducted during the 2024 Northeastern Section of the American Urological Association (NSAUA) meeting. Nine LEP novices (two attendings, one fellow, six residents) each performed enucleation of a 75 g hydrogel prostate using a thulium fiber laser under expert mentorship. Feasibility was defined as the ability to complete the enucleation using standard instrumentation. Face validity and usability were assessed using post-workshop 5-point Likert questionnaires. Exploratory performance metrics (laser time, tissue weight, energy use) were collected to demonstrate procedural feasibility but not to evaluate competency. Results: All participants completed the simulated enucleation. Face validity ratings exceeded the predefined threshold (overall mean 4.26), and 100% agreed that the model contained all relevant anatomy. Participants rated the difficulty as appropriate and reported that it realistically supported scope manipulation. Exploratory performance data showed wide variability among novices but confirmed that full enucleation was achievable. Conclusions: This hydrogel model demonstrates feasibility and strong face validity as an introductory LEP training platform. Its low consumable cost, anatomic realism, and compatibility with standard LEP equipment make it well-suited for workshops and residency curricula. Further studies will evaluate expert-based content validity and construct validity.