A paradigm shift in urology training: Laser endoscopic enucleation of the prostate may be easier than transurethral resection of the prostate in the learning curve of urology residents.

Background: Comparative studies on the training of endoscopic enucleation of the prostate (EEP) and transurethral resection of the prostate (TURP) are scarce. EEP's challenging learning curve has limited its adoption to experienced urologists. Understanding its learning dynamics during residency is essential for optimizing training. This study compares the learning curves of EEP and TURP among urology residents. Materials and methods: retrospective analysis of 129 benign prostatic hyperplasia patients who underwent TURP ( Results: EEP had a higher resection speed (0.47 vs. 0.32 g/min) and resection ratio (63% vs. 41%) than TURP. Proficiency was reached faster with EEP (5-7 cases) than with TURP (8-12 cases). Learning curves for EEP were more consistent, whereas TURP showed greater variability. Thulium laser enucleation of the prostate had shorter operative times than holmium laser enucleation of the prostate (91 vs. 140 min). There were no significant differences in complications or urinary incontinence. Limitations were the retrospective design, small number of cases per resident, and lack of detailed staff intervention data. Conclusions: EEP is not more difficult to learn than TURP and may offer a more predictable learning curve. Findings support incorporating EEP into residency training programs, even for residents without TURP experience.