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Transurethral treatment

The transurethral treatment curriculum includes Hands-on Training, with different models, focusing on the endoscopic management of lower urinary tract conditions, such as LUTS, urethral strictures or non-muscle-invasive bladder cancer.

With training, the goal is to produce a surgeon who is highly competent and confident in performing these procedures; and thereby mitigate the risks of complications. The development of this curriculum is divided into phases.

First phase

The list of procedures to be included in the TUT curriculum was decided based on the answers of a wide group of experts to a survey that included all the diagnostic and therapeutic transurethral procedures recommended by the EAU guidelines, and categorized according to their importance to Urology Residents, to every Urologist and to Dedicated Endourologists.

Second phase

The working group members organized the resultant list of procedures based on their complexity and according to the principles of the SISE program structured curricula. Based on that, the framework of the TUT curriculum was developed:

  • TUT-S1 (basic step): training of basic transurethral skills, encompassing flexible cystoscopy, rigid cystoscopy, bladder biopsies, basic resection loop handling and direct vision internal urethrotomy.
  • TUT-S2p (intermediate step for prostate): training of intermediate skills in transurethral resection of the prostate.
  • TUT-S2b (intermediate step for bladder): training of intermediate skills in transurethral resection of the bladder.
  • TUT-S3p (advanced step for prostate): training of advanced skills in advanced transurethral procedures, such as enucleation of the prostate or vaporization of the prostate.
  • TUT-S3b (advanced step for bladder): training of advanced skills in advanced transurethral procedures, such as en-block resection of bladder tumors or advanced endoscopic bladder imaging.

Third phase

According to the principles of the SISE program structured curricula, for each procedure a cognitive task analysis process was performed, followed by a Delphi consensus involving a wide group of renowned experts in the field, in order to determine the fundamental steps and the metrics of each procedure.

Fourth phase

Based on the resultant metrics for each procedure, the working group members will develop the set of exercises to be included in each step of the curriculum, that will subsequently undergo a validation process by a wide group on experts and trainees, to determine the most adequate benchmarks for each step.

EAU Working Group Lower Urinary Tract Endoscopy

The EAU Lower Urinary Tract Working Group, that includes members of the ESU hands-on training team, of the ESUT, of the YOU, of the EAU Management of non-neurogenic male LUTS guidelines panel and of the EAU Non-muscle-invasive guidelines panel, will be responsible for the development of the Transurethral Treatment (TUT) curriculum.

Chair
Tarik Emre Sener

Members
Tiago Ribeiro de Oliveira
Ben Van Cleynenbreugel
Ioannis Kartalas Goumas
Juan Pablo Caballero
Laurian Dragos
Param Mariappan
Lisa Moris
Luis Osório
Março Paciotti
Sergio Pereira
Davide Perri

Steps

Transurethral treatment - Step 1 (TUTs1)
Transurethral treatment - Step 2 (TUTs2 - TURP/TURBT)
Transurethral Treatment - Step 3 (TUTs3 - HOLEP / REZUM)

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