Current utility of artificial intelligence in benign prostate surgery: a review of literature on behalf of the EAU section of endourology.

OBJECTIVE

Artificial intelligence (AI) and its subsects, such as machine learning (ML) and virtual reality (VR) are subject to great interest from the urological community, and gaining space in the surgical treatment of benign prostatic hyperplasia (BPH). With this review, we aim to explore the current applications and their impact in BPH surgery.

MATERIALS AND

METHODS

A literature review was performed according to the PRISMA guidelines, searching online databases for eligible studies on the role of AI and subsets in different BPH surgery, including enucleation, resection and vaporisation of the prostate using various energy sources. This review was registered in PROSPERO (CRD42024606550).

RESULTS

The search and screening process retrieved 19 eligible studies, that were separated in two major categories. The first, on real-life applications, included 6 studies on ML prediction of postoperative outcomes and complications, with special regards to intraoperative bleeding, and the use of telemetry. The second group included 13 studies on the role of VR for training. The findings consistently reported on the efficacy of VR simulators in improving efficiency and reporting better performance for the most expert participants. VR fidelity and safety was unanimously rated as good.

CONCLUSIONS

Our review reveals that advanced techniques like ML and VR simulators improve BPH treatment, surgical training, and procedural safety. VR-based training enhances performance and reduces complications, effectively differentiating trainee expertise levels. As VR technology evolves, it is set to become integral to urological education, boosting outcomes and patient safety.