Three-dimensional (3D) printing technologies are increasingly applied in medicine, enabling precise reproduction of complex anatomical structures. In urology, training for advanced endoscopic procedures such as retrograde intrarenal surgery (RIRS) requires a high level of accuracy and manual skill, often hindered by limited access to real surgical cases. Anatomically accurate 3D-printed models offer a safe and effective solution for skill acquisition without involving patients. Objective: To assess the feasibility and effectiveness of using 3D-printed anatomical models as simulators for training in retrograde intrarenal surgery.

Patient CT scans were used to generate 3D reconstructions of the upper urinary tract. Anatomically accurate models of kidneys, pelvicalyceal systems, and ureters were printed using composite materials. Simulated stone fragments—both artificial and real—were placed in the models. Training sessions were conducted using flexible ureterorenoscopes and a thulium fiber laser. The system was evaluated under ex vivo conditions. In a pilot educational setting, 30 trainees (young urologists and residents) were divided into two groups; one group trained on the simulator for 1 hour daily over one week. Surgical performance and confidence were evaluated via timing and self-assessment questionnaires.

The 3D-printed simulator was successfully used to replicate key steps of RIRS. For many young physicians, it served as the first hands-on exposure to the procedure. Comparative analysis showed that participants who trained on the model achieved significantly greater confidence, smoother instrument handling, and higher procedural efficiency. Specifically, the average stone fragmentation time for 10 mm calculi was 30 minutes in the trained group versus 45 minutes in the untrained group (p < 0.05). Ex vivo tests confirmed the anatomical fidelity and practical utility of the model, including during use of real calculi and laser lithotripsy.

3D-printed anatomical simulators offer a valuable and reproducible platform for training in retrograde intrarenal surgery. These models allow young urologists to develop critical skills in a risk-free environment, shorten the learning curve, and potentially reduce complications in clinical practice. The developed simulator demonstrates strong potential for integration into structured urological education and certification programs.