Rethinking the term “gold standard” in benign prostate surgery: Reflections from the EAU Endourology Research Group

The term “gold standard” is widely used in benign prostatic obstruction (BPO) surgery to describe established procedures such as transurethral resection of the prostate (TURP) and, more recently, holmium laser enucleation of the prostate (HoLEP). This article argues that the term no longer reflects contemporary practice, where treatment should be individualised according to patient characteristics, priorities, and surgical expertise. Describing a single procedure as the gold standard risks oversimplifying decision-making and overlooking the growing range of effective evidence-based options. More precise terms, such as “preferred treatment” or “reference standard” in a defined clinical context, better reflect modern guideline-based care and support shared decision-making.