Abstract

Objective: In this study, we aim to determine the preferred treatment modalities in upper urinary system stone disease throughout Turkey in 2008.

Materials and methods: In our country, all healthcare providers who are subjected to Social Security Institution send their medical claims digitally to a data pool controlled by Social Security Institution which covers 70% of the population. Data sets were analyzed by national health authorities to facilitate policy making. In this study, we have analyzed the treatment approaches to urinary stone disease for a certain period of time (10 months) in 2008 by using selected data sets from this warehouse. To estimate the countrywide figures within a year, the obtained data is projected for the whole population. The quantitative data on open surgery, percutaneous nephrolithotomy (PCNL), ureteroscopy (URS) and shock wave lithotripsy (ESWL) in the treatment of upper urinary system stone disease have been estimated. The figures represent the number of procedures rather than the number of patients.

Results: Within a year 751,844 urological interventions were performed, 6.2% of which were related to urinary system stone disease. Totally 87,302 patients underwent surgical treatment or ESWL therapy within a year because of upper urinary system stone disease. Surgical treatment and ESWL was applied for 46,619 (53.3%) and 40,683 (46.7%) patients, respectively. Among management modalities applied for upper urinary system stone disease, open renal (11%) or ureteral surgery (6%), PCNL (17%), and ureterorenoscopic lithotripsy (66%) have been employed at various incidences. 

Conclusion: Procedures performed for the treatment of urinary system stone disease in Turkey were relatively high among all urological procedures. The percentage of ESWL in all upper urinary stone treatment is almost 50%. Open kidney surgery is still a common procedure with a rate of 39%. As is the recent trend in the reported data from other countries URS is the primary choice of treatment for ureteral stones in Turkey.