title: The case study in the applicability of the improvements in the treatment of urinary system stone diseases in Anatolia: the last ten years with the sample of Western Black Sea region.
abstract: OBJECTIVE
  The prevalence of stone diseases is high in Turkey. Thanks to the technological improvements and to the increase in the number of qualified and experienced specialists in the last thirty years, there has been an increase in the application of minimally invasive methods in the stone disease surgery. This study, with a sample survey of Western Black Sea region, aims at revealing the changes and improvements in the treatment of stone diseases in different centers in Anatolia within the last ten years.
  
  
  METHODS
  Six centers in 4 of the provinces of the Western Black Sea Region were selected and the patients' files were retrospectively analyzed. The treatment methods that were recommended for and/or applied to the patients diagnosed with urinary stone diseases were recorded by years. The urinary stone diseases were divided into three separate groups; kidney, ureters and bladder. Treatment options were recorded into categories as open surgery, percutaneous nephrolithotripsy, retrograde intrarenal surgery, semirigid ureterorenoscopy, flexible ureterorenoscopy, and ESWL.
  
  
  RESULTS
  A total of 26044 patients with stone diseases have been treated in the above-mentioned centers for the last 10 years. The distributions of the stone diseases in relation to their localization were as follows: - kidney stones: 9040 (34.7%), ureter stones: 15264 (58.6%), and bladder stones: 1740 (6.7%). As for the distribution of the treatment in relation to the treatment methods, it was seen that open surgery for 1032 (4%) patients, endoscopic surgery for 15038 (58%) patients, and ESWL for 9974 (38%) patients had been applied. While URS and PCNL are currently the commonly used treatment methods in the Western Black Sea Region, RIRS has begun to be used in a limited number of patients for the last 3 years.
  
  
  CONCLUSIONS
  Though being a little late, the advances in endrourology offer practical applications in the Western Black Sea region as well. Although this study suggests implications for the evaluating of the periphery outcomes of the improvements in stone disease treatments, for the planning of training schemes, and for equipment planning, further research based on more data from more centers is needed to have a nation-wide perspective.
authors.affiliation: Clinic of Urology, Private Kastamonu Anatolia Hospital, Kastamonu, Turkey.
authors.forename: Sadi
authors.initials: S
authors.lastname: Turkan
authors.affiliation: Clinic of Urology, Samsun Training and Research Hospital, Samsun, Turkey.
authors.forename: Lokman
authors.initials: L
authors.lastname: İrkılata
authors.affiliation: Clinic of Urology, Private İsfendiyar Anadolu Hospital, Kastamonu, Turkey.
authors.forename: Ozan
authors.initials: O
authors.lastname: Ekmekçioğlu
authors.affiliation: Clinic of Urology, Münif İslamoğlu State Hospital, Kastamonu, Turkey.
authors.forename: Halil Lütfi
authors.initials: HL
authors.lastname: Canat
authors.affiliation: Clinic of Urology, Private Karatekin Hospital, Çankırı, Turkey.
authors.forename: Cem
authors.initials: C
authors.lastname: Dilmen
authors.affiliation: Clinic of Urology, Atatürk State Hospital, Sinop, Turkey.
authors.forename: Muharrem
authors.initials: M
authors.lastname: Özkaya
keywords: Endoscopy; stone disease; treatment; urinary tract