FREQUENCY OF ENDOUROLOGICAL PROCEDURES AND APPLICATION OF NEW TECHNOLOGIES IN TURKEY: RESULTS OF AN QUESTIONNAIRE-BASED STUDY

Abstract

Abstract

Introduction: While deciding on the method of treatment for urinary system stone disease and BPH,

patient and disease characteristics as well as surgeons’ individual preferences play a major role. In this study

the interests of urologists and the subjects they need to be trained on besides their preferences on treatment of

BPH and urinary system stones and the frequency of using new technologies are investigated.

Materials and Methods: In this questionnaire-based study performed between September 2003-May 2004

question forms were handed or posted or faxed. Overall in Turkey, 336 questionnaires were assessed. Results

were evaluated separately according to the geographical region in which urologists had been working, their

speciality durations, the institution they had obtained their speciality and the one they were already working

as staff.

Results: At the end of assessment, the subject urologists were mostly interested in was found to be

“Endourology” with 69.9% which was followed by “Urooncology” with 42.5%. Interestingly, due to the

evaluation done according to the specialty duration, “Endourology” maintained to occupy the first rank. The

first two preferences of the urologists working in the university clinics and educational hospitals were

“Endourology” and “Urooncology” with similar rates while “Endourology” was number one with 83.2% in

service hospitals. In the study, 32.7% of the urologists expressed desire to be trained in laporoscopic surgery

while 25% stated that they did not have to be trained in any subject. Regarding the questions on the treatment

of urinary system stones, ESWL was the most preferred method of treatment for urinary system stones with

53.6%. Open surgery was selected for only 19.4% of the cases and the region it was most intensely performed

(32.6%) was South-East Anatolia. University hospitals were the treatment sites that use endourological

therapy most widely (35.6%) while this rate was only 15.2% in service hospitals. According to the results, it

was determined that the urologists included in this study applied medical treatment in 70.8%, TUR in 18.8%

and open surgery in 8.4% of BPH cases and the most preferred alternative minimal invasive treatment method

was holmium laser with 54.4%. TUR was in the first rank with 64.2% for the surgical therapy of BPH and

open surgery was the second preferred one. Middle Anatolia region was the one TUR was most intensely

performed (70.5%) while Mediterranean region was the one open surgery was most widely preferred (43.1%).

It was determined that open surgery preference slightly increased in the urologists with more than 10 years

speciality duration (33.2%). TUR was on the first rank with 79.3% in university hospitals.

Conclusion: We believe that this questionnaire-based study will light the way for the training and

planning efforts based on the establishment of deficiencies and goals in urology.