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Nationwide trends in urolithiasis and stone procedures in Iceland
Bragi Aðalsteinsson1, Edward Rumba2, Jóhann Páll Ingimarsson3
1Faculty of Medicine, School of Health Sciences, University of Iceland, Reykjavík, Iceland. bragi.adalsteinsson@gmail.com.
Objective:
This study aimed to assess nationwide trends in registered upper urinary tract stone disease and stone-related procedures in Iceland.
Material And Methods:
We performed a nationwide retrospective population-based study of adults aged 18 years or older with International Classification of Diseases, 10th revision codes N20, N22 or N23 in national hospital and specialist-care data from 2010 to 2024. Crude and age-standardised incidence rates were calculated per 100,000 adults. Stone-related procedures from 2013 to 2024 were identified using Nordic Classification of Surgical Procedures codes. Temporal trends were analysed using negative binomial regression with population offsets.
Results:
The cohort included 9,492 adults. Registered incidence ranged from 221 to 260 per 100,000 adults and remained stable (95% confidence interval -0.6% to 0.6%; p = 0.914); age standardisation and alternative case definitions gave the same conclusion. Among patients first registered from 2013 onward, 2,432/7,766 (31%) underwent a stone-related procedure. The procedure rate increased from 124.3 to 236.5 per 100,000 adults, corresponding to a 6% annual increase. Ureteroscopy accounted for 10% of procedure registrations in 2013-2016 and 30% in 2021-2024, while shock wave lithotripsy remained the most common procedure.
Conclusions:
Registered upper urinary tract stone incidence remained stable, but treatment activity increased substantially. Ureteroscopy use rose rapidly, although shock wave lithotripsy remained the predominant procedure.
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