BJU Int. 2026 Aug 12. doi: 10.1111/bju.70409. Online ahead of print.
ABSTRACT
OBJECTIVES: To describe contemporary trends in kidney stone disease (KSD)-related inpatient episodes, procedures, and costs in England and Scotland, with emphasis on post-coronavirus disease 2019 (COVID-19) service recovery, socioeconomic variation in Scotland, comparison with other urological procedures, and 10-year healthcare demand and cost projections.
MATERIALS AND METHODS: Retrospective descriptive analyses were conducted using English Hospital Episode Statistics (2020-2025) and Public Health Scotland data (2019-2024). KSD-related finished consultant inpatient episodes and procedures were identified using the International Statistical Classification of Diseases and Related Health Problems 10th Revision and Operation and Procedures fourth edition codes, respectively. Procedures were categorised as extracorporeal shockwave lithotripsy, ureterorenoscopy (URS), percutaneous nephrolithotomy, or open. Trends were compared with uro-oncological resections and benign prostate obstruction procedures. Socioeconomic variation was assessed using the Scottish Index of Multiple Deprivation. The 10-year healthcare demand and cost projections, accounting for National Health Service (NHS) cost uplift factors, were modelled using historical data.
RESULTS: The COVID-19 pandemic disproportionately reduced KSD-associated activity compared with procedures for bladder and kidney cancer. Although volumes now exceed pre-pandemic levels, inpatient episodes remain below baseline and waiting times remain prolonged. Between 2020 and 2025, inpatient episodes increased by 27.4% in England and 17% in Scotland, with URS accounting for >50% of interventions. KSD procedural volumes are comparable to the combined volume of uro-oncological resections and benign prostatic obstruction procedures. In Scotland, 44% of procedures were performed in the two most deprived socioeconomic quintiles versus 37% in the two least deprived. In England, KSD-associated episodes are projected to increase by 33% to 111 907 (95% confidence interval 96 057-130 373) by 2034-2035, with an estimated cumulative NHS cost of £1.82 billion over the next decade.
CONCLUSION: Kidney stone disease exacts a growing burden on healthcare services with incomplete recovery of inpatient care following the COVID-19 pandemic, socioeconomic disparities, and rising healthcare demand. These findings can inform service planning and prioritise evaluation of strategies to improve efficiency, equity, and prevention.
PMID:42581823 | DOI:10.1111/bju.70409
