Urolithiasis is a prevalent, recurrent urological condition with significant health and economic burdens worldwide. Epidemiological data suggest a rising global trend, with notable geographical variations in prevalence and recurrence. In Taiwan, prior studies showed varying prevalence rates influenced by age, gender, and geographic factors. However, comprehensive recent data on Taiwanese adults remain limited. This study aimed to assess the prevalence, incidence, and recurrence risk factors for urolithiasis in Taiwanese adults using a large-scale, population-based design.

This retrospective cohort study utilized data from Taiwan’s National Health Insurance Research Database (NHIRD) between 2011 and 2021. Adult urolithiasis cases were identified using ICD-9 (592.0-592.9, 594.0-594.9) and ICD-10 (N20-N23) codes. Incidence was defined as first-time diagnosis without prior episodes before 2011; recurrence was defined as a subsequent episode occurring ≥90 days after initial diagnosis. Prevalence was calculated annually. Statistical analyses included chi-square tests and multivariate regression to identify recurrence risk factors.

The study identified numerous urolithiasis cases among Taiwanese adults. Significant gender differences were noted, with males having higher prevalence and incidence than females. Overall, incidence rates decreased annually, particularly in eastern and central Taiwan. Conversely, prevalence rates increased each year, peaking among individuals over 60 years old. Recurrence analysis revealed several independent risk factors, including male gender, age 50-69 years, residence in eastern Taiwan or offshore islands, and comorbidities such as hypertension, dyslipidemia, hyperuricemia, gout, and hyperparathyroidism.

This comprehensive population-based study highlights significant epidemiological insights into adult urolithiasis in Taiwan, particularly emphasizing recurrent episodes. Identification of these risk factors aids clinicians in developing targeted preventive strategies to reduce recurrence and overall disease burden.