Introduction: Renal stones are a common urological problem worldwide, with tremendous health and financial burden. The management of upper renal tract stone disease has evolved significantly over the past three decades due to advances in endoscopic and laser technology. There is limited Australian contemporary data on patterns of management of urological stone disease. This study aimed to assess current urology trends in Australian management of upper renal tract stones, particularly with regard to trends in operative management of upper renal tract stones over the past five years. 

Methods: The National Medicare Australia and Australian Institute of Health and Welfare databases were used to obtain the annual number of procedures for upper renal tract stone disease. 

Results: The total number of renal colic presentations has risen over the past five years in Australia and, as expected, the total number of procedures claimed by Medicare Australia has also increased over this timeframe. This rise is primarily due to an increase in endoscopic management of upper renal tract stones. The total number and proportion of endoscopic management of stones have steadily increased from 14 880 (83.7%) in 2015–2016 to 17 051 (88.9%) in 2019–2020. Interestingly, the proportion of open, laparoscopic, and percutaneous nephrolithotomy has remained steady, meanwhile, shockwave lithotripsy numbers and proportions have declined. 

Conclusions: Endoscopic management of upper renal tract stones predominates in current Australian urological management of renal stones. Interestingly, the proportion of shockwave lithotripsy performed has declined while open, laparoscopic, and percutaneous nephrolithotomy numbers have remained steady.