Why do urinary stones seem to be caused by the neck, which is not even close? This starts with the parathyroid glands in the neck. The parathyroid glands, which are four bean-sized glands on either side of the thyroid gland in the neck, are endocrine organs in the human body, mainly responsible for releasing bone calcium into and out of the blood and then excreting it from the kidneys to regulate blood calcium balance. If hyperparathyroidism occurs, which means that too much parathyroid hormone is secreted, 1/5 to 2/5 of patients will develop urinary stones, which has a high incidence. What kind of urinary symptoms can occur with hyperparathyroidism? Patients often experience irritable thirst, excessive drinking and polyuria; recurrent, multiple urinary stones can cause renal colic, ureteral spasm, hematuria in the naked eye, and even gravel-like stones in the urine. Patients are also susceptible to recurrent urinary tract infections, and in a few cases, prolonged or severe disease can lead to renal insufficiency. What other body functions are affected by hyperparathyroidism? Hyperparathyroidism can cause digestive symptoms, such as poor appetite, nausea, vomiting, indigestion and constipation. Some patients may develop recurrent peptic ulcers, which can be characterized by epigastric pain and black stools. Some patients with hypercalcemia may develop acute or chronic pancreatitis, with clinical manifestations such as epigastric pain, nausea, vomiting, poor appetite and diarrhea, or even with acute pancreatitis. In the locomotor system, it often manifests as generalized diffuse and gradually increasing skeletal and joint pain, and bone pain is more prominent in weight-bearing bones, such as the lower limbs and lumbar spine. The cardiovascular system can promote vascular smooth muscle contraction, vascular calcification, and hypertension. Patients with the nervous system may experience apathy, depression, irritability, unresponsiveness, memory loss, and in severe cases, even hallucinations, mania, coma and other central nervous system symptoms. Psychiatric system patients may show signs of psychological abnormalities such as lethargy, drowsiness, depression, neuroticism, decreased social interaction ability, and even cognitive impairment. Hematologically, some patients with hyperparathyroidism can be combined with anemia. What are the conditions to consider hyperparathyroidism? 1. recurrent or active urinary stones or renal calcium deposits; 2. unexplained osteoporosis, especially with subperiosteal cortical resorption and/or alveolar plate resorption and bone cyst formation; 3. “giant cell tumors” of the long bones, ribs, jaws or clavicle, especially multiple cases; 4. Vomiting, untreated peptic ulcer, intractable constipation or recurrent pancreatitis; 5. Unexplained psychoneurological symptoms, especially with thirst, polyuria and bone pain; 6. Positive family history and mothers of children with neonatal hand-foot convulsions; How is hyperparathyroidism treated? Preferred treatment method. Indications for surgery include: 1) symptomatic hyperparathyroidism; 2) asymptomatic PHPT in patients with any of the following conditions: (1) hypercalcemia with calcium above the upper limit of normal of 0.25 mmol/L (1 mg/dL); (2) renal impairment with creatinine clearance below 60 ml/min; (3) BMD values below 2.5 standard deviations from peak bone mass at any site (T value <-2.5), and/or fragility fracture; (4) Age <50 years. (3) No contraindications to surgery and clear localization of the lesion.