Urolithiasis is a common and frequent disease in urology, and I would like to introduce to you the important progress made in the treatment of urolithiasis in recent years, this is the first part of it, and the rest of it, please look forward to! Patients and friends, you must have heard of Mr. Liang Yusheng’s “Seven Swords Down Heaven Mountain”. That represents the justice and power of the seven swords is really convincing and sigh, here I want to introduce you to the treatment of urinary stones of the three swords. You should know that although these three swords have been in the field for only two or three decades, but they have revolutionized the treatment pattern of urinary stones. With these three swords, urologists in the face of urolithiasis appears to be so full of confidence and sure-fire, it is these three swords so that the case of the original should be open surgery reduced to a low level of less than 10%. Now you can not help but ask “so these three swords and what is it”? Well, the following I will be the three swords to you slowly revealed it. First, the mountain hit the bull show hand DD extracorporeal shock wave lithotriptic machine (ESWL) To say that the first sword is not extracorporeal shock wave lithotriptic machine (ESWL) belongs to it, because in the three swords, it is the most widely used and the most common people are familiar with and accept. The ESWL in our hospital has been used in more than 10,000 cases of lithotripsy, and the good lithotripsy effect has been generally recognized by patients for a long time. The principle of ESWL lithotripsy is to focus the high-energy shock waves generated by the generator outside the body to the part of the human body where the urinary stones are located, to break them, and then the stones are discharged from the body along with the urine, which is compared to the way of lithotripsy as hitting the bulls at the mountain.The advantages of ESWL in treating the urinary stones are obvious, i.e., it does not require anesthesia, surgery, hospitalization, and not much money. The main indications for ESWL are: ① renal stones with a diameter of less than 2.0cm; ② ureteral stones with a diameter of less than 1.0cm (especially suitable for upper ureteral stones). It is necessary that the affected side of the renal function is still good and there is no urinary tract obstruction in the area below the stone. Studies have shown that ESWL treatment of upper calyceal stones <2.0 cm has an exclusion rate of 90%. For lower calyceal stones, <1 cm, 63% were eliminated; for 1-2 cm, 26% were eliminated; and for >2 cm, 14% were eliminated, with an overall elimination rate of 37% for lower calyceal stones treated with ESWL. Renal pelvis stones, <2cm, the exhaustion rate of >90%. However, the first sword of ESWL is not able to kill all urinary stones. For all kinds of renal stones (including all kinds of renal calyx stones and renal pelvis stones) and renal staghorn stones of >2cm, ESWL is not suitable for treatment, because: ① the rate of stone evacuation after ESWL treatment is very low, <30%. ② If ESWL is used to treat these patients, a ureteral stent tube needs to be placed before treatment. (iii) Due to the large size of the stones, these patients often need to repeat ESWL treatment several times, and may not be able to expel the stones, and finally treated with PCNL (percutaneous nephrolithotomy). ④ Due to the large size of stones, a large number of broken stones after ESWL treatment enter into the ureter to form stone street, causing ureteral obstruction, causing recurrent episodes of renal colic, and the long-term existence of stones causes hydronephrosis, which impairs renal function. ⑤ If a ureteral stone street is formed, ureteroscopic lithotripsy and lithotripsy (URSL) is often required to relieve the stone street. (6) Multiple repeated EWSL treatments will aggravate the damage of renal tissue. In conclusion, ESWL, which is claimed to be the first sword, is really easy to deal with most of the urinary stones. However, it is unscientific to magnify its efficacy without limitation. Please think about it, if ESWL can be suitable for all patients, why do we bother to seek the second sword, the third sword. What is annoying is that some informal hospitals, in order to pursue profits, have no choice but to treat large kidney stones repeatedly, which not only fails to cure kidney stones, but also causes serious renal function damage and even reaches the point of no salvage. This is not only detrimental to the reputation of the first sword of ESWL, but also an incalculable loss to the patients, and here I would like to remind everyone to pay attention to it!