Pain is an unpleasant sensory and emotional experience caused by objective or potential tissue damage. It is the first response of the nervous system when the body encounters an adverse stimulus or is attacked by a disease, the most common symptom that prompts patients to seek medical attention, and an important clue for doctors to diagnose the disease. Thus, the reduction, improvement and disappearance of pain often indicate the improvement, remission and cure of the disease. Does the relationship between pain and disease always follow this pattern? No. Painless urinary stones are the silent executioners that quietly damage the kidneys. Urolithiasis is the most common condition in urology; pain caused by urolithiasis is the most common urological emergency and one of the most intense pain conditions in the human body; pain is often characterized by acute paroxysmal severe colic in the lower back and abdomen – the medical term “renal colic”, which is It is caused by strong contraction or spasm of the smooth muscle of the urinary tract after urinary tract obstruction caused by stones, and the patient is restless, nauseous, vomiting, pale, sweating, and even has the feeling of pain. In fact, this is not always the case with urinary tract stones. In some cases, the stones are still there when the pain disappears, which means that the discharge of stones and the disappearance of pain are not synchronized, and are judged only by the pain relief. This means that the discharge of stones is not synchronized with the disappearance of pain, and judging the discharge of stones by the reduction of pain can have serious consequences. This summer, six cases of painless urinary tract stones were found in the physical examination department of the Fourth Hospital, all of whom had a history of acute renal colic 1 to 3 years ago and were treated with different methods of pain relief and stone removal, including one case receiving five external shock wave lithotripsy. All of them thought that the stone disease was cured after pain relief and were not reviewed again. Among them, 2 cases of deerstalker kidney stones and 4 cases of ureteral stones received percutaneous nephrolithotomy or ureteroscopic minimally invasive lithotripsy for stone extraction in the Department of Urology, respectively. However, all six patients suffered irreversible damage to the kidney function on the affected side, and the patients lamented the loss of partial kidney function caused by inadvertence. For this reason, it is important to remind everyone to correctly recognize pain as a disease signal. Many diseases have heavy pain in the early stage, and pain decreases or disappears at a certain stage in the course of the disease or at a later stage, such as mechanical conversion to ischemic intestinal obstruction; septic perforation of the appendix; gastric perforation from chemical peritonitis to bacterial peritonitis; fibrinous pleurisy to exudative pleurisy; these pathological transformations are accompanied by pain reduction, but the condition is worsening and not getting better. This is also the case with urinary stones. There are various reasons for the disappearance of pain, one being the migration of the stone to a relatively spacious urinary tract and the release of the obstruction; more commonly, paralysis of the smooth muscle of the urinary tract; and then the reduction of urine production by the kidney. Because there is more space in the renal calyces and pelvis, kidney stones sometimes grow to a large size without pain. Therefore, urinary stones cause pain related to their location, kidney function, and the recent movement of stones. Ureteral stones remain for a long time, often leading to local acute and chronic inflammation of the canal wall, and even the formation of inflammatory polyps wrapped around the stones, which not only cause difficulties in stone treatment, but also complete obstruction of the ureter leading to ipsilateral obstructive nephropathy, which seriously impairs kidney function, and such stones are painless, and are found to be badly affected by kidney removal due to severe hydronephrosis. Extracorporeal shock wave lithotripsy, although it can provide immediate pain relief, does not always yield the desired results and requires post-lithotripsy follow-up to prevent the retention of painless stones. The treatment should be individualized and specialized for stones of different timing, location and nature. Do not be afraid of severe pain and do not do nothing because it is not painful. Pain relief is the surface, stone removal is the root; release the obstruction, protect the kidney function is the basic rule of treatment.