To summarize the experience of ureteroscopy in the treatment of ureteral stones. METHODS: Retrospective analysis of 1285 cases of upper, middle and lower ureteral stones using ureteroscopic dual-frequency laser or pneumatic ballistic from May 2004 to December 2010 for lithotripsy. RESULTS: The one-time success rate of lithotripsy was 93.6% (1203/1285), ureteral dissection nephrectomy was performed in 1 case, conversion to open surgery was performed in 22 cases, double J-tube was simply placed in 49 cases with difficulty in accessing the ureteroscope, and the stone slipped into the kidney in 10 cases. There were no cases of renal rupture. Postoperative 2-4 weeks X-ray stone evacuation rate of 98.3%. Conclusion: ureteroscopic dual-frequency laser or pneumatic ballistic treatment of ureteral stones, the efficacy of the treatment is accurate, the method is safe, effective, with few complications. 1, data and methods 1.1 Clinical data This group of 1285 cases, age 21-82 years old, the average age of 40 years old, male 759 cases, female 526 cases, the stone is located in the upper section of the ureter 171 cases, in the middle of 211 cases, the lower section of the 903 cases (70%), of which the recent implementation of the extracorporeal shock wave lithotripsy in 97 cases, had been ureterotomy lithotripsy in 23 cases, the size of the stone 0.6-2.2cm ranging from the average 1.0cm. 1.0 cm. Before the operation, ultrasound or CT examination was performed, urine sediment was checked, and antibiotics were applied to control the obvious urinary tract infection. 1.2 Methods: Under lumbar anesthesia or epidural anesthesia, patients were placed in the lithotomy position, F12 ureter was left in place, and F8 ureteroscope was inserted under the supervision, to find the ureteral opening on the affected side, insert the guide wire as a guide, inject the water, and the pressure of the water was controlled at 150mm Hg, and the water injection rate was 50-80ml per minute, and then flush open the ureteral opening into the ureteroscope, and then push it into the ureteroscope while observing until the stone was found, and then set the head of the laser fiber in the stone surface contact, set pulse energy 120mg, and set pulse energy 120mg. Set the laser fiber head in contact with the stone surface, set the pulse energy of 120mJ, pulse frequency of 5-10Hz to be crushed, pneumatic ballistic set single or continuous, lithotripter to crush the stone, according to the degree of clarity of the field of view, the control of water injection pressure and flow rate to prevent the stone from drifting, and can be used to take out the foreign body forceps a little larger stone, thoroughly crushed stone to the end of the following each piece of 2.0mm, the full-length ureter to probe the ureter without any abnormality. The ureteroscope is withdrawn. The ureteroscope should be removed after the ureteroscope has been explored for the whole length of the ureter and there is no abnormality. The double J tube should be pushed into the ureter on the affected side along the guide wire, one end of which is placed in the renal pelvis and the other end is placed in the bladder, and then the guide wire should be withdrawn, and the urinary catheter should be left in place, and the ureter should be routinely antimicrobialized for a few days. The results of 1285 cases of one-time lithotripsy success 1203 cases, to carry out the early operation of 1 case due to the operation time is too long mishandling caused by ureteral rupture, finally led to nephrectomy, 22 cases of intraoperative due to ureteral perforation or stenosis or ureteral orifice can not be placed in the ureter after inserting the rot directly open ureterotomy to remove the stone, 49 cases due to ureteral stenosis or orifice can not be into the scope of the direct release of the guidewire, the stone slipped into the kidney of 10 cases. All cases were upper ureteral stones, no renal rupture during the operation, all patients had stable vital signs during the operation, no infectious shock after the operation, the operation time ranged from 10 minutes to 40 minutes, with an average of 20 minutes, and they were discharged from the hospital in 2-7 days, with an average hospitalization of 4 days, and the double J tube was pulled out for review after 2-4 weeks. 3, Discussion Dual-frequency laser lithotripsy is contact laser lithotripsy, the laser is converted into mechanical shock wave lithotripsy, almost no thermal damage, Th0mas animal experiments found that the depth of bladder mucosal bombardment damage of laser fibers on rabbits is not more than 0.1 mm, causing only mild congestive mucosal edema without muscle damage and perforation, the principle of pneumatic ballistic lithotripsy lithotripsy rod by compressed air bullets impact and back and forth movement, the impact amplitude is less than 2 mm, the impact amplitude is less than 2 mm. The principle of pneumatic ballistic lithotripsy is that the lithotripter is hit by a compressed air bullet and moves back and forth, the amplitude of impact is less than 2mm, no heat is generated, and there is only slight damage to the mucosa of the ureter, so both lithotrips are safe and effective, and they can be used in all segments of ureteral stones. Ureterolithiasis is basically caused by renal stone discharge, which can cause renal colic, hydronephrosis, renal function damage, ureteroscopic lithotripsy has become an alternative to open incision lithotripsy, compared with the open surgery and positional shockwave lithotripsy ureteroscopic lithotripsy has a lot of advantages, and it has been widely accepted by urologists, we summarize the ureteroscopic dual-frequency laser and pneumatic ballistic lithotripsy in 1,285 cases, the efficiency rate of 93.6%, fewer serious complications, and one case of severe complications, and one case of ureteroscopic lithotripsy. We summarize that 1285 cases of ureteroscopic double-frequency laser and pneumatic ballistic lithotripsy have an effective rate of 93.6%, with few serious complications. One nephrectomy case was carried out in the early stage of ureteroscopy, with insufficient experience, the upper section of the upper section of the stone was looked for for too long during the operation, and the perforated and torn ureter was not opened in time. The ureteral stenosis ureteroscopy can not probe to the stone or insertion and placement of double J tube are difficult, the patient asked for a one-time to take the net stone and change to open, ureteral perforation during the operation of the serious only two cases of conversion to open. In order to avoid ureteral perforation or mucosal avulsion tear surgery time should not be too long, preferably not more than 30 minutes, the technique is gentle, to enter the mirror under direct vision. Stone drift in the kidney are seen in the upper ureteral stone, early surgery or operator skill is not skilled easy to lead to stone drift, the author according to the ureteral three segments of the quadratic method, that the upper upper segment of the upper stone (i.e., lumbar 4 transverse protrusion above the segment of the ureter) in the lithotripsy process is easy to drift into the kidney, the use of percutaneous nephrolithotripsy is better, the upper segment of the lower, intermediate, and lower segment of the ureteral stone microscope lithotripsy success rate is high. Ureteroscopic lithotripsy leading to renal rupture has been reported domestically, we have not encountered, reduce the flushing pressure and flushing speed, shorten the operation time may reduce renal rupture, if the operation suddenly the affected side of the lower back pain is obvious, the urine is bright red should be concerned about renal rupture, such as that is the center of the open surgery, simply placed in the double J-tube part of the self-discharge of the stone or combined with the ESWL surgery, can be cleared of the stone. Ureteral polyps can not be removed because dual-frequency laser and pneumatic ballistics can not work on soft tissues. It has been reported in China that for patients with ureteral stones combined with polyps, after the stones are crushed, double J tube is inserted without dealing with polyps, which will disappear with the disappearance of stones and fade away.