Urinary tract stones are divided into upper urinary tract stones (kidney, ureter) and lower urinary tract stones (bladder, urethra), as shown in the figure. Since most of the clinical stones are upper urinary tract stones and upper urinary tract stones are more harmful to human body, we focus on the treatment of upper urinary tract stones. With the development of modern technology, the treatment of urinary tract stones has changed greatly: from traditional open surgery to modern minimally invasive therapies such as extracorporeal shock wave lithotripsy (ESWL), percutaneous nephrolithotomy (PCNL), holmium laser lithotripsy under ureteroscopy, and laparoscopic lithotripsy, which have the advantages of satisfactory lithotripsy, less damage to human body, faster recovery, and shorter hospitalization compared with open surgery. Compared with open surgery, it has the advantages of satisfactory lithotripsy effect, less damage to human body, quick recovery and short hospitalization. The choice of kidney stone treatment method is based on the size, location, stone composition, and the presence of accompanying anatomical abnormalities of the urinary system. 1.Extracorporeal shock wave lithotripsy (ESWL). ESWL has become the standard treatment for kidney stones with diameter ≤ 2.0 cm or surface area ≤ 300 mm because of its advantages of less trauma, fewer complications and no anesthesia. The disadvantage of ESWL for large kidney stones is that it requires repeated treatments and is prone to residual stone fragments after treatment, so it must be chosen carefully. The number of ESWL treatments is generally recommended to be no more than 3-5 times (depending on the lithotripter used), otherwise, percutaneous nephrolithotomy should be chosen; the interval between each lithotripsy should be 2-4 weeks. Although ESWL has the advantages of less trauma, fewer complications and no anesthesia than other lithotripsy methods, the lithotripsy effect of ESWL may vary greatly due to various conditions, and sometimes it does not achieve satisfactory results. 2. Percutaneous nephrolithotomy (PCNL) The indications for percutaneous nephrolithotomy (PCNL) are: ①. All kidney stones requiring open surgical intervention, including complete and incomplete deerstalker stones, kidney stones with stone diameter ≥ 2.0 cm, symptomatic stones in the calyces or diverticula, stones that are difficult to be crushed by extracorporeal shock wave and stones that have failed treatment. ②. Large stones in the upper ureter above the lumbar 4 vertebrae, with heavy obstruction or length diameter >1.5 cm; or ureteral stones due to polyp encapsulation and ureteral tortuosity, ineffective ESWL or failed ureteral placement. (3) Special types of kidney stones, including pediatric kidney stones with obvious obstruction, kidney stones in obese patients, kidney stones with obstruction at the pelvic-ureteral junction or ureteral stenosis, isolated kidney with stone obstruction, horseshoe kidney with stone obstruction, transplanted kidney with stone obstruction, and kidney stones without effusion, etc. Although PCNL has higher risk compared with ESWL, the lithotripsy effect of PCNL is usually satisfactory. With the improvement of laparoscopic equipment and the accumulation of clinical experience, most kidney stones can be treated by minimally invasive surgery with satisfactory results, and open surgery is only used when ESWL and ureteroscopic lithotripsy and lithotripsy have failed. In addition, open surgery can be used in cases where ureteroscopic stone extraction or ESWL is contraindicated. Posterior laparoscopic ureterotomy for stone extraction can be an alternative to open surgery. 2. Treatment of ureteral stones In general, the size of ureteral stones has an important reference value for the choice of treatment. Ureteral stones <1cm in diameter have the possibility of self-discharge. Stones smaller than 0.4 cm are mostly self-discharging, while stones ≥ 0.6 cm are preferred to drug-assisted stone removal. stones 0.7-1.0 cm are less likely to be removed as their diameter increases, and the choice between drug-discharging and surgical intervention should be made depending on the shape of the stone and the degree of obstruction. For stones > 1.0 cm in diameter, surgical intervention is preferred. The current treatment options for ureteral stones are extracorporeal shock wave lithotripsy (ESWL), ureteroscopic lithotripsy, laparoscopic and open surgery, lithotripsy and pharmacological treatment. Most of the ureteral stones can be treated by ESWL and ureteroscopic lithotripsy with satisfactory results. 1.Extracorporeal shock wave lithotripsy (ESWL) ESWL can be chosen according to the patient’s specific condition when the stone diameter is <1.0cm. Compared with ureteroscopy, extracorporeal shock wave lithotripsy has the advantages of minimally invasive and no anesthesia, but it is more likely to be re-treated, and because ureteral stones are often in a relatively embedded state in the ureteral lumen, the surrounding lack of a fluid environment conducive to stone crushing, compared with kidney stones of the same size, it is more difficult to crush them. Therefore, ESWL treatment of ureteral stones usually requires higher shock wave energy and more number of impacts. 2. Ureteroscopic stone extraction Since the ureteroscope was applied to the clinic in the 1980s, the treatment of ureteral stones has undergone fundamental changes. The application of new small-diameter rigid, semi-rigid and soft ureteroscopes, the extensive combination with new lithotripsy equipment such as ultrasonic lithotripsy, liquid electrolysis, pneumatic ballistic lithotripsy and laser lithotripsy, and the application of ureteroscopic direct vision lithotripsy basket extraction have greatly improved the success rate of minimally invasive ureteral stone treatment. Ureteroscopic lithotripsy is now not only limited to the middle and lower ureteral stones, but the application of clinical lithotripsy nets and lithotripsy baskets has also achieved satisfactory results in the treatment of upper ureteral stones.