For lower and middle ureteral stones, sometimes ureteroscopic lithotripsy under local anesthesia is performed without placing a double J tube after the procedure. Advantages: 1. No anesthesiologist and epidural anesthesia are needed, which saves the patient about 2,000 yuan of anesthesia cost. 2. No double J-tube is needed, which saves the patient about 1.5 thousand dollars on the cost of double J-tube materials and the cost of future review and extraction. 3.The whole operation time is about 5-10 minutes, EMS, laser or pneumatic ballistic lithotripsy will be used to break up the stone and remove it. 4.The anesthesia time is about 30 minutes-1 hour. 5.Patients have no obvious pain and other discomfort during the surgery. 6.No need to wait for 6 hours, and you can eat immediately after the operation. 7.No need to go to the pillow and lie flat for 6 hours after surgery. 8.Patients can get out of bed immediately after surgery, and do not need to wait until the 2nd-3rd day after surgery to get out of bed. 9.You can be discharged from the hospital on the 2nd-3rd day after surgery, and save the double J-tube review project and cost before and after discharge. 10.No postoperative discomfort such as hematuria and urinary pain caused by the long-term retention of the double J tube in the body, and no need for cystoscopic extraction, which can also avoid the risk of residual double J tube and induce the recurrence of stones. Disadvantages: Not all doctors recommend this procedure because it requires skill, delicacy, finesse and speed. Also, not all patients with ureteral calculi are suitable for this procedure.