Causes and clinical manifestations Ureteral stones usually originate in the kidney, and small kidney stones are usually asymptomatic, but if kidney stones fall into the ureter, they can cause ureteral obstruction, hydronephrosis, and ureteral dilatation, and patients show severe pain or swelling in the lower back, and some are accompanied by nausea and vomiting; some patients do not have any symptoms, but are only found to have stone disease by chance during physical examination. When the stone moves down to the end of the ureter, the patient may have the feeling of wanting to pull and urinate, and always wanting to go to the toilet. The patient may feel pain or no sensation when tapping on the lower back during physical examination. Diagnosis Ultrasound and routine urinalysis are preferred. Since the ultrasound signal attenuates significantly when it encounters gas in the intestinal tube, stones in the middle and lower ureter are easily invisible, so try to hold enough urine when doing ultrasound and use the distended bladder to push the intestinal tube to the side to increase the detection rate of stones in the lower ureter. A routine urine test often reveals red blood cells, which are the result of stones moving and cutting through the ureteral mucosa. When the ultrasound examination only finds fluid but not stones, if necessary, additional urograms or intravenous urography or CT of the urinary tract can be done, which often reveals stones that cannot be detected by ultrasound. How to treat? 1, the diameter of the stone less than 0.6cm can be used to jump treatment and drug de-stone, commonly used drugs: urinary stone pass pill, amber anti-stone particles, ranuncine tablets, nifedipine tablets, indomethacin tablets, etc.. Younger people can use jumping rope method; older people can use pawing heel or choose bad shock absorption tractor / farm vehicle bump treatment (the amplitude of bumping should be different from person to person, moderate to avoid complications such as lumbar spine slippage). If the stone is not discharged in two weeks of lithotripsy treatment, or if the stone does not move, it cannot continue lithotripsy, and further extracorporeal lithotripsy or ureteroscopic lithotripsy should be used. 2. Ureteral stones with diameter of 0.6cm~1.5cm and stay in the same place for less than 3 months can be treated by extracorporeal lithotripsy. If the number of lithotripsy is more than 3 times lithotripsy is not effective, in order to avoid stenosis due to ureteral injury after multiple lithotripsy it is recommended to switch to minimally invasive treatment. For kidney and upper ureteral stones, percutaneous nephrolithotomy is generally used (i.e., a small hole is made in the patient’s lower back and a nephrolithotomy device is inserted to break up the stones). For lower and middle ureteral stones, ureteroscopic lithotripsy is usually performed, in which a ureteroscope and lithotripsy device are inserted into the ureter through the urethra and bladder of the patient to break up the stones. In cases where extracorporeal lithotripsy, ureteroscopic lithotripsy, or percutaneous nephrolithotomy fails, laparoscopic ureterotomy for stone extraction can be considered, and open surgical stone extraction is also feasible.