When it comes to urinary stones, most patients will never forget the pain in the lower back and lower abdomen during an attack of renal colic, often accompanied by blood in the urine. The typical symptoms of stones – pain and hematuria – often cause patients to be highly nervous and attentive, and they are able to seek timely medical attention and treatment. However, asymptomatic stones are often underestimated by patients. Many people know that they have stones, but they have an indifferent attitude, or even complacent because they have never been in pain, and fail to do regular monitoring and follow-up, thus delaying timely treatment and even losing the whole kidney. Misconception 1: stones do not need treatment if they are not painful? Mr. Wang 2 years ago unit physical examination found a soy-sized stone in the left kidney, but never had back pain, so did not go to the hospital for examination and treatment. In the physical examination of the unit again this year, the ultrasound suggested that the stone had grown to the size of a peanut and had mild hydronephrosis, and the ultrasonographer suggested that he go to the urology department for regular treatment as soon as possible. Mr. Wang felt puzzled: I do not have any pain at all, but also need treatment? Ms. Li, who retired early, knew that she had “double kidney stones” for seven or eight years, which was discovered by an occasional ultrasound during a medical checkup. Over the years, never felt any discomfort, has not thought, plus retired at home, no formal physical examination, and did not go to the hospital for review. At the beginning of this year, Ms. Li found that her appetite has become significantly worse, but also often dizziness, shortness of breath, and even breathing difficulties after the activity, finally rushed to the serious situation, to the hospital outpatient medical treatment, internal medicine doctors after ultrasound, blood tests and other tests, confirmed that Ms. Li has “uremia”, and The “culprit” is precisely the two small stones! However, the stones are not the size of the year, but have grown into antler-shaped “cast stones”, full of the entire renal pelvis, and hydronephrosis and parenchymal atrophy. Ms. Li then realized the seriousness of the problem and immediately went through the hospitalization to get active treatment. But it was too late, the kidney parenchyma had shrunk, even if the stones were removed from both kidneys could not restore the function of both kidneys, and could only rely on regular hemodialysis to maintain life. Ms. Li could only regret that she had delayed the best time for treatment and could only lose her health and huge medical expenses for life. From this, we should clearly understand that just because a stone is not painful does not mean it does not need treatment. Any urinary tract stone of any size and in any part of the body needs to be treated actively, otherwise, as time goes on, the stone will slowly grow, gradually appearing pain, hematuria, infection, obstruction and other symptoms, and even suffer from loss of kidney function and become uremic. Many people, like Mr. Wang, do not pay attention to asymptomatic stones, and a considerable number of people, like the unfortunate Ms. Li, with stones for many years, and eventually uremic syndrome, and then the treatment effect is not satisfactory. Myth 2: No more painful stones means you are cured? Mr. Qiu, 25, came to the emergency room one day 3 years ago for “sudden onset of severe pain in the right side of his lower back”, and the emergency ultrasound indicated “stone in the upper part of the right ureter (1.5 cm) with right hydronephrosis”. After the emergency physician gave symptomatic treatment such as antispasmodic and analgesic treatment, Mr. Qiu’s back pain symptoms were significantly relieved, but he left behind the emergency physician’s advice to go to the urology department for further consultation. Since then, he never had any more episodes of back pain, and with his busy schedule, he forgot about it. In February of this year, Mr. Qiu felt soreness and swelling in his right lumbar region, and even felt a substantial lump on his own, which made him panic and go to the urology department. Finally, the whole useless right kidney could only be removed. A small stone caused a complete obstruction of the ureter, which led to a complete loss of function of the ipsilateral kidney, medically known as obstructive renal failure. The long-term obstruction caused by hydronephrosis compresses the kidney parenchyma, which eventually causes kidney atrophy and complete loss of kidney function. Kidney stones and ureteral stones are upper urinary tract stones, while bladder stones and urethral stones are lower urinary tract stones. In clinical practice, asymptomatic stones are found to be mostly upper urinary tract stones. The pain and hematuria of stones are not proportional to the size of the stone, and the location of the stone is often the key to the symptoms. Smaller kidney stones that move frequently in the renal pelvis with changes in position or fall into the ureter to stimulate the narrowing of the wall can cause strong peristalsis or spasm, resulting in lumbar and abdominal cramps and hematuria, i.e., “pain if you don’t pass”; while larger antler-shaped stones, because they coincide with the space of the urinary system, can be asymptomatic for a long time if they do not cause obstruction of the renal calyces or pelvis or secondary infection. If they do not cause obstruction or secondary infection, they can be asymptomatic for a long time, i.e. “no pain if they do not move”. Statistics show that kidney stones may persist for a long time without any uncomfortable symptoms, and about 50% to 60% of kidney stone patients have no significant pain history. Therefore, early detection and treatment of stones is particularly important. We recommend that an ultrasound examination at least once a year is essential. Once stones are detected, you should seek medical attention from the urology department of a regular hospital as soon as possible. Small stones (less than 0.6 cm) can mostly be treated conservatively, including drinking plenty of water, taking appropriate lithotripsy medications, exercising more, and eating a balanced diet. In case of larger stones, different individualized treatment plans can be chosen according to different sites and sizes. Under the leadership of Wu Denglong, a famous urologist, our urology department has carried out various minimally invasive surgeries (percutaneous nephrolithotomy, ureteroscopic lithotripsy, laparoscopic lithotripsy, etc.) and open surgeries (renal, ureteral and bladder lithotripsy, etc.), as well as non-invasive X-ray positioned extracorporeal shock wave lithotripsy (ESWL) treatment earlier in Shanghai, to provide stone patients with We also started the non-invasive ESWL treatment to relieve the pain of stone patients. Last year, our department upgraded the ESWL machine to ultrasound localization guidance earlier in Shanghai, which is non-invasive and easy to use, more dynamic observation and real-time monitoring of stone location, and avoids the risk of patients receiving repeated exposure. The stone treatment tools are advanced and comprehensive, and can fully meet the treatment requirements of patients with all kinds of stones.