Clinical data: 58 cases in this group. There were 46 male cases and 12 female cases. The age ranged from 26 to 70 years old, with an average of 41 years old. There were 18 cases of combined hypertension, 12 cases of prostatic hyperplasia, 8 cases of bladder neck stenosis after prostatic hyperplasia removal, 6 cases of previous cystotomy and lithotomy, and 6 cases of multiple bladder stones. The clinical manifestations were interrupted urine flow, fine urine line, hematuria and urinary frequency as the main symptoms. All cases were confirmed by ultrasound or x-ray. Stone size Q1cm was found in 6 cases, 1~2cm in 14 cases, 2~3cm in 24 cases, 3~4cm in 10 cases, and 4~5cm in 4 cases. Epidural anesthesia or lumbar anesthesia was used in the lithotomy position. The prostate trocar sheath with the obturator was inserted into the bladder (in the case of bladder neck stricture, it was dilated with a urethral dilator), the obturator was withdrawn, and a Wolf 8.0/9.8F ureteroscope was inserted into the bladder through the trocar sheath to find the stone, and then the trocar sheath was pushed forward slightly to tightly fit and fix the stone. A pneumatic ballistic lithotripsy metal probe is inserted from the working channel and the stones are crushed by continuous pulses, at which time the stone powder is seen to flow out from the electrosurgical sheath under the impetus of the hydraulic pump. A small amount of residual stones were flushed clean with Alec or hooked out with a spatula-shaped electrosurgical loop. In our group, all 58 cases were successfully lithotripsed at once, and the lithotripsy time was 3-20 min. 6 of 12 patients with combined prostatic hyperplasia underwent TURP after successful lithotripsy, and all 8 cases with bladder neck stenosis underwent TURN. There was no intraoperative complication, no stone residue, no bladder perforation, no infection, and no urinary extravasation in one case. In all cases, no residual stones were found in the bladder on postoperative radiographs. Discussion: Transurethral bladder pneumatic ballast lithotripsy has been reported in domestic data. Because of its advantages of small trauma, high success rate, few complications and easy acceptance by patients, it is a more ideal method for treating urinary tract stones at present. In the author’s opinion, if the bladder mucosa is damaged and bleeding and the fluid in the bladder cannot be drained effectively, the view is often unclear and complications such as perforation and urinary extravasation are likely to occur. In contrast, this procedure not only prevents the bladder stones from sliding, but also allows the fluid injected by the hydraulic pump to flow out from the sheath cavity of the electrodesiccoscope during the operation, which can flush out the broken stone powder from the sheath and form a natural reflux of the perfused fluid, resulting in a clear view and convenient stone fragmentation. It is a fast and efficient way to treat bladder stones. If other lesions of the bladder or urethra are found, sometimes electrodesiccation loops can be used to treat them together. The disadvantage of this procedure is that it is not suitable for pediatric patients and patients with severe urethral strictures that cannot be dilated.