The main reasons for very painful abdomen after extracorporeal lithotripsy are obstruction of ureter by gravel or blood clots, pain or injury caused by gravel. 1. Ureteral obstruction: after extracorporeal lithotripsy, the downward movement of stone fragments and blood clots may cause obstruction of the ureter, which may stimulate the smooth muscle spasm of the ureter and lead to renal colic. Especially when the obstruction is low, there may not be typical renal colic but mainly abdominal cramps, often accompanied by nausea and vomiting as well as symptoms such as hematuria. Abdominal pain is a very common symptom in the process of stone removal after lithotripsy, generally can follow the doctor’s instructions to use antispasmodic analgesic drugs to give appropriate treatment. 2. Pain caused by stone removal or injury: the stone in the discharge or lithotripsy process can cause local damage, the ureteral wall is stimulated may cause pain. The patient should drink plenty of water and be given anti-infective drugs such as levofloxacin if necessary. Most patients will pass the stone after abdominal pain, but if the pain is severe and intolerable, or if the stone cannot be passed after repeated episodes, it is necessary to follow up with the doctor to rule out other acute abdominal diseases and give further treatment. The above symptoms must be taken seriously, and it is recommended that patients go to the hospital in time to complete the examination to clarify the diagnosis, and then under the guidance of the doctor to deal with.