The goal of kidney and ureteral stone treatment is not only to relieve pain and protect kidney function, but also to find and remove the cause of the disease as much as possible to prevent stone recurrence. According to each patient’s general condition, stone size, stone composition, obstruction, infection, fluid accumulation, renal parenchymal damage and the tendency of stone recurrence, etc., the prevention and treatment plan should be formulated. 1.Conservative therapy (1) Drinking a lot of water can reduce the concentration of stone formation components in urine, reduce the chance of precipitation into stones, promote the discharge of small stones, and also facilitate the drainage of infection. Therefore, patients with stones should develop the habit of drinking more water and keep the daily urine volume above 2000-3000ml. (2) Control urinary tract infection Stones, obstruction and infection often form a vicious circle in the body, so when stones are combined with infection, the examination and treatment of stones should be carried out under the condition of controlling infection. The formation in the infected urine is often magnesium ammonium phosphate stones. (3) Adjust the diet according to the composition of the stone to determine the anti-stone diet. A low purine diet should be used for uric acid stones and a low methionine diet for cystine stones. Fruits and vegetables can turn urine alkaline, which is better for preventing uric acid and cystine stones. Meat foods make the urine acidic, which is better for preventing infection stones. For phosphate stones, a low-calcium, low-phosphorus diet and aluminum hydroxide gel can be used. Avoid high calcium, high salt, high oxalic acid, high animal protein, high animal fat and high sugar for calcium-containing kidney stones, and adopt a high fiber diet instead. (4) In the case of renal colic, the first thing to do is to relieve the pain. In the case of severe renal colic, abdominal distension, nausea and vomiting, most of them can be relieved after infusion of fluids, local hot compresses, injection of atropine, morphine or pethidine. Acupuncture and auricular acupuncture have pain-relieving effects. Injections of anti-inflammatory pain are more effective in relieving pain. (5) Lithotripsy treatment is often possible for stones with a diameter of less than 0.4 cm, and stones with a diameter of 0.4 to 0.6 cm or 1.0 cm, with smooth surface and no obvious obstruction or infection symptoms, can be discharged by a combination of Chinese and Western medicine. (6) Lithotripsy therapy ① Pure uric acid stones are better dissolved by oral medication. If there is a nephrostomy, alkaline drugs can be used to dissolve uric acid stones, the effect is also better. Drink plenty of water to keep the daily urine volume above 3000ml, adjust the urine pH to 6.5-7.0, restrict high purine diet and take allopurinol, which may dissolve the stone. Note that when using allopurinol, one should be alert to its nephrotoxicity, especially for those with poor renal function, and adjust its dose according to creatinine clearance. (2) Cystine stones are better dissolved with oral medication and transnephrostomy, with medication to dissolve cystine stones. In addition to drinking more water regularly day and night, up to 3000-4000ml per day, low methionine diet, alkalinizing urine to pH 7.0-7.5, D-penicillamine or Thiola can also be used. 2.Surgical treatment The purpose of surgical treatment is to remove the stones, isolated stones have significant efficacy, better than multiple and recurrent kidney stones. (1) Indications for surgical treatment are relative: it is generally believed that stones larger than 1.0 cm in diameter have less chance of self-exclusion, especially the common oxalic acid stones, which are difficult to discharge because of the unsmooth surface. Stone-induced obstruction that affects renal function, or if non-surgical treatment is ineffective, surgical treatment should be considered. In recent years, due to the development of extracorporeal shock wave lithotripsy and endoluminal urology, the indications for surgery have changed somewhat. (2) Principles of surgical treatment ① For bilateral kidney stones, in general, the side with the simpler and safer surgery should be taken first. In principle, if the total kidney function is still good, the side with serious obstruction should be first; if the total kidney function is poor, the side with better kidney function should be chosen first. If the stone is difficult to remove and the patient is in serious condition, ureteral cannula can be inserted via cystoscopy to access the renal pelvis for drainage or nephrostomy can be performed first. If necessary, artificial kidney or peritoneal dialysis treatment can be used before surgery. ②Ureteral stones on one side of the kidney should be removed from the ureter with severe obstruction first. (③Bilateral ureteral stones should be removed from the side with severe obstruction first. For kidney stones with primary urinary tract obstruction, such as combined pelvic ureteral junction stenosis, pyeloplasty should be performed at the same time to correct the obstruction. Patients with primary hyperthyroidism should undergo parathyroid surgery first, and some kidney stones may dissolve on their own after surgery. For acute obstructive anuria caused by stones, after surgical removal of stones to relieve the obstruction, attention should be paid to the prevention and treatment of water-electrolyte and acid-base metabolism disorders during the polyuria period. (3) Surgical methods ①Pelvic or sinusotomy has the advantages of less bleeding and fewer complications, and is most effective for single kidney stones. If most of the small stones are in the renal pelvis, the clot method of pyelotomy can be used. In recent years, this technique has been used in combination with intraoperative elastolithotomy to remove more complex renal cast stones. Care should be taken not to damage the pelvic ureteral junction to avoid postoperative stenosis. (2) Renal parenchymal resection is performed by making a radial incision on the posterior side of the kidney where there are fewer blood vessels or on the dorsal side of the kidney, or even by making a small incision on the dilated calyces only, in order to remove the kidney stones from the renal pelvis and calyces. If multiple stones are concentrated in one pole of the kidney and difficult to remove, partial nephrectomy of one pole of the kidney can be used. Nephrectomy is only considered when the kidney is severely damaged by antler-shaped or large number of stones combined with severe hydronephrosis or pus accumulation in the kidney, and the opposite kidney is normal. In recent years, the number of nephrectomies for kidney stones has gradually decreased. Ureterotomy should be performed before surgery to make sure that the site of the stone has not changed. Upper and middle ureteral stones are easier to operate than lower stones and have fewer complications. The ureteral stone extraction incision is aimed at the normal ureteral area above the stone, and the stone is pushed up and removed to avoid postoperative stricture. After stone extraction, catheterization is also used to investigate the distal end for obstruction. The prognosis for isolated stones is better than for multiple stones.