Isolated renal upper urinary tract stones can cause upper urinary tract obstruction, resulting in different degrees of hydronephrosis, impaired excretion of metabolites, azotemia, disorders of water-electrolyte and acid-base balance, and even uremic toxicity, which can be life-threatening. The principle of treatment for isolated renal upper urinary tract obstruction is to remove the obstruction as soon as possible to maximize the protection and restoration of renal function. Upper urinary tract obstruction can have a serious impact on renal function within a short period of time, and the length of obstruction is closely related to the recovery of renal function. Some data show that the glomerular filtration rate and renal function can be completely restored if the obstruction is lifted within 36 hours, 45~50% for 2 weeks, 15~30% for 3~4 weeks, and it is difficult to restore more than 6 weeks. In acute obstructive renal failure of isolated kidney with critical condition, simple, rapid, effective and less invasive way should be adopted to drain urine and improve systemic condition to create opportunities for second stage surgery. For acute upper urinary tract obstruction and more severe cases, we used ureteral placement for drainage or percutaneous nephrostomy, including 16 cases of ureteral placement for drainage and 22 cases of minimally invasive percutaneous nephrostomy, and further treatment will be done after the condition is stabilized. The purpose of ureteral drainage is to provide temporary drainage and to facilitate the discharge of stones after ESWL to prevent the formation of a “stone street” that can cause obstruction again. Percutaneous nephrostomy is a minimally invasive, efficient and successful drainage procedure that not only effectively drains urine, but also provides access for second-stage surgery. Ureteral placement for drainage is simpler and less expensive than percutaneous nephrostomy and is suitable for primary care hospitals; however, Mokhmalji et al. reported that ureteral placement can present with abdominal pain, bladder irritation and hematuria, and the double J-tube can be folded, twisted and distorted leading to obstruction; therefore, percutaneous nephrostomy (PCN) should be used to relieve upper urinary tract obstruction as much as possible in hospitals with the condition. For critically ill upper ureteral stones and multiple renal ureteral stones, percutaneous nephrostomy should be preferred. Urology Department of Dongguan People’s Hospital, Meng Xiangjun Retrograde ureteroscopic lithotripsy (URL) is suitable for middle and lower ureteral stones, for those who have difficulty in locating ESWL or failed treatment, and for those who have formed stone streets after ESWL, and for a small number of upper ureteral stones with relatively low location. For larger upper ureteral stones, because the stones are closer to the renal pelvis and can easily return to the kidney, ESWL can be combined with mPCNL for complete stone removal. mPCNL has a longer hospital stay and higher cost compared with URL, but the stone removal rate after mPCNL is significantly higher than URL. mPCNL has a 94% stone removal rate in our group, while URL has a 76% stone removal rate. The stone retrieval rate was 94% with mPCNL and 76% with URL. Conventional PCNL is still traumatic for patients because of the high F30 dilatation channel, and the incidence of intraoperative hemorrhage and renal cortical tear is also higher. It has been reported that using mPCNL for stone extraction, the puncture channel is only dilated to F14 or F16, and the risk of intraoperative bleeding and renal cortical tear is significantly reduced by using ureteroscope instead of nephrostomy. We used mPCNL to treat renal ureteral stones with a transfusion rate of only 1.4%. mPCNL provides good conditions for surgery because of the small puncture channel, less bleeding, and mild trauma, and can reduce the trauma to the isolated kidney by multiple lithotripsy. Liou et al. followed up 83 patients with isolated kidney treated by mPCNL or ESWL for a mean of 4.3 years and a maximum of 14 years and found no damage to No damage to renal function was found. Due to the improvement of lithotripsy instruments and the accumulated clinical experience of the operator, ESWL is now the preferred method for the treatment of most kidney stones, which is suitable for kidney stones <2 cm without upper urinary tract obstruction, but mPCNL is required in the following cases: 1) stones >2 cm in diameter; 2) stones <2 cm in diameter with upper urinary tract obstruction (ureteral stones or stenosis); 3) cast kidney stones, transplanted kidney stones, multiple kidney stones, intra-calvarium stones with obstruction at the neck of the calyx, stones in the lower calyx; 4, negative stones with difficult x-ray localization, difficult to locate by eswl; 5, those who failed eswl treatment; 6, cystine, calcium oxalate stones, not suitable for eswl treatment. Minimally invasive percutaneous nephrolithotomy should be used to treat isolated kidney stones with single-channel extraction as much as possible to reduce the loss of renal units. The puncture point should be chosen between the middle and upper renal calyces so that the ureteroscope can reach the most calyces. For cast kidney stones and multiple kidney stones, we adopt single-channel staged mPCNL with an interval of 5-7 days, and place one double-J tube after surgery, and remove the double-J tube after 4-6 weeks. After removal of the ureteral stent, close follow-up is performed, and if residual stones are found to move down the ureter, the stones are treated by ureteroscopic pneumatic ballistic lithotripsy. To deal with isolated kidney stones, puncture positioning should be accurate and surgical operation should be gentle so as not to tear the renal calyces, leading to intraoperative bleeding and affecting surgical operation. When one kidney is damaged or removed, the kidney on the healthy side immediately compensates for the increase in renal blood flow, and the traditional open surgery is traumatic and prone to bleeding. The use of minimally invasive endoluminal technique for the treatment of isolated renal upper urinary tract stone disease requires no incision, minimal trauma, less bleeding, basically no blood transfusion, reduced perioperative complication rate, rapid postoperative recovery, and maximum protection of renal function. Its indications are wide, and its success rate and safety are better than those of traditional open surgery, and it can be repeatedly removed for several times. At this stage, with the improvement of surgical techniques, the improvement of intracavitary instruments and the application of laser technology, minimally invasive techniques have become the main treatment for urolithiasis, especially in the treatment of isolated suprarenal urinary tract stones, which can be an important treatment method.