溶石：stones composed of pure uric acid can be chemically dissolved through oral medication under the guidance of a physician. Oral stone-dissolving drugs are used to dissolve uric acid stones by alkalizing the urine with alkaline sodium citrate, sodium hydrogen potassium citrate, or sodium bicarbonate. Drug-assisted lithotripsy is often more effective for kidney stones, as the volume of urine in the ureter is relatively small, resulting in poor lithotripsy efficacy for ureteral stones.

The effectiveness of drug therapy depends on multiple factors such as the composition, location, and size of the stone. At the same time, patients may experience recurrent renal colic symptoms during the treatment process. As a result, patients require repeated outpatient review follow-ups, and the efficacy is not definitive.

In vitro lithotripsy utilizes high-energy shock waves generated by discharge, which are transmitted through water and can be directly focused on kidney/ureteral stones with the assistance of fluoroscopy. The change in tissue density between the soft kidney tissue and the hard stone causes energy to be released on the surface of the stone, thereby breaking it down. This method isconvenient and quick，and can be completed in the outpatient department without surgery, which is favored by many stone patients。

In vitro lithotripsy is suitable for small kidney stones, but the efficacy is uncertain and affected by various factors, such as the patient's body shape, the composition of the stone, and the conditions of the ureteral stone expulsion. Large stones may even require multiple in vitro lithotripsies to achieve the desired effect.

In vitro lithotripsy is suitable for small kidney stones, but the efficacy is uncertain and affected by various factors, such as the patient's body shape, the composition of the stone, and the conditions of the ureteral stone expulsion. Large stones may even require multiple in vitro lithotripsies to achieve the desired effect.Some patients have thin ureters, and small stones cannot be excreted together, like "a thousand soldiers crossing a single log bridge", completely blocking the ureter. At this time, emergency surgery is needed to relieve the obstruction.

There are also many "contraindications" for extracorporeal lithotripsy, such as renal insufficiency, urinary tract infection, coagulation dysfunction, pregnant women, serious cardiovascular and cerebrovascular diseases and diabetes, skeletal deformity, severe obesity, etc.

In short, extracorporeal lithotripsy is a double-edged sword. Patients must undergo extracorporeal lithotripsy under the guidance of a professional urological surgeon. After lithotripsy, they should pay attention to follow-up observations and timely treatment of complications.

Ureteroscopy is the most common surgical procedure for treating kidney stones, and is also known colloquially as "minimally invasive surgery." The procedure is completely performed within the body cavity, with minimal damage to surrounding organs. The surgery uses holmium laser and other tools under endoscopic visualization to break up or remove the stones, which is more effective than extracorporeal lithotripsy and is suitable for the treatment of ureteral and renal stones.

Ureteroscopy is generally applicable to the surgical treatment of middle and lower ureteral stones. Ureteroscopy is a flexible surgical instrument suitable for the treatment of high-positioned stones.For kidneystones less than 2cmvarious ureteral stones, and stones after extracorporeal shock wave therapy, ureteroscopy (flexible) surgery is recommended.

The advantages of ureteroscopy (flexible)surgery are its precise efficacy, high stone clearance rate,and few surgical procedures. Most patients can achieve a high stone clearance rate with only one treatment. Its disadvantage is that it needs to be performed under anesthesia and is invasive, with the risk of surgical complications.