It can be selected according to the specific equipment conditions of medical units and the preferences of operators. Because the diameter of the instrument is too large, it is easy to cause urethral mucosal injury, so the so-called "forceps" lithotripsy has been rarely used. At present, pneumatic ballistic lithotripsy and holmium laser lithotripsy are the most widely used in clinic.
Operators need to strengthen their proficiency in surgical operations to avoid unnecessary injuries; During the operation, try to break the stone and wash the stone fragments. Generally, the diameter of residual stone is about 1 ~ 2 mm, which can ensure its self-discharge; Anti-infection treatment should be strengthened after operation, and patients should be asked to drink plenty of water to promote the discharge of stones.
(2) ESWL can treat stones with a diameter of 65438±0 ~ 2cm in prone position. However, due to the large volume of bladder, the stone activity is obviously higher than that of upper urinary tract, so it is difficult to focus and locate during operation, and the effect of lithotripsy is difficult to determine, so it is rarely used at present.
(3) Suprapubic cystolithotomy is feasible for patients with large stones or other bladder diseases that need treatment. Indications are: ① children with bladder stones; ② The stone volume is too large; ③ Patients with benign prostatic hyperplasia or urethral stricture need open surgery; ④ bladder diverticulum stones, especially huge bladder diverticulum stones; ⑤ Bladder tumor requires open surgery; ⑥ stones growing on the basis of foreign bodies in bladder; ⑦ Those who cannot undergo endoscopic surgery for various reasons.