ObjectiveTo observe the clinical result of treating upper urinary tract calculi greater than 2cmwith combining flexible and rigid ureteroscopic Ho: YAG laser lithotripsy under the help of ESWL.MethodsForty patients with upper urinary tract calculi greater than 2 cm were observed, the diameter of the calculi of them wasbetween 2 cm and 3.2 cm, and the average value was 2.6 cm.Twenty-one patients were treated by combiningflexible and rigid ureteroscopic Ho:YAG laser lithotripsy, others were treated by flexible ureteroscopic Ho:YAGlaser lithotripsy only, and ESWL was performed after the operation for some big remains.ResultsThe averageoperative time of combining flexible and rigid ureteroscopic group was 96 minutes, and that of the other group was144 minutes, the difference of operative time between these 2 groups was significant (P<0.05).In combiningflexible and rigid ureteroscopic group 13 patients got a successful lithotripsy in the operation, 6 patients with bigremains got a successful ESWL after the operation, the total success rate of this group was 90%;to the other group, 8 patients got a successful lithotripsy in the operation, 4 patients with big remains got a successful ESWL after theoperation, the total success rate of this group was 60%, the difference was significant (P<0.05).No serious complications occurred in both groups.ConclusionCompared with the flexible ureteroscopic Ho: YAG laserlithotripsy, combining flexible and rigid ureteroscopic Ho:YAG laser lithotripsy can get a better result for shorteroperative time, higher success rate, in treatment of upper urinary tract calculi greater than 2 cm, and the help ofESWL will make the results better.However, careful chosen of patients is important for a good result. [ABSTRACT FROM AUTHOR]