Objective To explore the microtraumatic treatment for obstructive renal dysfunction caused by upper urinary stones. Methods A total of 43 cases of obstructive renal dysfunction caused by upper urinary stones was treated with microtraumatic treatment from August 1998 to December 2005.The treatment included ureteroscopic pneumatic lithotripsy, ureteroscopic double-J catheter placement followed by extracorporeal shock wave lithotripsy(ESWL),percutaneous nephrolithotomy,and primary percutaneous nephrostomy followed by ureteroscopic lithotripsy,or ESWL,or stone removal through the fistula.Results The operation time was 23~150 min(mean, 47 min) and the hospitalization time was 3~20 d(mean,7.2 d).Renal functions recovered to normal within 2 weeks ~ 3 months after operation in 29 cases;different degrees of azotemia remained 3 months after operation in 12 cases,their renal functions were improved significantly,with the serum creatinine levels decreased from 712.4 ?mol/L(326~2882.7 ?mol/L) preoperatively to 294.6 ?mol/L(173~532 ?mol/L) postoperatively;uremia remained in the rest of 2 cases and a long-term dialysis was required.The stone clearance rate was 88%(38/43).Follow-up checkups in the 43 cases for 3 months ~ 5 years(mean,1.5 years) found no death or pyonephrosis.The mean serum creatinine was 186.2 ?mol/L(39.9~933.1 ?mol/L).Recurrence occurred in 9 cases.Conclusions Microtraumatic treatment has advantages of minimal trauma,good tolerance of patients,and satisfactory safety for treating obstructive renal dysfunction caused by upper urinary stones.Different microtraumatic methods can be selected according to patient's condition.