ObjectiveTo explore the feasibility of flexible ureteroscopic lithotripsy(FURL)with holmium laser for treating large-volume renal calculi. MethodsForty-six patients with large-volume(diameter ＞3 cm) renal calculi undergoing FURL with holmium laser were enrolled as observation group. Another 46 renal calculi patients with the maximum calculary diameter＜3 cm underwent FURL on the same day or recently by the same surgeon, and were enrolled as control group. The duration of operation, clearance rate of calculi and postoperative complications were analyzed and compared between the two groups. ResultsIn the observation group, 36 patients were cured by the first surgery, 8 patients by the second surgery, 1 patient by the third surgery, and 1 patient by the fourth surgery; the clearance rate of calculi was 89.1%; the duration of operation was （86.0±3.2）min; postoperative fever (T＞38℃)occurred in 6 cases involving 2 cases with hyperpyrexia; no septic shock occurred, and steinstrasse occurred in 5 cases after surgery. In the control group, all of the 46 patients were cured by the first surgery, and the clearance rate of calculi was 93.1%; the duration of operation was （38.1±2.5）min; postoperative fever (T＞38℃)occurred in 3 cases; no septic shock occurred, and steinstrasse occurred in 1 cases after surgery. The duration of operation was longer in the observation group compared to the control group（P＜0.05）;there were no statistical differences in the incident rate of postoperative complications, postoperative fever and the clearance rate of calculi between the two groups （all P＞0.05）. ConclusionFURL with holmium laser can effectively remove the large-volume renal calculi but does not increase the postoperative complications.

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