Objective: To analyze the effect of Shiwei Powder combined with stone composition analysis on stone removal efficiency and complication rates after ureteroscopic holmium laser lithotripsy (FURL). Methods: Ninety six patients with FURL admitted to the hospital from March 2023 to March 2025 were selected and randomly divided into two groups. The observation group was treated with FURL combined with Shiwei Powder, while the control group was treated with FURL monotherapy. Based on the stone composition of the two groups, the stone removal efficiency, complication rates, recurrence rates, TCM syndrome scores, and inflammatory factor levels were compared. Results: The stone removal efficiency of the observation group was higher than that of the control group. The stone composition was mainly calcium oxalate monohydrate and composite stones containing calcium oxalate monohydrate. The incidence of postoperative complications was lower in the observation group than in the control group (P < 0.05). After 3–6 months of follow-up, the recurrence rate in the observation group was lower than that in the control group (P < 0.05). After treatment, the TCM syndrome scores and inflammatory factor levels in the observation group were lower than those in the control group (P < 0.05). Conclusion: Based on the results of urinary stone composition analysis, patients treated with Shiwei Powder after FURL have higher stone removal efficiency. The most significant effect is observed in urinary stones composed of calcium oxalate monohydrate and composite stones containing calcium oxalate monohydrate. This treatment can improve stone removal, prevent complications, reduce recurrences, effectively improve disease symptoms, and reduce inflammation.
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