To evaluate the safety and efficiency of the Aihua (AH)-1 stone removal system (SRS) to treat bladder stones. Thirty five patients with of bladder stones >2 cm and with benign prostatic hyperplasia were treated by transurethral cystolithotripsy with the SRS and TURP. The results in these patients were compared with 14 patients treated with current devices. In the SRS group, 26 patients had a single stone. Average stone size was 3.34 ± 1.03 cm, total operating time was 55.12 ± 19.95 min, and stone removal time was 23.30 ± 17.08 min. In the control group, 12 patients had a single stone. The average stone size was 2.46 ± 0.45 cm (larger stone size in SRS group, P < 0.05), total operating time was 79.85 ± 24.63 min (shorter operating time in SRS group, P < 0.05) and stone removal time was 43.28 ± 24.18 min the control group (shorter removal time in SRS group, P < 0.05). Mean stone size was 2.37 ± 1.18 cm and mean time to remove one stone was 12.57 ± 12.99 min in the SRS group. Mean stone size was 2.40 ± 0.48 cm (no significant difference between groups, P > 0.05) and mean time to remove one stone was 33.23 ± 25.26 min in the control group (shorter time in the SRA group, P < 0.001). No significant complication was found in the SRS group. This study suggests that multiple functions of SRS can be expected in transurethral cystolithotripsy. It can be used to fix stones during lithotripsy, and automatically collect stones and extract more stones through the sheath at one time during lithoextraction, which can reduce surgical time and damage to the bladder and urethra. This surgical procedure appears to be safe and efficient, and operating indications for transurethral cystolithotripsy could be expanded with this surgical procedure.