I have been exposed to and using flexible ureteroscopes for some time now, and its advantages, which I will not go into here. This is because it is promoted in many places and by doctors. My personal feeling is that the flexible scope is a powerful weapon that the urologist has mastered and has one more method to use when fighting stones. However, a good use of the weapon requires a good grasp of the indications. This weapon cannot replace other weapons, such as PCN and percutaneous nephrolithoscopy. Only complement each other, the combination of the short and long, in order to benefit from invincibility. Here are some cold thoughts: 1. Soft microscopy is only for stone fragmentation, not stone removal. It can only break the stones it can hit, and the stone fragments need to be discharged by themselves. Whether it can be discharged or not, this is related to the angle of the infrarenal pelvis and calyces, the size and texture of the stones. Therefore, the stone discharge may be very long, there may be ureteral stone blockage, forming stone street, requiring ureteroscopy to operate again, and the stones may not be discharged and combine together again, forming large stones again. 2. The operation time is long and may require multiple operations, which extremely test the patience and stability of the surgeon. Patients have to have economic and cure time considerations, both of which should be ample. 3. There are also specialist complications, such as ureteral injury and urogenital infection. To summarize, flexible scopes are definitely not an alternative to PCN, and each has its own indications. Anyone who says “other doctors need a hole in the kidney for surgery, I use a flexible scope without a hole.” You need to calm and cool down a bit.