Kidney Stones
Shockwave lithotripsy is still the operation Korea performs most for urinary stones. The scan that finds them rose 394.8 percent — in a disease that recurs, in patients who are mostly of working age.
Andrew Cho7 min read
Prostate
This coverage has asked repeatedly what happens to the men Korea finds late. The answer, in national prescribing data, is androgen deprivation — and two studies now put numbers on what that costs.
Andrew Cho7 min read
Prostate
The country that became the world's reference case for finding cancer too early has the opposite problem in prostate cancer. This is what the published data shows, where it runs out, and what it never recorded at all.
Andrew Cho9 min read
Prostate
Three articles here have described what prostate surgery does to continence and none has described the alternative. Randomised patient-reported data and two Korean series fill the gap — and disagree about how much is happening, for a reason worth knowing.
Andrew Cho7 min read
Prostate
Pooled data on 12,620 men finds age, urethral length and existing urinary symptoms predict continence after robotic prostatectomy. All three are measurable at the clinic visit where the decision is made.
Andrew Cho6 min read
Signed opinion — marked as opinion in structured data, not reporting.
From Practice
A surgeon on what repeated inflammation does to the anatomy, why the number of incisions is the wrong thing to compare, and why the decision that matters is the one made mid-operation.
From Practice
A urologist on what the visit after stone surgery is actually for — the stent and its date, the fragments left behind on purpose, and a kidney that has to be seen to have gone down.
From Practice
The operation that removes the most tissue is the one recommended when the bleeding risk is highest. A urologist on why that is not a contradiction, and on what the guidelines actually name.
One question, one self-contained answer, sources listed.
A thyroid nodule found on a screening ultrasound is a common incidental finding rather than a diagnosis: a meta-analysis of 95,394 asymptomatic adults found 30.6 percent had one, most smaller than one centimetre, and Korea's experience shows that scanning for them produced a fifteen-fold rise in thyroid cancer diagnoses with no corresponding fall in thyroid cancer deaths.
For localised prostate cancer, the randomised evidence at 15 years found no significant difference in prostate cancer death between active monitoring, surgery and radiotherapy (3.1, 2.2 and 2.9 percent respectively, P equals 0.53), but monitoring carried roughly twice the rate of metastasis and progression, while surgery carried the worst effects on continence and sexual function.
PSA testing does reduce prostate cancer deaths, but by a small absolute amount and at the cost of diagnosing cancers that would never have caused harm: at 23 years the European screening trial found 13 percent lower prostate cancer mortality, an absolute risk reduction of 0.22 percent, one death prevented per 456 men invited, and 30 percent more cancers diagnosed.
Screening multiplied thyroid cancer diagnoses in South Korea without a matching change in deaths: incidence rose 6.4-fold between 1999 and 2008, with 94.4 percent of the increase consisting of tumours smaller than 20 mm found mainly by screening, while an international analysis attributed more than 85 percent of Korean female cases in 2013–17 to overdiagnosis.
For low-risk papillary thyroid microcarcinoma the Korean Thyroid Association's 2025 guideline permits active surveillance — monitoring rather than removing the tumour — in patients with no lymph node or distant metastasis, no gross extension beyond the thyroid, no invasion of the trachea or recurrent laryngeal nerve, and no aggressive histology.
Diarrhoea after gallbladder removal affected 13.3 percent of 3,476 patients pooled across 21 studies in a systematic review, and is attributed to bile draining continuously into the intestine rather than being released after meals, so that bile acids reach the colon and draw water into it.