Men’s mental health: Connection to urologic health

Abstract

Historically,thespecialtyofurologyhasfocusedonsingle-systemdiseases.Inrecentyears,however,therehasbeenincreasingrecognition oftheinterconnectivitybetweenthevarioussystems,suchascardiovasculardisease,metabolicsyndrome,erectiledysfunctionandprostatecancer.Thisconstellationofdisease/syndromeanddysfunction mayplaceurologistsatthecentreofmen'soverallhealthconcerns. Asurologistsconsideringtakingonaleadershiproleinmen'shealth, theyshouldalsoconsidertheirpotentialinhelpingmensufferingfrom thesignificantburdenofamentalhealthdisorder.Urologistsmay haveauniqueopportunitytoidentifymentalhealthissuesintheir malepatients,influencehealthybehaviourchange,andsuccessfully refermen,whomightotherwisenotseekhelp,toappropriatemedical/ psychologicalcare. Men's mental healthAn estimated 3.4 million Canadian men are currently living with mental illness. 1 This number is likely an underestimation given that a large proportion of men experiencing symptoms of mental illness do not seek the help of a professional. [2][3][4] This gap in care has grave outcomes as Canadian men are at least 3 times more likely to die by suicide than Canadian women 5 -a figure that increases to 7 times among elderly men.6 Specific to urologic diseases/disorders, such as urologic cancers, lower urinary tract symptoms and erectile dysfunction (ED), men experience elevated levels of anxiety and depression. 7,8 For example, the risk of suicide in men with prostate cancer is over 4 times that of a similarly aged man without prostate cancer. 9 Patients with lower urinary tract symptoms (LUTS) experience elevated levels of psychosocial distress, with depression rates of 6% to 21% and anxiety rates of 3% to 10%. 10 An estimated 10% of men with ED suffer from depression, and 2.5% to 37% suffer from anxiety.11 Given the relationship between mental health and overall health-related quality of life, it is clear that increasing numbers of men in general, and men with urologic disease, are suffering a significant burden and that most of this burden remains untreated by healthcare professionals. Barriers to accessing mental health services include stigma, differences in expression of emotional problems (compared to women), maladaptive coping, and lack of awareness of support services in the community. StigmaResults suggest that the most prominent barrier to seeking and accessing mental health services is stigma.12,13 Seeking mental healthcare services remains a secretive and shameful activity for many individuals.14 The anticipation of social consequences and discrimination is often enough to force men into silence. While mental health stigma is not exclusively a male issue, men face a disproportionate amount of stigma, which is often perpetuated by masculine ideals of strength and self-reliance. A firm belief in stoicism and the need to control emotions may lead some men with anxiety and depression to perceive emotional distress as shameful, and hide their symptoms from others. 13,15 Differences in expression of emotional problemsAnother factor that may complicate se...

»Dude, How Much Health Do You Have Left?«

“…The consequences of framing individuals as solely responsible for their health are clearly apparent in men's health disparities. Men -the primary arbitrators of these masculine health practices -surpass other genders in their morbidity and mortality rates from a multitude of cancers and diseases, they more often engage in high-risk activities like excessive drinking and speeding, and they suffer biopsychosocial distress when their masculinity comes into question -especially through medical diagnoses of such things as testicular or prostate cancer (Evans et al 2011;Matthew and Elterman 2014;Elder and Griffith 2016). Health and health management under biomedicalization are then seen as articulations and markers of masculinity.…”

Krankheit in Digitalen Spielen

“…The consequences of framing individuals as solely responsible for their health are clearly apparent in men's health disparities. Men -the primary arbitrators of these masculine health practices -surpass other genders in their morbidity and mortality rates from a multitude of cancers and diseases, they more often engage in high-risk activities like excessive drinking and speeding, and they suffer biopsychosocial distress when their masculinity comes into question -especially through medical diagnoses of such things as testicular or prostate cancer (Evans et al 2011;Matthew and Elterman 2014;Elder and Griffith 2016). Health and health management under biomedicalization are then seen as articulations and markers of masculinity.…”

Health‐related quality of life in patients undergoing TURP: Translating evidence into urological nursing practice

“…According to this description, it seems clear that functional status domain is well connected with the symptoms and general health perception domain in this model. 66 These strategies should be considered as the first-line approach due to the fact from a recent study in the US Nursing Homes (NHs) reported the high mortality rates and a functional status decline in NH resident after 1-year minor urology surgery including TURP. 64 Coupled with this, urinary incontinence contributes to higher odds of loneliness and is highly associated with mental health problems (ie, depression).…”

“…65 Urological nurses along with urologist are emphasized to strengthen their role in mental health issues by identifying the current problems, influencing a healthy behaviour change, referring patients when impossible to seek help to appropriate psychological healthcare center. 66 These strategies should be considered as the first-line approach due to the fact from a recent study in the US Nursing Homes (NHs) reported the high mortality rates and a functional status decline in NH resident after 1-year minor urology surgery including TURP. 67 Related to the "social function", a social support approach involving other health professionals is important in preventing social function impairment.…”