Kenneth Gannon

Distress in sub-fertile men: A longitudinal study

Abstract This study aims to describe the experiences of sub-fertile men and to document change over time. Patients attending a specialist male sub-fertility clinic completed questionnaires at clinic attendance and at 6 weeks and 18 months following consultation. Data were collected on mood, blame, life satisfaction, sexuality and expectations of pregnancy. Results suggest that these men are highly anxious. They blame themselves for their fertility problems and often feel less of a man because of them. Their satisfaction with life is much less than they perceive it would be if they had a baby. Expectations of life satisfaction and blame are both implicated in contributing to distress. Measures of mood, life satisfaction and self-blame are unchanged at 6 weeks and 18 months.

Men and chronic illness: a qualitative study of LUTS.

In order to determine how men react to and manage chronic conditions 16 men with Lower Urinary Tract Symptoms (LUTS) were interviewed to examine the relationship between detecting symptoms and seeking medical help, perceptions of symptoms and the impact of symptoms on daily life. Transcripts were analysed employing IPA and four major themes identified: Uncertainty/Trying to understand, Implications, Ways of coping and Self-concept/Identity. Uncertainty about the nature and origins of their condition and its gradual onset contributed to the delay in seeking medical advice. Men adopted a range of coping strategies to manage their symptoms. Implications for primary health care consultations are considered.

Re-constructing masculinity following radical prostatectomy for prostate cancer.

Prostate cancer is common in older men. Surgical treatment involving removal of the prostate can result in temporary or permanent erectile dysfunction (ED) and incontinence and have a major impact on mens masculine identity. Seven men were interviewed about their experiences and concerns following prostatectomy, and the transcripts were analysed employing Foucauldian Discourse Analysis to identify the ways in which they constructed their masculinity. Participants drew upon four main discourses when discussing the impact of surgical treatment on their sense of masculinity: masculine identity and sexual activity, ED as a normative experience, mental resilience and vulnerability. Penetrative sex was constructed as central to a masculine identity, but inability to achieve this was normalised in terms of the ageing process. Stereotypically masculine qualities of emotional control and rationality were drawn on in describing their reaction to the diagnosis and treatment of cancer but they also experienced a new-found sense of physical vulnerability. The findings are discussed in terms of their implications for the clinical management of ED post-surgery and helping men adjust to life following treatment.

Men's experiences of having lower urinary tract symptoms: factors relating to bother

To gain an understanding of mens experiences of having lower urinary tract symptoms (LUTS) and of bother, a principle determinant of whether a patient has an intervention for LUTS.

Third-party prospective evaluation of patient outcomes after dynamic graciloplasty.

Dynamic graciloplasty (DGP) is a complex procedure designed to improve bowel function in patients with end‐stage faecal incontinence. Outcomes of DGP were examined in comparison with stoma formation or continued medical management.

The experiences of young people with Epidermolysis Bullosa Simplex: a qualitative study.

The objective of this study was to explore the experiences of young people with Epidermolysis Bullosa Simplex (EBS). Eleven participants aged 10 -14 years were interviewed and Interpretative Phenomenological Analysis was employed. A key theme was ‘self as different’. This related to experiences of negative treatment and exclusion from peers; a lack of understanding of others about the condition; and a sense of the self as ‘wrong’. Findings indicate the importance of providing appropriate psychological and peer support, as well as wider community education and intervention, as part of the holistic treatment of young people with this chronic, painful and visible skin condition.

Lower urinary tract symptoms in men : self-perceptions and the concept of bother

An interesting study from the UK explores the meaning men attach to their experiences of having LUTS and to understand the meaning of the word bother in this context. Their findings are very helpful to clinicians, and perhaps to people constructing clinical trials in the future. A second report assesses the bothersomeness and impact on quality of life of urinary incontinence in women in France, Germany, Spain and the UK. The author concluded from their study that when determining the most appropriate management strategy doctors should consider the experience of being incontinent as being unique to each individual.

Low Urinary Tract

An interesting study from the UK explores the meaning men attach to their experiences of having LUTS and to understand the meaning of the word bother in this context. Their findings are very helpful to clinicians, and perhaps to people constructing clinical trials in the future. A second report assesses the bothersomeness and impact on quality of life of urinary incontinence in women in France, Germany, Spain and the UK. The author concluded from their study that when determining the most appropriate management strategy doctors should consider the experience of being incontinent as being unique to each individual.

Male subfertility: is pregnancy the only issue?: Psychological responses matter too—and are different in men

The management of male subfertility is changing radically. The advent of intracytoplasmic sperm injection in particular has given some men the chance to father children even when they have no sperm in their ejaculate. However, the focus on pregnancy as the most important outcome of subfertility treatment appears to have taken place to the exclusion of other outcomes, such as the psychological well being of the couple and, in particular, of the man. Traditionally the little research there has been into psychological responses has focused on women. Recently a start has been made in redressing this imbalance, and it appears that mens experiences of, and responses to, subfertility are fundamentally different from that of their partners. Recognition of the need to take into account psychological outcomes of subfertility and its management is not new but it seems to have slipped …

Psychological factors in the aetiology and treatment of recurrent miscarriage. a review and critique

Abstract Despite recent advances in medically-based therapies for recurrent miscarriage there is a continuing interest both in the possible role of psychological factors in the causation and maintenance of this condition and in psychologically-based methods of treating it. The present paper reviews the way in which empirical research and clinical observation have contributed to the development and elaboration of psychological theories of recurrent miscarriage and therapies for its treatment. The evidence upon which such theories and therapies were based is examined critically, as are the research methodologies employed. The problems involved both in designing and interpreting the results of psychologically-based treatment programmes are considered and suggestions for overcoming these difficulties are advanced. A discussion of whether continued research into this topic is warranted concludes that it is, provided that lessons from past mistakes are adequately heeded.