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Men's Health, with Cork University Hospital: Actions that men can take to enhance their health 

Health experts at Cork University Hospital offer advice for men of all ages to help them spot symptoms and take early actions to enhance or even save their lives.


Essential advice on health and wellbeing for men

working with men of all ages to achieve better health outcomes is the principal focus of the expert health advice gathered on this page and in the companion booklet, ‘Let’s Talk Men’s Health’, distributed with the Irish Examiner. 

This content is part of a focused Men’s Health Week campaign, November 14-19, 2022, compiled in partnership with CUH Charity, with health specialists at Cork University Hospital, along with interviews with some of their patients whose lives have been enhanced by seeking and following the caring advice.

The content also offers insights on new approaches and new technologies that, combined with tried and proven methods, are delivering positive health outcomes for men.

Staff nurses in the 4D ward, CUH: Marieke Buckley, Mary McGuane, Bhanu Priya, Feba Eldhose, Róisín Vickery and Anna O'Sullivan, pictured Outside Cork University Hospital.

Staff nurses in the 4D ward, CUH: Marieke Buckley, Mary McGuane, Bhanu Priya, Feba Eldhose, Róisín Vickery and Anna O'Sullivan, pictured Outside Cork University Hospital.PICTURE DENIS MINIHANE

New era on horizon for delivery of trauma services 

ireland is embarking on reconfiguration of how trauma care is delivered. 

Soon there will be two trauma networks in Ireland with a major trauma centre at the hub of each, working in collaboration with trauma units and local injury units. 

Cork University Hospital will be the Major Trauma Centre for the South Trauma Network which takes in all of Munster and somewhat beyond. 

This arrangement of services results in better outcomes, less people dying and less people living on with debilitating injuries. In the near future, the Paramedic in the National Ambulance Service will identify severely injured patients prehospital, commence their resuscitation and make the decision to bypass smaller hospitals to ensure the patient gets to the right place in the right time. 

For the less severe injuries, wounds and broken bones, you can present to your local injury unit (LIU). These are really efficient facilities and will have you in and out very quickly. 

They are linked with the specialist services in the Trauma Units and Major Trauma Centres should you need to be transferred on. 

To find out more about your local LIU check out https://www2.hse.ie/services/injury-units/ 

Medical team examining X-ray image of a pelvis in the hospital.

Medical team examining X-ray image of a pelvis in the hospital.PICTURE GETTY IMAGES

What local injury units can treat (from HSE website): 

·    Broken bones to legs, from knees to toes 
·    Broken bones to arms, from collarbone (clavicle) to fingertips 
·    All sprains and strains 
·    Minor facial injuries (including oral, dental and nasal injuries) 
·    Minor scalds and burns 
·    Wounds, bites, cuts, grazes and scalp lacerations (cuts) 
·    Small abscesses and boils 
·    Splinters and fish hooks 
·    Things suck in eyes, ears or nose 
·    Minor head injuries (fully-conscious patients, who did not have loss of consciousness or vomit after the head injury) 

X-ray hip fracture of old man, X-ray image intertrochanteric fracture

X-ray hip fracture of old man, X-ray image intertrochanteric fracture

What injury units may not treat:

·    Conditions due to medical illness - for example, fever, seizures, headache 
·    Injury causing chest pain, abdominal pain or shortness of breath 
·    Serious head injury 
·    Chest pain 
·    Respiratory conditions 
·    Abdominal (stomach) pain 
·    Gynaecological problems 
·    Neck or back pain 
·    Pregnancy-related conditions 
·    Pelvis or hip fractures 
·    Injuries due to self-harm 
·    Suspected serious injury after an accident 
·    Not being able to walk following a fall from a height or a motor vehicle crash 

In these cases, you should attend your nearest emergency department rather than an injury unit. 

Dave Doyle pictured in his garden at his home in Cobh.

Dave Doyle pictured in his garden at his home in Cobh. PICTURE HOWARD CROWDY

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The rehab team gave me back my confidence after the heart attack. They built me up, mentally and physically

Dave Doyle former CUH cardiac inpatient, reflects on why he feels lucky to be alive.

when Dave Doyle’s father died from a heart attack at 59, he vowed he’d get a complete health check done privately when he reached his fifties. He did so in Dublin in 2021. 

What showed up, he says, was that his cholesterol was ‘a bit high’. So he took the statins that were prescribed and carried on with his life. 

“I did stress tests, and [coronary] calcium tests. I did everything I could. Then three or four months after the complete health check, on an Easter Sunday morning in 2021, while out walking with my wife, I got chest pain, after walking up a hill. 

“I thought I had indigestion. I couldn’t keep going. I’d left my phone in the car but a group strolling behind us knew a retired doctor who lived nearby. They called him and he came down, then he contacted another doctor. Soon there were three doctors, none my own, around me. While we waited for an ambulance, one called for his daughter to bring an aspirin.”

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naturally, Doyle, then 52, felt ‘scared and a bit stressed’ at the time: “Because Covid had arrived in the country, my wife wasn’t allowed to go into the hospital with me and as my phone was still back in my car, I couldn't call her. 

“When the ambulance took me to CUH, I was still in denial. But the test results confirmed I’d had a heart incident. Later I was sent down for an angiogram. This showed that I’d need three stents put in.” 

When that was done and the anaesthetic wore off, the relief Doyle felt ‘was immense.’ 

Doyle never smoked. But he was a shift-worker and had been for 30 years. 

Describing his life now, he says: “I switched from shift-work to normal hours. Pfizer, my employer, has been fantastic. This simple change had a hugely positive impact. I now sleep well and feel better. Also, I return regularly to CUH to see my consultant.” 

Dave is full of praise for CUH physiotherapist, Peter Morgan, and the rest of the rehab team. 

 “They gave me back my confidence, which had been shattered by the heart attack. They built me up, mentally and physically. Without their support, I’d have been panicking after going home from hospital, if I found myself out of breath while exercising. Now I know what to do and how far to push myself, and how to work with my heart rate.” 

Unsurprisingly, the cardiac scare has changed him: “Stuff that used to bother me before, doesn’t anymore. I’ve a healthier lifestyle, walking a lot and sailing around Cobh. I’m lucky I got to stand up again and walk away after the heart-attack. Too many never get that chance.” 

 
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Easy exercise routines to enhance heart health in men 

Heart disease accounted for 17.5% of deaths in Ireland in 2021, according to CSO figures. Of these, 53% were male, which is in keeping with previous findings of higher mortality rates from heart disease among men than women. 

One way that men can reduce their risk of heart disease is by incorporating regular exercise into their lifestyle. Studies report that leading an active lifestyle reduces mortality from heart disease and increases longevity. 

Regular exercise has a direct beneficial effect on the heart, inducing adaptive changes at a cellular level. This and similar adaptive processes in the lungs and muscles all contribute to improved physical fitness.  

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regular exercise can also reduce other cardiovascular risk factors such as high cholesterol, high blood pressure, obesity and stress. 

Health experts advise at least 150 minutes of moderate-intensity or 75 minutes of high intensity aerobic exercise per week, or a mix of both, preferably spread over the week. 

However, only 54% of Irish men achieve 150 minutes of moderate intensity exercise per week. This number decreases from 63% in the 25–34-year age group, to only 20% in the 75+ age group. 

Encouragingly though, for men who are currently inactive, taking up exercise later in life can still overcome prior years of inactivity. So, it is never too late to start! 

Examples of aerobic exercises include: walking jogging, cycling, swimming, dancing, rowing, kayaking and so on. Start by doing small amounts of physical activity, and gradually increase the frequency, intensity and duration over time. 

Check your testicles at least once a month in the shower. Look for hard lumps, smooth or rounded bumps. Look for changes in size, shape or consistency or painful areas.

Check your testicles at least once a month in the shower. Look for hard lumps, smooth or rounded bumps. Look for changes in size, shape or consistency or painful areas. PICTURE GETTY IMAGES 

Testicular cancer: Spotting the signs and reducing the risk! 

Most testicular cancers are germ cell tumours. Germ cells are the special cells that are needed for reproduction. There are two main types of testicular cancer: Seminoma and non-seminoma.  

Seminomas: These usually develop between the ages of 30 and 50. One in three testicular cancers is a seminoma. Seminomas grow slowly and respond very well to treatment. 

Non-seminomas: These develop between the ages of 15 and early 40s. They tend to grow and spread faster than seminomas. They include teratomas, embryonal cancers and mixed germ-cell tumours. 

Did you know? Did you know! Testicular cancer is more common in men who were born with a testicle that did not come down into the scrotum (undescended testicle). 

 

What are the symptoms of testicular cancer?

·    A painless lump or swelling in your testicle 
·    Pain, discomfort or heaviness in your testicle or scrotum 
·    Pain or dull ache in your groin or tummy 
·    A change in the way your testicle feels  

Testicle cancer symptoms infographics.

Testicle cancer symptoms infographics. PICTURE GETTY IMAGES

Check your testicles

·    Check your testicles at least once a month 
·    Perform the test in the shower
·    Use soap 
·    Check one testicle at a time 
·    Gently roll it between your fingers
·    Feel up the spermatic cords on the back side of the testicles
·    Look for hard lumps, smooth or rounded bumps  
·    Look for changes in size, shape or consistency 
·    Look for any painful areas

Male prostate cancer diagram illustration

Male prostate cancer diagram illustration PICTURE GETTY IMAGES

 

Prostate Cancer

Prostate cancer happens when the normal cells in the rotate gland change and grow to form a mass of cells called a tumour. These cancer cells can affect how the prostate works. 

Prostate Cancer Cells may not grow at all or else grow slowly during a man’s lifetime. Many men never develop problems or symptoms from their prostate cancer. In some, prostate cancer grows more quickly and needs treatment to prevent it spreading outside the prostate gland. 

In most cases prostate cancer can be cured or kept under control. 

It is most common in men in the fifties and onwards. It can occur on rare occasions in men in the late forties. The risk of developing prostate cancer rises with age 

The Warning Signs

·  Difficulty passing urine
·  Passing urine more often than usual, especially at night
·  Needing to rush to the toilet 
·  Stopping and starting while passing urine, or weak flow 
·  Feeling like you are not emptying your bladder fully 
·  Blood in the urine 
·  Pain when passing urine 

 
Healthy diet and daily exercise can help reduce the risk of cancer, particularly valuable advice for men aged 50 and over.

Healthy diet and daily exercise can help reduce the risk of cancer, particularly valuable advice for men aged 50 and over.  PICTURE GETTY IMAGES

Get the tools to reduce your prostate cancer risk

Be active  Aim for at least 30 minutes of moderate physical activity a day.  

Be a healthy weight  Aim for at least 30 minutes of moderate physical activity a day.  

Have a healthy diet  eat fruit, vegetables, and pulses. Limit food high in sugar, salt and fat. Avoid processed meat and limit red meat.

Get checked  if you are over 50 you should see your doctor every year for a check-up. If you have a family history of prostate cancer you should have regular check-ups from the age of 40. 

Did you know? Your risk of prostate cancer increases as you get older. Most men with the disease are over 50. If your brother or father has had prostate cancer, your risk is also higher. 

 
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Inflammatory low back pain/ AxSPA 

Low back pain is very common and over 80 % of people will have at least one episode of low back pain in their lifetimes. 

Axial Spondloarthopathy (AxSpA) is a rare cause of low back pain. It is more common in men than women. It is an inflammatory arthritis which affects the spine and the sacroiliac joints which are the joints between base of the spine and the pelvis. An early diagnosis is important as it is a treatable condition, however the average delay to diagnosis is over eight years. 

Up to 13% of people with inflammatory bowel disease such as Chron’s or ulcerative colitis may have AxSpA. It is also more common in people who have a skin condition called psoriasis. 

Other joints such as the hip and knee can be affected and may become painful and swollen. Problems such as heel pain because of plantar fasciitis and achilles tendonitis can occur as part of this condition. Inflammation of the eye called uveitis can also occur in people with AxSpA. 

Up to 40% of people with AxSpa do not contact a doctor within a year of symptom onset. If you have most of the symptoms listed please discuss with your GP who can refer you to a rheumatologist if needed. 

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Inflammatory low back pain symptoms: 

·    Gradual onset 
·    Ongoing for 3 months 
·    Low back stiffness in the morning for at least 30 minutes
·    Pain is better with movement and worse with rest 
·    Waking in the night because of back pain 
·    Onset usually before age 40

Treatment includes anti-inflammatory medication and other medication to control inflammation as needed. This will be decided by a rheumatologist who is a doctor who specialises in the management of arthritis. 

Regular exercise including fitness, exercises to maintain spine flexibility and strengthening exercises are also an important part of long-term management. A chartered physiotherapist can assess, plan and prescribe an individual exercise program with the person living with this condition. 

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Since April 2022, CUH has been performing transperineal (TP) biopsy of the prostate under local anaesthetic in CUH. This is a relatively quick procedure that takes 15-30 minutes and is performed as a day case. PICTURE GETTY IMAGES

Transperineal Prostate biopsy under local anaesthetic: new approach now in Cork

An MRI scan of the prostate is performed in men when a Urologist is suspicious that they may have prostate cancer. 

While the MRI scan can localise the potential cancer in the prostate, a biopsy is still needed to confirm the presence of cancer and to assess the grade to aid in treatment planning. 

Traditionally, a transrectal ultrasound guided (TRUS) biopsy was performed of the prostate. 

This is where a small ultrasound probe is inserted into the rectum to visualise the prostate and samples of tissue from the prostate are taken with a needle through the rectal wall. 

A potential serious side effect from this type of biopsy is sepsis (serious complication of an infection), which can happen in up to 1-2 in 100 men, as the biopsy needle introduces bacteria from the rectum into the prostate. 

A template transperineal biopsy is occasionally performed, but because patients have to undergo a general anaesthetic for this type of biopsy it is not suitable/practical for most men. 

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A transperineal biopsy is a biopsy to look for cancer cells in the prostate. This helps to diagnose prostate cancer. 

Prostate biopsy medical healthcare vector illustration. PICTURE GETTY IMAGES

Since April 2022, we have been performing transperineal (TP) biopsy of the prostate under local anaesthetic in CUH. This is a relatively quick procedure that takes 15-30 minutes and is performed as a day case. 

Men are able to leave 30 minutes after the procedure and are able to drive themselves home. 

A small ultrasound probe is placed into the rectum like the TRUS biopsy but the samples of tissue are now taken using a small needle though the perineum (skin between the scrotum and rectum) after local anaesthetic is given to this area. 

This almost completely eradicates the risk of sepsis. It also allows us to access areas of the prostate that we could not reach previously with the TRUS technique. 

TP biopsy is a safer and superior method for getting tissue from the prostate and we are delighted to be able to offer this service to men in the South/Southwest region. 

Men Health booklet

Irish Examiner Let's Talk Men's Health Booklet

To read our complimentary epaper edition click here

This report on Men’s Health was also produced as an information booklet by the Irish Examiner in association with Cork University Hospital and CUH Charity, entitled 'Let's Talk Men's Health'. It features contributions from the CUH service teams spread across a range of departments, working to deliver healthcare services to men of all ages right across Munster,  learn more. CUH Charity is currently raising funds and awareness of a number of key health services for men, learn more. The Irish Examiner, CUH and CUH Charity information booklet 'Let's Talk Men's Health' is a core element in the hospital's current public information campaign on men's health services.

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The team in CUH theatre 8: Dr Colm Lane, consultant anaesthetist; Meera George, staff nurse; Olga Kenny, staff nurse; Bindu Mathew, CNM1; Maura O'Donoghue, CNM2; Mr Kevin O'Connor, consultant urologist, and Mohammed Hegazy, urology SPR. PICTURE DENIS MINIHANE

CUH seeks public support to fund life-saving health services for men 

Michael Nason

CEO of CUH Charity

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The team at Cork University Hospital are very grateful to the public for their support. Public donations help CUH deliver services that enhance and save lives.

raising funds to support projects that might not otherwise happen is a core mission of Cork University Hospital Charity. 

CUH Charity thanks the public for its donations, which raised €3.2m for a new Da Vinci Xi Robotic System to allow Cork University Hospital which has saved and enhanced many lives, notably of men with cancer, during 2022. The benefits of a robot over conventional surgery will be seen in the areas of urology, colorectal, cardiac and thoracic cancer. 

 “CUH Charity greatly appreciates the many individuals and groups that raise money for a specific cause or department within CUH,” says Michael Nason, CEO of CUH Charity. “Often they do it to honour the memory of someone who lost their life in the health system, maybe through cancer, heart, or some other ailment. 

 “Others feel driven to give something back, having had a hugely positive experience of how their child, husband, wife or some other loved one was looked after at CUH. So they run, cycle or organise an event to fundraise. 

 “In this way, CUH Charity engages closely with CUH patients and consultants and with members of the public. In so doing, we have found those who work at CUH to be really good people who work incredibly hard.” 

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The Da Vinci Xi Robot in the theatre.PICTURE DENIS MINIHANE

robotic surgery is usually associated with minimally invasive surgery, procedures performed through tiny incisions. The benefits of robotic over conventional surgery are well known in urology, colorectal, cardiac and thoracic cancer. 

Kevin O’Connor, consultant urologist at CUH says: “The da Vinci Xi surgical system facilitates the surgery in many ways, which include improved magnification, improved surgeon ergonomics and greater technical ease of suturing in a tight space deep in the abdomen. This translates into better outcomes for patients in relation to less pain and a quicker recovery.” 

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The Robotic Console in theatre 8.PICTURE DENIS MINIHANE

 “AT CUH, we are a hospital serving 1.5 million people, with half a million patients attending annually,” says Michael Nason.“The improvement in treatment the robot brings to patients is immense. Also, its dual-control mechanism facilitates teaching and research as students get to learn while standing side by side with working surgeons.

“The health system can’t pay for everything. It’s that way all over the world. CUH Charity is asking individuals, groups, organisations and philanthropists to please give whatever they can to help CUH in the delivery of essential health services.  

“When a community comes together, it can deliver on powerful results. Your fundraising efforts and donations will literally be Saving and Changing Lives. We thank you for your support and we ask you to continue supporting our work to ensure the CUH team have the best of equipment to work with.” To donate to Cork University Hospital Charity and help it support the provision of health services at CUH, visit:   https://www.cuhcharity.ie/donate-page/


To donate please do any of the following:
Tel: 021 423 4529
www.cuhcharity.ie
Or post your donation to:
CUH Charity,
Room 8 Main Concourse,
Cork University Hospital,
Wilton,
Cork.

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