Journal of the New Zealand Medical Association, 12-December-2008, Vol 121 No 1287
Doctoring New Zealand’s gay men
Jeffery Adams, Tim McCreanor, Virginia Braun
This research reported investigates gay men’s experiences of using general practitioner (GP) services. The key result is concerned with how men attempt to access high quality GP services. Participants reported two main ways they achieve this. The first is through selection of doctor; the second is through controlling disclosure of their sexuality to the doctor. While many men reported good healthcare experiences, others did not. In order to optimise quality of care, gay men carefully managed their relationship with their doctors. Doctors play a crucial role in facilitating an environment to allow disclosure. While a minority of men have disclosed sexuality and sexual behaviours to their doctors, most men have not, arguably to the detriment of their healthcare. We argue that doctors need to be cognisant of the health needs of gay men in order to provide high quality care and conclude that there is a need for medical practitioners and associations and gay men to jointly address these issues.
A 12-year review of gunshot injuries: Auckland City Hospital experience
Li Hsee, Ian Civil
Gunshot (GSW) wounds in Auckland are very uncommon comparing with other major cities worldwide. Because GSW are uncommon, trainees and specialists have little exposure to their management. The aim of this study is to look at a cohort of patients with gunshot injuries treated at Auckland City Hospital over a 12-year period in order to determine their incidence, presentation, severity of injuries and outcomes.
Management of low-velocity, non-gunshot-wound penetrating abdominal injury: have we moved with the times?
Li Hsee, Ian Civil
The incidence of penetrating abdominal injuries in Australia and New Zealand is still low. We undertook this study to determine whether surgical practice and management have changed in this population of patients. Despite the availabilities of key-hole surgery and advanced imaging techniques, surgical practice in a major metropolitan New Zealand hospital had not changed in managing penetrating abdominal injuries.
Robot-assisted laparoscopic radical prostatectomy (RALP)—a new surgical treatment for cancer of the prostate
Liam C Wilson, Joanna Pickford, Peter J Gilling
The da Vinci surgical robot is a significant technological advance in the treatment of prostate cancer with over 70% of all men with prostate cancer now having this form of treatment. Developed by the US military, it has evolved into a state-of-the-art machine which allows the surgeon unparalleled access and vision inside the abdomen and pelvis. This enables surgical precision not previously possible with standard open or key-hole surgery. The nature of the robotic surgery means that men have a shorter hospital stay and faster return to work and normal activities. Our unit in Tauranga was the first centre to use the robot in New Zealand and our study looked at the first 30 men having RALP for prostate cancer. The outcomes were excellent, with the average length of hospital stay being 1.4 days. There were no major complications and the surgical outcomes compare very favourably to published series anywhere in the world.
A prospective study analysing the effect of pain on probe insertion, and the biopsy strategy, on the patients’ perception of pain during TRUS-guided biopsy of the prostate
Samarth Chopra, Edward W J Rowe, Marc Laniado, Anup Patel
With increasing use of prostate specific antigen (PSA) as a screening test for cancer of prostate, there is need for developing predictive nomograms to pick up patients who would develop complications from transrectal ultrasound (TRUS) and biopsy of prostate. This paper is part of screening study done to diagnose cancer of prostate and looked at predicting factors for patients who would benefit from use of anaesthesia/analgesia at time of biopsy, and change in technique of doing biopsies for prostate.
Who goes to a sexual health clinic? Gender differences in service utilisation
Jane Morgan, Jarrod Haar
Data from recent initiatives in the Waikato district to improve access to GP-provided sexual health care suggests most consults are by young women. Where do young men go with sexual health concerns, if anywhere? This audit of Hamilton sexual health clinic attendees suggests men aged 20 years and older are at least, if not more, likely than women of the same age to attend a sexual health clinic for sexual health concerns. However, in keeping with other New Zealand research, there appears to be under-utilisation by younger men. To improve sexual health for men and women, help-seeking must be timely and effective. We need to better understand and address sexual healthcare barriers for younger men.
Declining sperm quality in New Zealand over 20 years
Rebecca Shine, John Peek, Mary Birdsall
This is a study looking at the sperm test results from 975 men over a 20-year period (1987 to 2007) who volunteered to be sperm donors at Fertility Associates in Auckland and Wellington. We observed a significant drop in sperm counts over 20 years (110 million per ml to 50 million per ml) along with a reduction in volume. This is the first study of its kind in New Zealand and reflects similar observations seen in other countries such as Scotland, Denmark, and France. The cause of this decline in sperm counts is unknown, although many suggest an environmental influence.
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