Ɔhaw ahorow a ɛfa mmadwoa ho? Momma yensua Ejaculatory Duct Obstruction ho ade!

So ɛtɔ mmere bi a wote nka sɛ wo mmadwoa dodow sua bere a wo ne obi reda? Anaasɛ worehyia ɔhaw wɔ nyinsɛn mu? Ebia nea enti a ɛte saa ne biribi a wunsusuw ho. Ɛnnɛ, momma yɛnka ɔhaw bi a ɛka mmarima ho asɛm, nanso wɔnka ho asɛm pii - ejaculatory duct obstruction, anaa EDO.

Dɛn ne Ejaculatory Duct Obstruction?

Sɛ yɛbɛka no tiawa a, Ejaculatory Duct Obstruction (EDO) yɛ ɔbarima mmadwoa ntini a esiw. Ɛte sɛ nsu paipu a asiw. Eyi betumi ayɛ nea ɛde awo a wontumi nwo , nanso mpɛn pii no, nnuruyɛfo betumi asa.

Dɛn ne vas deferens? Ɔkwan bɛn so na ɛyɛ adwuma?

Okay, afei momma yɛnhwɛ nea ejaculatory duct yɛ. Wowɔ ntini abien (vas deferens) a ɛde mmadwoa fi wo mmadwoa mu. Saa ntini abien yi ne seminal vesicle ducts (nsu a efi ntini afoforo abien a ɛyɛ mmadwoa mu) bom yɛ ejaculatory ducts (EDs). Bere a saa ntini ahorow yi fa prostate gland no mu no, nsu a prostate gland no yɛ no de ka mmadwoa no ho. Awiei koraa no, mmadwoa a edi mũ no fa nsu a ɛkɔ nipadua no mu no mu fi nipadua no mu bere a wɔkanyan nna no. So wote ase? Saa nsu yi de mmadwoa no kɔ.

Saa tebea yi abu so dɛn?

Sɛnea ɛbɛyɛ a wubenya adwene wɔ sɛnea saa akwanside yi abu so no ho no, wobu akontaa sɛ mmarima a wɔwɔ azoospermia, tebea a mmadwoa nni mmadwoa mu no mu bɛyɛ 5% na wɔwɔ saa akwanside yi. Azospermia ankasa ka mmarima bɛyɛ 1%.

So vas deferens akwanside ahorow bi wɔ hɔ?

Yiw, vas deferens obstruction (EDO) ahorow atitiriw pii wɔ hɔ. Momma yɛnhwɛ nea wɔyɛ:

• EDO a edi mũ anaasɛ nea wɔagye din: Eyi ne bere a wɔasiw nsukorade abien no nyinaa ano koraa. Fa no sɛ nsu afiri abien no nyinaa asiw koraa.
• EDO a enni mũ anaasɛ ne fã bi: Wɔ eyi mu no, ebia ntini biako asiw koraa, anaasɛ ntini abien no nyinaa betumi asiw fã bi. Ɛte sɛ nea paipu bi akɔfa fã.
• EDO a ɛyɛ adwuma: Eyi te sɛ EDO a edi mũ, nanso honam fam kwan biara nni duct no mu. Eyi kyerɛ sɛ biribiara nsiw duct no mu, nanso ɔhaw bi wɔ duct no dwumadi mu.

So wowɔ saa sɛnkyerɛnne ahorow yi nso?

Sɛ wowɔ vas deferens obstruction (EDO) a, wubetumi anya saa sɛnkyerɛnne ahorow yi bi:

• Nkwammoaa a wɔtow gu no dodow so tew (ennu 1.5 ml).
• Mma a wɔtow gu so tew ne/anaasɛ mmadwoa dodow a ɛba fam.
• Ɛyaw a wɔte nka bere a obi reda anaa bere a ɔne obi da akyi.
• Ɛyaw a ɛfa prostate gland ho.
• Mogya a ɛwɔ mmadwoa mu (wɔ nnuruyɛ mu no yɛfrɛ eyi `(hematospermia)`).
• Mogya a ɛwɔ nsuo mu (wɔfrɛ eyi `hematuria`).
• Awo a wontumi nwo.

Ebia sɛnkyerɛnne ahorow bi abu so wɔ ɔkwan biako so sen foforo, enti sɛ wowɔ saa sɛnkyerɛnne ahorow yi bi a, ɛbɛyɛ papa sɛ wobɛkɔ oduruyɛfo nkyɛn.

Dɛn na ɛde eyi ba?

Okay, afei momma yɛnhwɛ nea ɛde saa vas deferens obstruction (EDO) yi ba. Ntease ahorow pii betumi aba:

• Awosu mu nneɛma a ɛde ba: Ɛtɔ mmere bi a, awosu mu tebea horow te sɛ cystic fibrosis betumi ama nsakrae aba nipadua no nhyehyɛe mu a ɛba bere a wɔawo no. Sɛ nhwɛso no, ebia vas deferens no nni hɔ (`atresia`) anaasɛ ebetumi ayɛ ketewaa (`atrophic`).
• Ntini a ɛyɛ akuru a efi oprehyɛn a wɔayɛ wɔ akyi berɛmo mu dedaw anaasɛ nsu a ɛkɔ nsu mu no asɛe. Saa akuru yi betumi asiw nsukorade no ano.
• Abo (calculi): Te sɛ asaabo mu abo no, nneɛma nketenkete a ɛte sɛ abo betumi ayɛ na asiw wɔ saa mmadwoa ntini yi mu.
• Nkwammoaa: Ntini betumi ayɛ ntini no mu anaa atwa ho ahyia, na ama ayɛ den.
• Nsuo mu yareɛ a ɛtaa ba (UTIs).
• Prostatitis a enni sabea.
• Epididymitis yɛ ɔfe a ɛba epididymis, ntini a ɛde mmadwoa kɔ akyi berɛmo no akyi no mu.

Afei nso, ɛtɔ mmere bi a ɔhaw ahorow a ɛba mmadwoa ntini no mu no betumi de sɛnkyerɛnne ahorow a ɛte sɛ vas deferens a asiw aba.

Sɔhwɛ ahorow bɛn na wɔreyɛ de ahu eyi pɛpɛɛpɛ?

Oduruyɛfo betumi ayɛ nhwehwɛmu a edidi so yi mu biako anaa nea ɛboro saa de akyerɛ sɛ wɔahu sɛ ɔwɔ ntini a ɛma mogya tu (EDO):

• Semen analysis: Eyi ne sɔhwɛ a ɛho hia sen biara. Ɛhwɛ nneɛma pii te sɛ mmadwoa dodow, sɛnea ɛkeka ne ho, ne sɛnea ɛte.
• Semen fructose nhwehwɛmu: Fructose yɛ asikre bi a ɛwɔ mmadwoa mu. Ɛyɛ seminal vesicles no na ɛyɛ. Sɛ ɛba fam a, ebetumi ayɛ ɔhaw wɔ saa ntini ahorow no ho.
• Transrectal ultrasound (TRUS): Eyi ma wuhu nneɛma te sɛ prostate, seminal vesicles, ne vas deferens pefee. Eyi betumi aboa ma wɔahu akwanside biara.
• X-ray nhwehwɛmu a wɔyɛ wɔ vas deferens no ho.
• Sɔhwɛ a ɛfa aduru a wɔde yɛ aduru a wɔde hyɛ ntini a ɛwɔ nipadua no mu no ho. Wɔfrɛ eyi sɛ vasogram. Eyi betumi ahwɛ sɛ ebia nsukorabea ahorow no asiw anaa.

Dɛn na woreyɛ sɛ ayaresa?

Aduruyɛ akwan titiriw abien na wɔfa so sa saa tebea yi (EDO). Eyinom taa yɛ oprehyɛn:

• Transurethral resection of the ejaculatory ducts (TURED): Eyi hwehwɛ sɛ wɔde adwinnade ketewaa bi fa urethra no mu na wotwitwa ntini (te sɛ cyst anaa akuru) a esiw ejaculatory ducts no ano no.
• Seminal vesiculoscopy: Eyi nso yɛ adeyɛ a wɔde mfoninitwa afiri ketewaa bi (endoscope anaa telescope) fa urethra no mu kɔ prostate no mu, kɔ seminal vesicles no mu, na wohu nea ɛde siw no bae na woyi fi hɔ. Eyi yɛ adeyɛ a ɛyɛ mmerɛw kakra sen TURED.

Ɛtɔ mmere bi a, nnuruyɛfo a wɔyɛ oprehyɛn betumi de akwan abien no nyinaa abom. Nanso, ebehia sɛ wonom nnuru a ekum ɔyare mmoawa na amma ɔyare mmoawa ankɔ so wɔ oprehyɛn no akyi.

Nnuruyɛfo taa kamfo kyerɛ sɛ fa wo mmadwoa (anaasɛ mmadwoa a wode sie) nwini mu ansa na woayɛ saa ayaresa ahorow yi. Esiane sɛ ɛnyɛ bere nyinaa na saa ayaresa ahorow yi di yiye 100% nti, ɛyɛ adwene pa sɛ wobɛyɛ saa a daakye wɔ w’adwenem.

Bere tenten ahe na egye na obi ho atɔ no wɔ ayaresa akyi?

Wɔtaa yɛ saa oprehyɛn ahorow yi a wontra ayaresabea na ɛma wo kwan ma wokɔ fie da koro no ara (`outpatient procedures`).

• Wɔde Foley catheter bɛfa wo barima no mu na aboa wo ma woatow wo ho nna abien kosi abiɛsa wɔ oprehyɛn no akyi. Ebia ɛbɛyɛ nea ɛnyɛ dɛ kakra kosi sɛ wobeyi afi hɔ.
• Ebia mogya bɛba wo nsu ne wo mmadwoa mu bere tiaa bi wɔ oprehyɛn akyi. Eyi yɛ ade a ɛfata, nanso sɛ mogya tu pii a, ɛsɛ sɛ woka kyerɛ wo duruyɛfo.
• Ɛsɛ sɛ wokwati nna kosi sɛ wobɛkɔ wo duruyɛfo nkyɛn na wɔayi catheter no, ne kosi sɛ wo duruyɛfo betu wo fo sɛ ɛnte saa.
• Mma wo mu duru nboro nkaribo 10 (bɛyɛ kilogram 4.5) so bɛyɛ adapɛn abien. Twe wo ho fi dwumadi ahorow a ɛyɛ den ho.
• Fa nnuru a wɔde kum ɛyaw ne nnuru a ekum ɔyare mmoawa sɛnea wo duruyɛfo akyerɛ wo no pɛpɛɛpɛ.
• Sɛ oduruyɛfo no ma wo kwan wie a, wubetumi asan akɔ wo dwumadi ahorow a woyɛ daa no so.

So nsunsuanso bɔne bi wɔ TURED oprehyɛn mu?

Eyinom yɛ nsunsuanso bɔne anaa nsɛnnennen a ɛtɔ mmere bi a ebetumi aba wɔ `TURED` oprehyɛn akyi no bi. Ɛnto obiara, nanso eye sɛ wubehu:

• Sɛ wowɔ anigye kɛse mu a , ebia nsu bi te sɛ nsu bepue.
• Epididymitis (ntini a ɛde mmadwoa kɔ akyi berɛmo no akyi no mu ɔfe) betumi aba.
• Ebia akwanside no bɛsan aba bio.
• Ɛntaa mma koraa sɛ ebia akyi berɛmo no bɛsɛe kakra.
• Ebia nsu a wontumi nhyɛ mu (eyi nso ho yɛ na yiye).

Sɛ woyɛ Seminal Vesiculoscopy a, dɛn na ɛba?

Nsunsuanso bɔne a efi saa ``Seminal vesiculoscopy`` oprehyɛn yi mu ba no ho yɛ na yiye. Wɔn mu dodow no ara yɛ bere tiaa mu de, te sɛ ɛyaw. Nanso, nnipa binom a wɔayɛ wɔn oprehyɛn yi abɔ nneɛma te sɛ:

• Sɛ wote nka sɛ mmadwoa dodow a ɛrepue no sua.
• Te a wɔte nka sɛ nna mu dwumadi anaa adwumayɛ asesa.

Ɛmfa ho oprehyɛn biara a wobɛyɛ no, ɛho hia sɛ wo ne wo duruyɛfo susuw biribiara ho yiye ansa na wɔayɛ.

So ɔkwan bi wɔ hɔ a wɔbɛfa so asiw eyi ano?

Nokwarem no, mprempren ɔkwan biara nni hɔ a ɛda adi pefee a wɔbɛfa so asiw saa vas deferens a wɔasiw ano yi ano. Efisɛ nneɛma bi a ɛde ba no fi awo mu. Nanso, sɛ wotaa nya nsu mu yare (UTIs) a, wubetumi atew asiane a ɛwɔ hɔ no so akodu baabi denam ayaresa a ɛfata a wubenya ama wɔn na woabɔ wo ho ban afi nna mu nyarewa ho no so.

Sɛ wowɔ awosu mu haw ho haw bi a, wubetumi ne awosu ho ɔfotufo bi ahyia abɔ ho nkɔmmɔ.

Nnuru bi wɔ hɔ a ebetumi aka ɔbarima ne ɔbea nna, nanso ɛmma obi ntumi nkɔ ɔbarima ne ɔbea nna mu tẽẽ. Nnuru yi a wobɛkwati no betumi aboa ma ɔbarima ne ɔbea nna atu mpɔn akodu baabi (wɔ nnuruyɛfo afotu ase nkutoo):

• Nnuru a wɔfrɛ no `(Alpha blockers)` (sɛ nhwɛso no, nnuru a wɔde sa prostate a ayɛ kɛse te sɛ `(tamsulosin)`).
• Mogya mmoroso nnuru bi te sɛ thiazides, prazosin, ne phentolamine.
• Nnuru a wɔde sa adwenemyareɛ binom, te sɛ `(thioridazine - Mellaril®)`, `(haloperidol - Haldol®)` ne `(chlordiazepoxide - Librium®)`.
• Nnuru bi a ekum adwenemhaw, te sɛ imipramine ne amitriptyline.

Nea ɛho hia sen biara ne sɛ, nnyae nnuru yi mu biara nom anaasɛ nsakra dodow a wode ma no a wo ne wo duruyɛfo nkasa.

Sɛ mewɔ saa tebea yi a, dɛn na ɛba?

Mpɛn pii no, wuhu sɛ wowɔ EDO bere a wowɔ ɔhaw wɔ nyinsɛn mu no. Anaasɛ ebetumi afi ɛyaw a ɛkɔ so nti. Ɛwom sɛ EDO betumi ayɛ nea ɛnyɛ dɛ de, nanso ɛnyɛ nea ɛde nkwa to asiane mu anaasɛ ɛde ɔyare mmoawa ba. Ɛno yɛ ahotɔ, ɛnte saa? Mpɛn pii no, nnuruyɛfo betumi asa saa tebea yi yiye na wɔasan awo bio.

Bere bɛn na ɛsɛ sɛ mekɔ oduruyɛfo nkyɛn?

Sɛ wowɔ saa nsɛm yi bi a, kɔ oduruyɛfo anaa wo ne no nkasa ntɛm ara:

• Sɛ mogya tu foforo anaa ɛboro so (wɔ mmadwoa anaa nsu mu).
• Sɛ wowɔ ɛyaw foforo anaa ɛkɔ soro (wɔ yafunu ase, atwa awotwaa ho ahyia, bere a wo ne obi renya nna mu kyɛfa).
• Sɛ wowɔ atiridiinini a ɛboro digrii Fahrenheit 102 (bɛyɛ Celsius 38.9).
• Sɛ wote nka sɛ awɔw wom na wo ho popo a.
• Sɛ wɔayɛ wo oprehyɛn wɔ wo nan ho na ɛho ahonhon anaa ɛyaw wɔ kuru no ho a.
• Sɛ wowɔ aduru bi a worenom ho akisikuru (e.g. honam ani akisikuru, ɛyɛ den sɛ wobɛhome).

Sɛ worebɔ mmɔden sɛ wobɛwo akokoaa nanso worehyia ɔhaw a, bisa wo duruyɛfo no ma ɔmmoa wo mma wunhu nea ɔhaw no yɛ. Sɛ wowɔ fallopian tube a asiw a, ebia wo duruyɛfo bɛkamfo akyerɛ sɛ wɔnyɛ oprehyɛn mfa nsiesie nea asiw no. Oprehyɛn ahorow yi betumi adi nkonim kɛse. Sɛ wo ne wo duruyɛfo bɛkasa nokwarem a, ɛno ne ɔkwan a eye sen biara a wobɛfa so asi gyinae a eye sen biara wɔ w’akwahosan ho.

Nkrasɛm a ɛho hia sen biara a ɛsɛ sɛ wode kɔ fie no bi

Ejaculatory Duct Obstruction yɛ tebea a wotumi sa a ɛka mmarima. Ɛho hia sɛ wohu eyi.

• Hwɛ yare no ho sɛnkyerɛnne: Sɛ wo mmadwoa dodow sua, ɛyaw, anaa mogya wɔ wo mmadwoa anaa wo nsu mu a, hwɛ hu sɛ wobɛhwehwɛ aduruyɛfo afotu. Mma w’ani nnye ho.
• Eyi betumi ayɛ nea enti a wonwo mma: Sɛ wo ne wo hokafo rehwɛ akokoaa kwan nanso woretwentwɛn wo nan ase a, ɛbɛyɛ nea nyansa wom sɛ wobɛhwehwɛ eyi nso mu.
• Ɛho hia sɛ wuhu yare no pɛpɛɛpɛ: Kwati sɛ wubegyina nea wokenkan wɔ Intanɛt so so ahwehwɛ wo ho. Ma oduruyɛfo a ɔfata nkɔyɛ nhwehwɛmu na woahu nea ɛde ba ankasa.
• Ayaresa ahorow wɔ hɔ: Oprehyɛn te sɛ `(TURED)` ne `(Seminal vesiculoscopy)` betumi asa saa tebea yi yiye. Nha wo ho.
• Wo ne wo duruyɛfo nkasa pefee: Ɛho hia paa sɛ wo ne wo duruyɛfo bɛbɔ wo haw, wo suro, ne nea wohwɛ kwan ho nkɔmmɔ pefee. Ɛno ansa na wubetumi apaw ayaresa a eye ma wo.

Kae sɛ ɛho nhia sɛ wofɛre anaasɛ wusuro sɛ wobɛka nsɛm yi ho asɛm. W’akwahosan ne w’anigye ne ade a ɛho hia sen biara!

` Ejaculatory Duct Obstruction, Mmarima a Wontumi Nwo, Nkwaboaa, Nkwammoaa, TURED, Prostate