So ɛyɛ den ma wo nso sɛ wobɛtow wo ho yiye? Momma yensua Non-Neurogenic Voiding Dysfunction ho ade!

So ɛtɔ mmere bi a wote nka sɛ worehyia ɔhaw wɔ wo ho a wobɛtow ? Anaasɛ wote nka sɛ wo akisikuru no nnyaa mpan koraa bere a woatoto wo ho awie no ? Ebia woretu nsu mpo mpofirim. Eyi nyɛ ɔhaw mma wo nko, na mmom nnipa pii nso. Ɛnnɛ, yɛbɛka nsu a wontumi nhyɛ mu a ɛnyɛ ntini mu haw biara na ɛde ba ho asɛm . Wɔ aduruyɛ mu no, yɛfrɛ eyi ``Non-Neurogenic Voiding Dysfunction''.

Dɛn ne Non-Neurogenic Voiding Dysfunction a Ɛyɛ Adwuma?

Sɛ yɛbɛka no tiawa a, eyi yɛ tebea a wuntumi nyi wo akisikuru mu koraa. Asɛmfua "non-neurogenic" a ɛwɔ ha no kyerɛ sɛ ɛnyɛ ɔhaw biara a ɛwɔ wo ntini mu, kyerɛ sɛ, w'amemene, w'akyi berɛmo, anaa ntini mu na ɛde tebea no ba. "Voiding dysfunction" kyerɛ sɛ ɔkwan a wɔfa so tow nsu no nkɔ yiye.

Saa tebea yi betumi aba obiara so. Mpɛn pii no, eyi betumi afi akisikuru ntini a ɛyɛ mmerɛw, nsu a ɛtwetwe nsu no mu baabi a asiw, anaa subammɔne a yɛasua bere tenten. Nanso, saa tebea yi taa ba mmofra nkumaa a wɔabɛyɛ tiafi a wɔatete wɔn a wɔadi fi mfe 4 kosi 6 ne mmea a wɔadi boro mfe 40. Fa no sɛ, ɛsɛ sɛ mmofra a wɔadi fi mfe 4 kosi 6 biara mu bɛyɛ biako to nsu awia esiane `(Non-neurogenic voiding dysfunction)` yi nti. Afei nso, mmea a wɔadi boro mfe 40 bɛboro 6% na wɔwɔ saa tebea yi.

Dɛn ne tebea yi ho sɛnkyerɛnne? (Nsɛnkyerɛnne a Ɛkyerɛ sɛ Non-Neurogenic Voiding Dysfunction)

Hwɛ sɛ wowɔ saa su ahorow yi bi anaa:

• So ɛyɛ den sɛ wubefi ase atow nsu ? Anaasɛ ɛsɛ sɛ wohyɛ wo ho so bere a woretow nsu no ?
• So nsu a ɛkɔ nsu mu no yɛ teateaa paa? Anaasɛ nsu a ɛkɔ nsu mu no fi ase, gyae kakra, na afei efi ase bio?
• So ɛsɛ sɛ wohyɛ wo yafunu mu ntini mu den bere a woretow nsu no ? Anaasɛ ɛsɛ sɛ wode wo nsa abien nyinaa kura wo yafunu ase?
• So wote nka sɛ wo akisikuru no nnyaa mpan bere a woatow awie mpo ?
• So wo ho ayɛ wo hyew ? (Eyi nso taa yɛ nea ɛfa ho)
• So woretow wo ho asen sɛnea wotaa tow (wotaa tow wo ho) anaasɛ ɛnnɔɔso?
• So woto wo nsu bi mu wɔ akwanhyia mu (urinary incontinence)?
• So wote nka mpofirim sɛ ɛho hia ntɛm ara sɛ wobɛtow nsu (urge incontinence)?
• Nsu a wɔtow bɛboro pɛnkoro anadwo bere a wɔadaSo ɛsɛ sɛ wosɔre na woayɛ (nocturia)?

Su titiriw a ebia mmofra nkumaa benya:

Sɛ mmofra nkumaa wɔ saa tebea yi a, ebia wɔbɛda nneɛma te sɛ:

• Wo ntade a wobɛma ayɛ nwini awiabere (bere a woatete wo tiafi akyi mpo).
• Nneɛma ahorow bi wɔ hɔ a ebetumi ama obi akɔto nsu mu . Nhwɛsoɔ:
• Me nan atwa ho ahyia.
• Sɛ obi bɔ fam bere a ɔte hɔ.
• Wɔde wɔn nsa anaa wɔn nan ase akura wɔn nan mu.

Sɛ wuhu sɛ wo ba reyɛ saa nneɛma yi a, ɛsɛ sɛ wohaw wo ho kakra.

Dɛn na ɛde eyi ba? (Nneɛma a Ɛde Non-Neurogenic Voiding Dysfunction Ba) .

Nneɛma atitiriw pii nti na tebea yi ba:

• Akisikuru ntini a ɛyɛ mmerɛw.
• Biribi asiw wo nsu a ɛkɔ wo nsu mu no mu baabi.
• Akisikuru a ɛyɛ adwuma boro so (akisikuru a ɛyɛ adwuma boro so).
• Akisikuru no ntumi nyɛ adwuma yiye, a ɛkyerɛ sɛ atenka biara nni hɔ sɛ ɛsɛ sɛ wɔtow nsu (``akisikuru a ɛnyɛ adwuma'').
• Akisikuru (eyi yɛ ade a ɛho hia yiye).
• Nsuo mu Nyarewa (UTIs).
• Ɛwom mpo sɛ ɛsɛ sɛ woto wo ho , wubu w’ani gu so na wotwɛn kosi sɛ wo akisikuru no bɛyɛ ma ansa na woakɔtow wo ho akyiri yi.
• Wɔ mmarima mu no, ɛyɛ prostate gland a ayɛ kɛse (Benign Prostatic Hyperplasia - BPH).
• Prostate kokoram.

Wɔ mmofra nkumaa mu no, eyi nso betumi afi tebea bi a wɔfrɛ no "dysfunctional elimination syndrome," a ɛyɛ bere a ntini ne ntini a ɛwɔ akisikuru no mu no ntumi nyɛ adwuma yiye.

Dɛn ne nsɛnnennen a ebetumi afi tebea yi mu aba?

Sɛ wo dwonku mu mpan koraa a, mmoawa a wɔwɔ nsu a aka no mu no betumi de nyarewa aba. Sɛ nhwɛso no, nsu mu yare (UTIs). Ɛda adi nso sɛ wubenya asaabo mu abo anaa akisikuru mu abo. Ɛtɔ mmere bi a, sɛ ɔhaw yi mu yɛ den a, ebetumi mpo asɛe asaabo.

Nea ɛho hia sen biara ne sɛ, sɛ wunya ɔhaw bi wɔ nsu a wobɛtow ho a, ebetumi aka w’adwene nso. Nnipa pii te aniwu ne dadwen nka efisɛ wontumi nni wɔn nsu so . Ebia wubesusuw nso sɛ, “So meyɛ adesoa ma afoforo?” Sɛ ɛsɛ sɛ wugyae wo da biara da dwumadi ahorow a wowɔ saa sɛnkyerɛnne ahorow yi bere nyinaa a. Sɛ eyi nti wotwe wo ho fi ɔmanfo ho a, ebia wubehyia tebea horow a emu yɛ den te sɛ dadwen ne adwenemhaw nso.

Ɔkwan bɛn so na nnuruyɛfo hu sɛ obi anya ntini a ɛnyɛ nea ɛma mogya tu no yɛ adwuma yiye?

Oduruyɛfo betumi ahu sɛ obi ayɛ nea ɛnyɛ ntini mu yare a ɛma obi ho yɛ hyew denam w’aduruyɛ ho abakɔsɛm a obebisa ne nipadua mu nhwehwɛmu a ɔbɛyɛ so. Obetumi nso ayɛ pelvic nhwehwɛmu ama mmea anaasɛ digital rectal exam ama mmarima.

Nea ɛka ho no, ebia wo duruyɛfo bɛka akyerɛ wo sɛ yɛ "bladder diary." Wɔ mu no, wobɛkyerɛw sɛ:

• Nsu dodow ahe na wonom da biara?
• Bere bɛn na woto wo ho ?
• Nsu dodow ahe na wofa bere koro mu?
• Bere bɛn ne ɔkwan bɛn so na nsu no pue a wɔanhyɛ da?

Sɛ oduruyɛfo no de saa nsɛm yi di dwuma a, obetumi nso ayɛ nhwehwɛmu afoforo pii de akyerɛ sɛ wɔahu yare no.

Sɔhwɛ ahorow bɛn na wɔyɛ?

Oduruyɛfo no betumi ayɛ nhwehwɛmu ahorow yi mu biako anaa nea ɛboro saa:

• Prostate-specific antigen (PSA) nhwehwɛmu: Eyi yɛ mogya mu nhwehwɛmu. Ɛhwehwɛ PSA dodow a ɛkɔ soro. Sɛ PSA dodow kɔ soro a, ebia ɔhaw bi bɛba prostate gland no so.
• Nsuo mu nhwehwɛmu: Eyi betumi aboa ma woahu sɛ wowɔ nsu mu yare (UTI) anaa.
• Ultrasound scan: Eyi hwɛ sɛnea nsu dodow a aka wɔ wo akisikuru mu bere a woatow nsu awie no . Ebetumi nso ahwɛ sɛ tebea no aka w’asaabo anaa.
• Urodynamic testing: Saa nhwehwɛmu ahorow yi kyerɛ nsu dodow a wo akisikuru betumi akura ne sɛnea ntini a ɛwɔ wo akisikuru, urethra, ne pelvic floor no reyɛ adwuma yiye.
• Cystoscopy: Wɔ sɔhwɛ yi mu no, oduruyɛfo no de adwinnade tenten bi a ɛyɛ tratraa (a mfoninitwa afiri abata ho) fa wo nsu a ɛkɔ wo nsu mu no mu de hwɛ sɛ ɔhaw ahorow bi wɔ wo nsu a ɛkɔ wo nsu mu ne wo akisikuru mu anaa.

Wɔ mmofra nkumaa fam no, mpɛn pii no, sɔhwɛ ahorow yi nyɛ nea wɔde wɔn ho hyɛ mu kɛse. Ebia oduruyɛfo no bɛka akyerɛ wo sɛ kyerɛw wo nsu ho kyerɛwtohɔ, na ebia wobɛkamfo mogya mu nhwehwɛmu, nsu mu nhwehwɛmu, ultrasound, ne urodynamic nhwehwɛmu bi nkutoo akyerɛ wo.

Ɔkwan bɛn so na wɔsa eyi? (Ɔkwan bɛn so na wɔsa?)

Saa tebea yi (Non-neurogenic voiding dysfunction) ayaresa gu ahorow gyina nea ɛde ba no so. Ebia ayaresa no bi ne:

1. Ntetee a wɔde ma akisikuru

Wubetumi atete wo akisikuru ntini ahorow no ma akura nsu mu bere tenten. Eyi kyerɛ sɛ ɛsɛ sɛ wokɔ tiafi bere a wokɔ daa da mũ no nyinaa, sɛ mpo wonte nka sɛ ɛho nhia sɛ wokɔ tiafi . Eyi betumi aboa ma wo akisikuru no asiw ano. Apɔw-mu-teɛteɛ ho ɔbenfo a ne ho akokwaw wɔ ɔhaw ahorow a ɛwɔ akyi berɛmo mu ho betumi aboa wo wɔ eyi mu.

2. Apɔw-mu-teɛteɛ a wɔde yɛ apɔw-mu-teɛteɛ (Pelvic floor therapy) .

Apɔw-mu-teɛteɛ ho ɔbenfo a wɔatete no titiriw betumi akyerɛ wo sɛnea wobɛma wo hwene mu ntini ahorow no adwo sɛnea ɛbɛyɛ a wubetumi atow wo ho ntɛmntɛm. Wobetumi nso de "biofeedback sensors" ahyɛ wo vagina anaa rectum mu de ahwɛ ahu sɛ woreyɛ apɔw-mu-teɛteɛ wɔ ntini a ɛfata mu.

Wɔbɛkyerɛ wo Kegel apɔw-mu-teɛteɛ nso de ahyɛ wo pelvic floor ntini ahorow den. Ntini a ɛyɛ den a ɛwɔ akyi berɛmo no mu no boa ma wosiw nsu a wontumi nhyɛ no ano na ɛkanyan sɛ obi ntumi nhyɛ nsu mu.

3. Nnuru a wɔde di dwuma

Nnuru bi wɔ hɔ a ebetumi aboa ma nsu mu haw ahorow atu mpɔn. Nhwɛso ahorow:

• Nnuru a esiw alpha ano, sɛ nhwɛso no tamsulosin (Flomax®).
• Nnuru a wɔde ko tia nsu mu akisikuru, te sɛ oxybutynin (Ditropan®) ne tolterodine (Detrol®).

4. Botulinum awuduru

Ebia wo duruyɛfo de botulinum awuduru (Botox®) bɛhyɛ wo akisikuru mu. Eyi ma akisikuru ntini ahorow no dwo na ɛtew ɔpɛ a obi ntumi nhyɛ ne ho so no so.

5. Percutaneous tibial ntini a wɔde kanyan (PTNS) .

Ɛtɔ da bi a, ɛsɛ sɛ woma wo ntini no "boost" kakra na ama woakanyan wo bladder ntini. Wɔ PTNS mu no, wo duruyɛfo de electrode bi si baabi a ɛbɛn wo tibial nerve wɔ wo nansoaa mu. Afei, wɔde anyinam ahoɔden nsɛnkyerɛnne a ɛyɛ brɛoo paa kɔma electrode no. Eyi kanyan tibial nerve no, na afei ɛkɔ sacral nerves a ɛwɔ wo pelvis no mu no. Eyi ma nsɛnkyerɛnne a ɛnteɛ a efi sacral nerves mu kɔ urinary sphincter, akisikuru, ne pelvic floor ntini ahorow mu no gyae, na ɛboa ma wosan di akisikuru no so.

6. Sacral ntini a wɔkanyan no

Wɔ saa adeyɛ yi mu no, wo duruyɛfo no bɛyɛ oprehyɛn de electrode ahorow bɛhyɛ honam ani wɔ w’asen atifi pɛɛ. Saa electrode ahorow yi nam waya teateaa (probe) a ɛkɔ honam ani ase so de anyinam ahoɔden nsɛnkyerɛnne a ɛyɛ brɛoo kɔ sacral nerve no mu. Saa nsɛnkyerɛnne yi kanyan ntini a ɛwɔ wo akisikuru mu no ma ɛtwetwe.

7. Wɔn ho a wɔde hyɛ nipadua mu

Wubetumi de afiri a wɔde fa nsu mu ahyɛ wo akisikuru mu bere ne bere mu na woaboaboa wo nsu ano wɔ kotoku mu. Wo duruyɛfo bɛkyerɛ wo sɛnea wobɛyɛ eyi (self-catheterization).

8. Oprehyɛn a wɔyɛ

Sɛ ayaresa afoforo ntumi nyɛ adwuma a, ebia wo duruyɛfo bɛkamfo akyerɛ sɛ wɔnyɛ oprehyɛn a wɔde ma akisikuru no yɛ kɛse (cystoplasty). Saa oprehyɛn yi ma wo akisikuru no yɛ kɛse ma enti ebetumi akura nsu pii .Mitumi di nneɛma pii ho dwuma.

Dɛn ne ayaresa ahorow a edi kan a wɔde sa akisikuru a ɛnyɛ ntini a ɛma nipadua no yɛ adwuma boro so no?

Mpɛn pii no, nea edidi so yi ne ayaresa a edi kan a wɔde sa tebea yi:

• Nnuan ne anonne a epira akisikuru (tii, kɔfe, nsa, nnuan a ɛyɛ nnuhwam anaa acid wom) a wɔbɛtew so.
• Ntetee a wɔde ma akisikuru.

Sɛ suban mu nsakrae yi mmoa a, nnuruyɛfo betumi akyerɛw nnuru te sɛ eyinom, a egyina sɛnea ɛnyɛ ntini mu nsu a ɛtwetwe nsu no yɛ adwuma so:

• Nnuru a ɛko tia cholinergic
• Nneɛma a wɔde siw alfa ano
• Beta 3 a ɛma nipadua no nya ɔyare mmoawa

Ɔkwan bɛn so na wɔsa tebea yi wɔ mmofra nkumaa mu?

Alpha-blockers ne nnuru a ɛko tia cholinergic betumi aboa ma wɔasa akisikuru a ɛyɛ adwuma boro so wɔ mmofra nkumaa mu. Wobetumi akyerɛkyerɛ mmofra binom nso sɛ wɔnyɛ apɔw-mu-teɛteɛ wɔ wɔn akyi berɛmo mu.

Ebia oduruyɛfo no nso bɛkamfo akyerɛ sɛ wɔbɛtete akisikuru. Sɛ nhwɛso no, abofra no a wɔbɛhyɛ no nkuran ma wakɔ tiafi wɔ mmere a wɔahyɛ mu na wɔakyerɛkyerɛ no sɛnea ɛsɛ sɛ wogyina hɔ wɔ tiafi so.

Ɛrenkyɛ na me ho atɔ me wɔ ayaresa akyi?

Ɛsono sɛnea wɔde sa yare no. Bladder ntetee ne pelvic floor apɔw-mu-teɛteɛ betumi afi ase ayɛ adwuma wɔ adapɛn anaa asram kakraa bi mu. Mpɛn pii no, ntini a wɔkanyan no fi ase yɛ adwuma wɔ adapɛn kakraa bi mu. Ɛsɛ sɛ nnuru fi ase yɛ adwuma wɔ nna anaa adapɛn kakraa bi mu. Wo duruyɛfo bɛma woanya eyi ho adwene pa.

Bere bɛn na ɛsɛ sɛ mekɔ oduruyɛfo nkyɛn?

Wo ne oduruyɛfo nkasa bere a wudi kan hu ɔhaw ahorow yi wɔ tiafi a wobɛkɔ mu no ara pɛ:

• Sɛ obi ntumi ntow nsu bere tenten.
• Nsakrae a ɛba wo nsu mu : Sɛ nhwɛso no, hua a ano yɛ den, kɔla tuntum, anaa mogya a ɛba wo nsu mu (hematuria).
• Ɛyaw a ɛba bere a woretow nsu (dysuria).
• Nsɛnkyerɛnne a ɛkɔ so daa a ɛkyerɛ sɛ obi ayɛ akisikuru.
• Nsɛnkyerɛnne a ɛkyerɛ sɛ obi anya ɔyare no: atiridiinini, atiridiinini, tiyɛ.

Sɛ wokɔ oduruyɛfo nkyɛn a, wubetumi abisa nsɛm yi nso:

• Wobɛyɛ dɛn ahu sɛ mewɔ `(Non-neurogenic voiding dysfunction)`?
• Dɛn nti na me tebea no te?
• Ayaresa bɛn na wokamfo kyerɛ me?
• Dɛn ne saa ayaresa no mu nsunsuanso bɔne?
• Bere tenten ahe na ebegye na wɔahu nea efi saa ayaresa no mu ba?
• Asetra mu nsakrae bɛn na wokamfo kyerɛ na ama me yare no ho sɛnkyerɛnne so atew?
• Nsɛnnennen bɛn na ɛsɛ sɛ mehwɛ yiye wɔ ho?
• So ɛsɛ sɛ mekɔ oduruyɛfo a ɔhwɛ ntini mu yare nkyɛn?

So wobetumi asiw eyi ano?

Wubetumi aboa ma wɔasiw tebea yi ano (Non-neurogenic voiding dysfunction) denam nsakrae a wobɛyɛ wɔ w’asetra kwan ne w’aduan mu no so. Ebia eyinom bi ne:

• Nnuan ne anonne a epira akisikuru no a wɔbɛtew so: Nsã a caffeine wom (kɔfe, tii), nnuaba a wɔfrɛ no citrus (te sɛ akutu, limes), nnuan a ɛyɛ nnuhwam, ne nsa nyinaa betumi akanyan akisikuru no na ɛde ɔhaw ahorow aba nsu mu .
• Nnuan a ahoɔdennuru pii wom a wubedi: Akisikuru betumi ama tebea yi aba anaasɛ ama ayɛ kɛse. Wubetumi anya fiber denam bankye, nnuaba, nhabannuru, ne aburow a wɔayam (abodoo a wɔayam, oats, quinoa, aburow a wɔayam, ne pasta a wɔayam) pii a wubedi so. Wubetumi nso anom nnuru a wɔde sa akisikuru (` akisikuru ') de ayɛ akisikuru. Nanso, ɛsɛ sɛ wo ne wo duruyɛfo kasa ansa na woanom nnuru a wɔde siw akisikuru anaa wode ama abofra.
• Wo mu duru a ɛfata a wobɛkɔ so akura mu: Sɛ wo nipadua mu duru (BMI) boro 25 (woyɛ kɛse dodo) a, ebetumi de nhyɛso aba wo akisikuru so na ama nsu a ɛretu.
• Sigaretnom a wobegyae: Nicotine, ade titiriw a wɔde yɛ tawa no betumi akanyan ntini a ɛwɔ akisikuru no mu. Wɔn a wɔnom sigaret nso taa nya ɔfe a enni sabea, na ebetumi de nhyɛso aba akisikuru no so.

Sɛ mewɔ non-neurogenic voiding dysfunction a, dɛn na metumi ahwɛ kwan?

Adwene a nnipa a wɔwɔ saa tebea yi wɔ no ye. Sɛ wɔyɛ ayaresa a, nnipa dodow no ara tumi di wɔn akisikuru so. Ɛntaa mma sɛ wɔyɛ oprehyɛn de ma akisikuru no yɛ kɛse (cystoplasty).

Nsonsonoe bɛn na ɛda Non-neurogenic ne Neurogenic Voiding Dysfunction ntam?

Neurogenic voiding dysfunction (a wɔsan frɛ no neurogenic bladder) yɛ tebea a ɛka wo ntini nhyehyɛe. Eyi kyerɛ sɛ wuntumi nni wo akisikuru so esiane ɔhaw bi a ɛwɔ w’amemene, ntini, anaa w’akyi berɛmo mu nti.

Nanso, ``Non-neurogenic voiding dysfunction'' a yɛkaa ho asɛm nnɛ no yɛ tebea a ɛba a ntini nhyehyɛe no mfa ne ho nhyɛ mu.

Ade a ɛho hia sen biara a ɛsɛ sɛ wokae: Non-Neurogenic voiding dysfunction (NNOVD) yɛ tebea a ɛde nkwa to asiane mu a ebetumi aka mmofra ne mpanyimfo nyinaa. Ebetumi ayɛ aniwu na ɛnyɛ dɛ. Ebetumi nso ama woate nka sɛ worentow wo ho bere a ɛho hia no. Nanso, wompɛ sɛ wobɛma tebea yi aka w’asetra pa. Sɛ wo anaa wo dɔfo bi rehu saa sɛnkyerɛnne ahorow yi a, wo ne oduruyɛfo nkasa. Wobetumi aboa wo ma woahu nea ɛde ba no na woasa.

Nsɛm a Wɔaboaboa Ano (Nkrasɛm a Wɔde Kɔ Fie) .

Okay, enti seesei wowɔ nteaseɛ pa wɔ deɛ yɛkaa ho asɛm nnɛ no ho, ``Non-Neurogenic Voiding Dysfunction''. Eyi nyɛ hwee sɛ ntini a ɛma nipadua no yɛ adwuma yiye.Eyi ne ade a ɛho hia sen biara. Akisikuru ntini a ɛyɛ mmerɛw, nsu a ɛtwetwe nsu no mu akwanside, subammɔne, ne akisikuru betumi de eyi aba.

• Nsɛnkyerɛnne: Ɛyɛ den sɛ wobɛtow nsu , nsu a wontumi nhyɛ mu, akisikuru a enni mũ, nsu a wɔtow gu a ɔmpɛ , mmofra a wɔtow gu awiabere, ne nea ɛkeka ho.
• Nhwehwɛmu a wɔyɛ: Ɛdenam aduruyɛ mu nhwehwɛmu, nsu mu da biara da nsɛm, ultrasound, ne urodynamic nhwehwɛmu so.
• Ayaresa: Asetra mu nsakrae, akisikuru ntetee, akyi berɛmo mu apɔw-mu-teɛteɛ, nnuru, ne ayaresa pɔtee bi.
• Nea ɛho hia: Sɛ wowɔ yare no ho sɛnkyerɛnne bi a, nfɛre na hwehwɛ aduruyɛ mu afotu. Sɛ wofi ayaresa ase ntɛm a, ebetumi asiw nsɛnnennen ano.

Sɛ wowɔ nsɛmmisa foforo bi fa eyi ho a, ntwentwɛn wo nan ase sɛ wubebisa oduruyɛfo. Kɔ so nya apɔwmuden!

` Non-neurogenic voiding dysfunction, urinary incontinence, akisikuru, urinary tract infections, contipation, mmofra nsuo mu haw, urinary control, urinary incontinence, akisikuru a ɛyɛ adwuma boro so, akisikuru ntetee