So w’asaabo no asiw esiane ureter a asiw nti? (Ureteropelvic Junction - UPJ Obstruction) Momma yɛnka eyi ho asɛm!

Ɛtɔ da bi a yɛn ba kumaa no te nka sɛ akisikuru ketewaa bi wɔ ne yafunu mu, anaasɛ ɔtaa nya ɔyare mmoawa wɔ nsu mu, ɛnte saa? Ebia na ɔwɔ atiridiinini. Ade biako nti a saa nneɛma yi ba ne baabi a nsu no fi ase fi asaabo no mu no siw. Ɛnnɛ, yɛbɛka saa tebea yi a wɔfrɛ no `(Ureteropelvic Junction Obstruction)` anaa `(UPJ Obstruction)` ho asɛm kɔ akyiri, tiawa.

Dɛn ne ‘ureteropelvic junction obstruction’ yi?

Sɛ yɛbɛka no tiawa a, baabi a ɛte sɛ funnel wɔ w’asaabo abien no nyinaa atifi, na yɛfrɛ no `(Renal Pelvis)` . Nsu a ɛsen fi asaabo mu no boaboa ano wɔ saa `(Renal Pelvis)` yi mu. Afei saa nsuo yi sian kɔ afiri bi a wɔfrɛ no `(Ureter)` mu na ɛboaboa ano wɔ akisikuru no mu. Nkitahodi a `(Renal Pelvis)` ne `(Ureter)` hyia no, wɔfrɛ no `(Ureteropelvic Junction - UPJ)`. Sɛ biribi asiw, kyerɛ sɛ, asiw, wɔ saa nhyiam yi so esiane biribi nti a, nsu no nkɔ fam yiye. Eyi ne nea yɛfrɛ no `(UPJ Akwanside)`.

Mpɛn pii no, asaabo biara wɔ `(Ureter)` biako pɛ. Yɛn asaabo yi nneɛma fĩ ne nsu a ɛboro so fi mogya no mu na ɛma nsu. Nsuo a ɛba saa kwan yi so no boaboa ano wɔ `(Renal Pelvis)` mu, ɛfa `(UPJ)` mu, na ɛfa `(Ureter)` no mu kɔ akisikuru no mu. Sɛ `(UPJ Obstruction)` bi wɔ hɔ a, saa nsuo a ɛsen yi yɛ brɛoo paa, na ɛtɔ da bi a ɛtumi gyae koraa. Eyi ma asiane a ɛwɔ hɔ sɛ asaabo bɛsɛe no yɛ kɛse.

Mpɛn pii no, saa tebea yi a wɔfrɛ no `(UPJ Obstruction)` yɛ biribi a ɛwɔ hɔ wɔ awo mu (kyerɛ sɛ, `(Congenital urinary abnormality)`). Na ɛtaa ka asaabo biako pɛ. Edin afoforo a wɔde frɛ eyi ne `(UP junction obstruction)`, `(Obstruction of the ureteropelvic junction)`, anaa `(UPJO)` tiawa.

So eyi `(UPJ Obstruction)` yɛ tebea a emu yɛ den?

Yiw, UPJ Obstruction yɛ tebea a emu yɛ den. Sɛ wɔansa no yiye a, ebetumi mpo ama asaabo ayɛ adwuma yiye . Ɛno nti na ɛho hia sɛ wohu na woyɛ nneɛma a ɛho hia no. Biribiara nni hɔ a ɛsɛ sɛ wohaw wo ho wɔ ho, nanso ɛsɛ sɛ wohwɛ yiye.

Tebea yi abu so dɛn?

Akontaabu kyerɛ sɛ nkokoaa a wɔwo wɔn 1,500 biara mu bɛyɛ biako wɔ saa tebea yi (UPJ Obstruction). Eyi kyerɛ sɛ, ɛwom sɛ ɛnyɛ nea abu so kɛse de, nanso ebetumi ato obiara.

Dɛn ne sɛnkyerɛnne ahorow a ɛkyerɛ sɛ obi ayɛ `(Ureteropelvic Junction Obstruction)`?

Nsɛnkyerɛnne ahorow pii wɔ hɔ a ɛtaa ba a wobetumi ahu wɔ tebea yi mu. Nanso, ɛtɔ mmere bi a, titiriw wɔ nkokoaa nkumaa mu no, ebia abɔnten so sɛnkyerɛnne biara nni hɔ.

• Nkate a ɛte sɛ akuru wɔ yafunu no mu, titiriw wɔ yafunu no nkyɛn. Eyi fi asaabo no a ɛho ahonhon esiane nsu a asiw nti. Ɛte sɛ nea nsu mu afiri.
• Nsuo mu yareɛ a ɛtaa ba (UTIs), ne atiridiinini. Sɛ abofra kumaa taa nya UTI a, eyi yɛ biribi a ɛsɛ sɛ wususuw ho.
• Flank ɛyaw. Eyi yɛ ɛyaw a wɔte nka wɔ asaabo no akyi. Ɛtɔ da bi a, ɛyaw yi ba na ɛkɔ.
• Asaabo mu abo. Ɛda adi sɛ asaabo mu abo taa ba bere a nsu no asiw no.
• Mogya a ɛwɔ nsu mu (`(Hematuria)`) .
• Akisikuru ne ɔfe.
• Abofra no nkɔso a ɛkyɛ anaasɛ ne mu duru a ɛso tew . Ɛtɔ mmere bi a, wotumi hu saa tebea horow yi nso.

Dɛn ne ade titiriw a ɛde UPJ Akwanside ba?

Maka dedaw sɛ UPJ Obstruction tebea dodow no ara fi awo mu . Eyi kyerɛ sɛ, sɛ akokoaa wɔ awotwaa mu a, nsu a wɔde fa nsu mu no afã horow, titiriw ureter anaa asaabo no, ntumi nhyehyɛ no yiye. Ɛtɔ mmere bi a, mogya ntini bi a ɛfa UPJ no mu a wɔhyɛ no nso betumi afi saa akwanside yi aba. Mpɛn pii no, eyinom yɛ nsɛm a esisi a ɛba kwa. Nanso, sɛ obi a ɔwɔ w’abusua mu anya saa tebea yi a, ebia asiane a ɛba fam sɛ wo nso wubenya bi.

Ɛntaa mma koraa sɛ mpanyimfo benya ``UPJ Obstruction``. Nanso, ebetumi aba mpanyimfo mu esiane nneɛma a edidi so yi nti:

• Esiane asaabo mu abo nti .
• Esiane ɔyare mmoawa a ɛwɔ nsu a ɛwɔ soro (`Upper UTIs`) nti .
• Bere a wɔyɛɛ no ​​oprehyɛn wɔ saa beae no akyi.
• Esiane sɛ ɛho ahon (`(Swelling)`) wɔ nsuo a ɛwɔ soro no mu nti .

Hena na tebea yi ka no kɛse?

Sɛnea mprempren nsɛm kyerɛ no, mmarima betumi anya UPJ Abstruction bɛboro mmɔho abien sen mmea. Nhwehwɛmu nso ada no adi sɛ tebea no betumi aba asaabo benkum mu bɛyɛ mmɔho abien sen asaabo nifa.

Dɛn ne nsɛnnennen a ebetumi aba wɔ UPJ Obstruction mu?

Sɛ wɔansa saa tebea yi (UPJ Obstruction) yiye a, nsɛnnennen ahorow betumi aba.

• Nsuo mu yare a ɛsan ba bio (UTIs) . Ɛtɔ da bi a, srade a atwa asaabo no ho ahyia no betumi ahonhon (perinephric stranding).
• Ɛyaw a enni sabea betumi aba wɔ baabi a ɛyaw no .
• Asaabo mu abo foforo (``asaabo mu abo a ɛto so abien``) betumi ayɛ.

Ade a ɛho hia sen biara ne sɛ sɛ wɔansa bere tenten a, saa `(UPJ Obstruction)` yi betumi asɛe asaabo no na awiei koraa no ɛde asaabo no adi nkogu . Ɛno nti na ɛho hia sɛ wohu na wosa no ntɛm no.

Ɔkwan bɛn so na wobehu `(UPJ Obstruction)` tebea no?

Mpɛn pii no, .Nnuruyɛfo betumi ahu UPJ Obstruction bere a wɔreyɛ ultrasound scan bere a akokoaa no da so ara wɔ awotwaa mu no. Nea enti a ɛte saa ne sɛ nsu a ɛsiw no de nhyɛso ba asaabo no akyi, na ɛma ɛhohoro sen sɛnea ɛte daa. Wɔfrɛ eyi hydronephrosis . Wobetumi ahu eyi pefee wɔ ultrasound so.

Sɛ wɔwo akokoaa no akyi mpo a, nnuruyɛfo betumi ahyɛ sɛ wɔnyɛ nhwehwɛmu ahorow na ama wɔahu sɛnea asaabo no reyɛ nsu na ɛretu. Eyinom bi ne:

• Mogya ne nsuo mu nhwehwɛmu (`(Mogya mu nhwehwɛmu ne nsuo mu nhwehwɛmu)`). Nhwehwɛmu te sɛ `(Blood Urea Nitrogen - BUN)` ne `(Creatinine Clearance)` betumi akyerɛ sɛnea asaabo no reyɛ mogya no yiye.
• Sɔhwɛ bi a wɔfrɛ no ``Intravenous Pyelogram - IVP'' hwehwɛ sɛ wode aduru soronko bi bɛhyɛ ntini bi a ɛwɔ wo nsa mu na woatwa ``X-ray'' mfonini. Afei wobetumi ahu aduru no bere a ɛfa asaabo no mu, ``Renal Pelvis'', ne ``Ureter'' mu de hwɛ sɛ ebia biribi asiw ano anaa.
• Adwene mu Nhwehwɛmu. Wɔ sɔhwɛ yi mu no, wɔde radioactive ade kakraa bi gu ntini bi mu na wɔde mfoninitwa afiri titiriw bi hwɛ sɛnea ɛfa asaabo no mu. Eyi betumi ama woanya sɛnea asaabo no reyɛ adwuma yiye ne baabi a asaabo no asiw no ho adwene pa.
• Ultrasound, CT scan, ne MRI a wɔde yɛ nhwehwɛmu. Saa mfoninitwa nhwehwɛmu ahorow yi tumi hu sɛnea asaabo, nsu a ɛkɔ nsu mu, ne akisikuru no te, ne akwanside biara a ɛwɔ asaabo no mu no pefee.

Ɔkwan bɛn so na wɔsa `(UPJ Akwanside)`?

Eyi gyina tebea no so ankasa. Sɛ wo ba no wɔ UPJ Obstruction a, ɛtɔ mmere bi a n’ankasa betumi ayɛ yiye wɔ n’asetra mu asram 18 a edi kan no mu. Saa bere yi mu no, wo ba no duruyɛfo bɛyɛ ultrasound scan ne nhwehwɛmu afoforo daa de ahwɛ sɛ nea asiw no no nsɛe hwee.

Nanso, sɛ abofra no da so ara ntumi ntow nsu wɔ asram 18 akyi, a ɛkyerɛ sɛ nea asiw no da so ara wɔ hɔ a, ɛda adi sɛ ɛho behia sɛ wɔyɛ no oprehyɛn a wɔfrɛ no ``Open Pyeloplasty'' . Wɔ eyi mu no, mmofra ntini ho ɔyaresafo yɛ ntwitwiridii kɛse, yi ɔfã a asiw no, na ɔsan de ``Ureter'' no bata asaabo no ho, na ɛma ɛtrɛw kakra. ``Open Pyeloplasty'' taa gye nnɔnhwerew kakraa bi, na ɛwɔ nkonimdi dodow bɛyɛ 95%.

Wɔ tebea horow bi mu no, oduruyɛfo a ɔyɛ oprehyɛn no betumi de ɔkwan bi a wɔfrɛ no `(Minimally invasive pyeloplasty)`, a ɛyɛ robɔt kwan (`(oprehyɛn robɔt)`) ayɛ oprehyɛn yi. Afei, wɔtwa ketewaa bi na wɔfa robɔt so yɛ `(Laparoscope)` ne oprehyɛn nnwinnade afoforo. Saa kwan yi nkonimdi te sɛ `(Open Pyeloplasty) de no.` Nanso, eyi hwehwɛ sɛ oduruyɛfo a ɔyɛ oprehyɛn no nya mfiridwuma ho nimdeɛ pii. Egyina abofra no mfe ne ne kɛse nso so.

Ɔkwan foforo a wɔfa so yɛ ne adeyɛ a wɔfrɛ no ``Endopyelotomy''.Wɔ eyi mu no, oprehyɛn ho ɔbenfo no de adwinnade bi a wɔfrɛ no ``Endoscope`` (tube teateaa a mfoninitwa afiri wom) fa urethra (``Urethra``), fa ``Ureter`` no ho, na ɔhwɛ sɛnea asiw no. Afei, wɔde waya bi fa ɔkwan bi a ɛwɔ ``Endoscope`` no mu, de twa akwanside no, na wɔde ``drain``, kyerɛ sɛ, tube, si hɔ. Wogyaw saa ``drain`` yi wɔ nea ɛwɔ hɔ adapɛn pii kosi sɛ ɛbɛsa. Wɔ ``Endopyelotomy`` mu no, ɛho nhia sɛ wɔtwa, na ɛyɛ mmerɛw sen oprehyɛn abien a aka no. Nanso, nkonimdi dodow no sua kakra. Ɛtɔ mmere bi a, ebia ɛho behia sɛ wɔyɛ eyi bɛboro pɛnkoro.

Me ho bɛtɔ me ntɛm dɛn wɔ ayaresa akyi?

Egyina ayaresa a wonyae wɔ wo UPJ Obstruction no ho so. Nnipa dodow no ara ho tɔ wɔn wɔ adapɛn abien kosi anan ntam. Nanso, ɛsono wo nipadua, enti bere a wo ho bɛtɔ wo no betumi ayɛ soronko. Wo duruyɛfo bɛma woanya eyi ho adwene a eye sen biara.

So wobetumi asiw UPJ Obstruction ano?

Aduruyɛ mu nhwehwɛmufo nnya nhuu abusuabɔ biara a ɛda aduan ne aduannuru a wonya wɔ nyinsɛn mu ne UPJ Obstruction a ɛba akokoaa no mu no ntam. Wei kyerɛ sɛ biribiara nni hɔ a yɛbɛtumi ayɛ de asiw UPJ Obstruction ano wɔ awoɔ mu.

Nanso, wɔ mpanyimfo a wɔanwo wɔn a wɔwɔ UPJ Obstruction fam no, nneɛma a edidi so yi a wɔbɛkwati no betumi aboa ma asiane yi so atew:

• Asaabo mu abo a ɛbɛba a wobesiw ano .
• Ahobammɔ a wɔbɔ fi nsu mu yare (UTIs) ho .
• Kwati a wobɛkwati sɛ wobɛhaw w’asaabo .

Dɛn ne anidasoɔ a ɛwɔ tebea `(UPJ Obstruction)` no ho?

Sɛ wohu ntɛm na wɔsa no yiye a, anidaso a ɛwɔ hɔ ma UPJ Obstruction no ye yiye. Mmofra dodow no ara nnya nsɛnnennen a ɛtra hɔ kyɛ. Afei nso, sɛ wohu ansa na wɔrewo a, ɛtɔ mmere bi a ebetumi asa a wonnya ayaresa biara.

Nanso, sɛ wohu sɛ wowɔ UPJ Obstruction akyiri yi wɔ w’asetra mu a, asiane a ɛwɔ hɔ sɛ w’asaabo bɛsɛe no kɛse kakra. Wɔ tebea horow a emu yɛ den mu no, sɛ wɔansa a, UPJ Obstruction betumi ama asaabo no ayɛ adwuma yiye na owu mpo. Ɛno nti na ɛho hia paa sɛ wobehu yare no ntɛm na wɔasa no yare no.

Bere bɛn na ɛsɛ sɛ wokɔ oduruyɛfo nkyɛn?

Sɛ wo anaa wo ba no wɔ saa sɛnkyerɛnne yi bi a, kɔ oduruyɛfo nkyɛn ntɛm ara:

• Sɛ mogya wɔ nsuo no mu a (`(Hematuria)`) .
• Sɛ ɛkyere wo nsam te sɛ akisikuru wɔ wo yafunu mu a.
• Sɛ wowɔ ɛyaw wɔ yafunu atifi anaa w’akyi (`(Flank pain)`) .
• Sɛ wowɔ atiridiinini a.
• Sɛ abofra no nyin ayɛ basaa (`(Growth faltering / failure to thrive)`) .

Bere bɛn na ɛsɛ sɛ wokɔ Emergency Treatment Unit (ETU) ?

Sɛ wuntumi ntow nsu a, kɔ baabi a ɛbɛn wo a wɔhwɛ wɔn a wɔwɔ ayaresa a egye ntɛmpɛ mu ntɛm ara.Eyi nyɛ biribi a ɛsɛ sɛ wɔtwentwɛn so.

Nsɛm bɛn na ɛsɛ sɛ wubisa oduruyɛfo no?

Wubetumi abisa oduruyɛfo no nsɛm te sɛ eyinom:

• Wobɛyɛ dɛn ahu saa tebea yi `(Ureteropelvic Junction Obstruction)`?
• Wosusu sɛ me ba no UPJ Obstruction no bɛkɔ yie sɛ wɔnsa no yareɛ a?
• Dɛn ne ayaresa a wobetumi apaw?
• Sɛ ɛho hia sɛ wɔyɛ oprehyɛn a, ɔkwan bɛn na wokamfo kyerɛ?
• Hokwan bɛn na ɛwɔ hɔ sɛ UPJ Obstruction bɛsan aba bio?

Nsonsonoe bɛn na ɛwɔ `(Ureteropelvic Junction Obstruction)` ne `(Ureterovesical Junction - UVJ) Obstruction` ntam?

Sɛ yɛbɛka no tiawa a, Ureteropelvic Junction (UPJ) ne Ureterovesical Junction (UVJ) akwanside nyinaa ba wo urethra (ureter) awiei. UVJ ne baabi a wo ureter no ne wo akisikuru no di nkitaho. UVJ akwanside bi ba wɔ hɔ. Nanso UPJ akwanside ba wɔ Renal Pelvis, baabi a ureter no ne w’asaabo no di nkitaho no.

Enti, nkrasɛm bɛn na ɛsɛ sɛ yɛde fi eyinom nyinaa mu kɔ fie?

Ɛyɛ ade a ɛfata sɛ wobɛte ehu nka bere a wote sɛ ebia wo ba no benya ɔhaw yi, sɛ́ ɛyɛ bere a wɔreyɛ scan bere a wo ba no da so ara wɔ awotwaa mu anaasɛ wɔawo akyi no. Ebia wobɛte nka sɛ wode asodi no to wo ho so, na wususuw ho sɛ, ‘So meyɛɛ bɔne bi? So biribi wɔ hɔ a anka metumi ayɛ de asiw eyi ano?’ Nanso nokwarem no, saa tebea a wɔfrɛ no `(Ureteropelvic Junction Obstruction)` yi yɛ biribi a ɛtɔ mmere bi a ɛba ara kwa. Nnuruyɛfo mpo ntumi nka nea ɛde ba ankasa.

Adeɛ a ɛho hia paa ne sɛ nnipa pii bɛtumi anya ahoɔden afiri saa `(UPJ Obstruction)` tebea yi mu. Enti, nsuro sɛ wobɛkɔ oduruyɛfo nkyɛn na wo ne no akasa. Wɔte nsɛmmisa ne ehu a ɛwɔ w’adwenem nyinaa ase. Wɔbɛboa wo wɔ ɔkwan biara a wobetumi so na wɔabua wo nsɛmmisa nyinaa. Nhwehwɛmu a wɔyɛ no ntɛm ne ayaresa a ɛfata ne nneɛma a ɛho hia sen biara wɔ ha.

` Asaabo, Nsuo Kwa, UPJ Akwantuo, Mmofra Nnuruyɛ, Nsuo Nhyehyɛeɛ, Oprehyɛn, Ureteropelvic Junction Akwantuo