Ðe wò ayiku xe mɔ na tsinyegoe si xea mɔ na wòa? (Ureteropelvic Junction - UPJ Obstruction) Mina míaƒo nu tso esia ŋu!

Ɣeaɖewoɣi la, mía vi suea senɛ le eɖokui me abe ƒunukpeƒetetedɔ sue aɖe le eƒe dɔgbo me ene, alo aɖuɖɔtoedɔlélewo dzea eŋu enuenu, alo? Ðewohĩ kple asrã. Susu ɖeka si ta nu siawo tsona ate ŋu anye xexe le teƒe si aɖuɖɔa dzea egɔme tso ayiku me. Egbea, míaƒo nu tsitotsito, bɔbɔe ŋutɔ, tso nɔnɔme sia si woyɔna be `(Ureteropelvic Junction Obstruction)` alo `(UPJ Obstruction)` ŋu.

Nukae nye ‘ureteropelvic junction ƒe mɔxexe’ sia?

Kpuie ko la, teƒe aɖe si le abe funnel ene le wò ayiku eveawo tame, si míeyɔna be `(Renal Pelvis)` . Aɖuɖɔ si sina tso ayiku me la ƒoa ƒu ɖe `(Renal Pelvis)` sia me. Emegbe aɖuɖɔ sia toa mɔ̃ aɖe si woyɔna be `(Ureter)` me eye wòƒoa ƒu ɖe tsinyegoea me. Woyɔa afisi `(Renal Pelvis)` kple `(Ureter)` do go le be `(Ureteropelvic Junction - UPJ)`. Ne xexe aɖe, si fia be xexe aɖe, le ƒoƒoƒe sia le susu aɖe ta la, aɖuɖɔa meɖina nyuie o. Esiae nye nusi míeyɔna be `(UPJ Mɔxexeɖenu)`.

Zi geɖe la, `(Ureter)` ɖeka koe nɔa ayiku ɖesiaɖe si. Míaƒe ayikuwo ɖea gbeɖuɖɔwo kple tsi si sɔ gbɔ ɖe ʋua me ɖa eye wòwɔa aɖuɖɔ. Aɖuɖɔ si wowɔna alea la ƒoa ƒu ɖe `(Renal Pelvis)` me, toa `(UPJ)` me, eye wòzɔa mɔ to `(Ureter)` me yia tsinyegoea me. Ne `(UPJ Obstruction)` li la, aɖuɖɔ sia ƒe sisi nɔa blewu ŋutɔ, eye ɣeaɖewoɣi la, ate ŋu atɔ keŋkeŋ. Esia nana ayiku ƒe gbegblẽ ƒe afɔkua dzina ɖe edzi.

Zi geɖe la, nɔnɔme sia si woyɔna be `(UPJ Obstruction)` nye nane si nɔa anyi le vidzidzi me (si fia be, `(Congenital urinary abnormality)`). Eye zi geɖe la, ayiku ɖeka koe wòdzena. Ŋkɔ bubu siwo wotsɔ na esiae nye `(UP junction obstruction)`, `(Obstruction of the ureteropelvic junction)`, alo `(UPJO)` kpuie.

Ðe `(UPJ Obstruction)` nye nɔnɔme sesẽ aɖea?

Ẽ, UPJ Mɔxexe nye nɔnɔme sesẽ aɖe. Ne womewɔ atike nɛ nyuie o la, ate ŋu ana ayiku nawɔ dɔ nyuie gɔ̃ hã . Esia tae wòle vevie be nànyae ahaɖe afɔ siwo hiã. Naneke meli si ŋu nàtsi dzi ɖo o, gake ele be nàɖɔ ŋu ɖo.

Aleke gbegbee nɔnɔme sia bɔe?

Le akɔntabubu nu la, dɔléle sia (UPJ Obstruction) le vidzĩ 1,500 ɖesiaɖe si wodzi dometɔ ɖeka ŋu . Esia fia be, togbɔ be mebɔ boo o hã la, ate ŋu adzɔ ɖe ame sia ame dzi.

Nukae nye `(Ureteropelvic Junction Obstruction)` ƒe dzesiwo?

Dzesi geɖe li siwo bɔ siwo woate ŋu akpɔ le nɔnɔme sia me. Gake ɣeaɖewoɣi, vevietɔ le vidzĩ suewo gome la, gotagome dzesi aɖeke ate ŋu anɔ wo ŋu o.

• Seselelãme si le abe ƒunukpeƒe ene le ƒodo me, vevietɔ le ƒodo ƒe axadzi. Esia tso ayiku ƒe vuvu le aɖuɖɔ ƒe xexe ta. Ewɔna nam abe tsi ƒe ʋuʋudedi ene.
• Aɖuɖɔtoe me dɔléle (UTI) enuenu tsɔ kpe ɖe dzoxɔxɔ ŋu. Ne ɖevi sue aɖe le UTI xɔm enuenu la, esia nye nusi ŋu wòle be woabu.
• Axadziveve. Esia nye vevesese si wosena le ayiku ƒe megbe. Ɣeaɖewoɣi la, vevesese sia vana eye wòdzona.
• Ayiku me kpewo. Anɔ eme be ayiku me kpewo dzɔna ne woxe aɖuɖɔ.
• Ʋu le aɖuɖɔ me (`(Hematuria)`) .
• Aɖuɖɔtoe kple ʋuʋudedi.
• Ðevia ƒe tsitsi ƒe megbetsitsi alo eƒe lolome dzi ɖeɖe kpɔtɔ . Ɣeaɖewoɣi la, woate ŋu akpɔ nɔnɔme siawo hã.

Nuka koŋ gbɔe UPJ ƒe Mɔxexeɖedɔa tso?

Megblɔ xoxo be UPJ Obstruction ƒe nɔnɔme akpa gãtɔ nye esiwo wodzina . Esia fia be ne vidzĩ le vidzidɔ me la, aɖuɖɔtoe ƒe akpa aɖewo, vevietɔ tsinyegoe alo ayiku, mewɔa dɔ nyuie o. Ɣeaɖewoɣi la, ʋuka aɖe si toa UPJ me ƒe nutete hã ate ŋu ahe mɔxexe sia vɛ. Zi geɖe la, esiawo nyea nudzɔdzɔ siwo dzɔna le vome. Gake ne dɔléle sia nɔ wò ƒomea me tɔ aɖe ŋu la, ate ŋu adzɔ be wò hã nàxɔe.

Ƒã ŋutɔ be ame tsitsiwo naxɔ ``UPJ Mɔxexe``. Gake ate ŋu adzɔ le ame tsitsiwo me le susu siwo gbɔna ta:

• Le ayiku me kpewo ta .
• Le dɔlékui siwo le aɖuɖɔtoe si le etame (`Upper UTIs`) ta .
• Le amekoko le nuto ma megbe.
• Le aɖuɖɔtoe ƒe akpa si le etame ƒe vuvu (`(Vuvu)`) ta .

Ameka dzie nɔnɔme sia gblẽa nu le wu?

Le nyatakaka siwo li fifia nu la, ŋutsuwo ate ŋu axɔ UPJ Obstruction wu nyɔnuwo zi gbɔ zi eve. Numekukuwo ɖee fia hã be nɔnɔmea ate ŋu adzɔ le miame ayiku me abe zi gbɔ zi eve ene wu ɖusime ayiku.

Nukawoe nye kuxi siwo ate ŋu ado tso UPJ ƒe Mɔxexeɖedɔa me?

Ne womeda nɔnɔme sia (UPJ Obstruction) nyuie o la, kuxi vovovowo ate ŋu ado mo ɖa.

• Aɖuɖɔtoe me dɔléle siwo gbugbɔna (UTIs) . Ɣeaɖewoɣi la, ami siwo ƒo xlã ayikuawo ate ŋu avuvu (perinephric stranding).
• Vevesese atraɖii ate ŋu adzɔ le teƒe si dɔlélea le .
• Ayiku me kpe bubuwo (``ayiku me kpe evelia``) ateŋu adzɔ.

Nu vevitɔe nye be ne womewɔ atike nɛ ɣeyiɣi didi o la, `(UPJ Obstruction)` sia ate ŋu agblẽ nu le ayikuwo ŋu eye mlɔeba la, ayikuwo nawɔ dɔ nyuie . Esia tae wòle vevie be woakpɔ dɔlélea ahadae kaba ɖo.

Aleke woawɔ anya `(UPJ Obstruction)` nɔnɔmea?

Zi geɖe la, .Ðɔktawo ate ŋu akpɔ UPJ Obstruction le ultrasound scan wɔwɔ me esime vidzĩa gakpɔtɔ le vidzidɔa me. Esia le alea elabena aɖuɖɔtoe ƒe xexe nana ayikua ƒe megbe tsia dzi, si wɔnɛ be wòvuvuna wu alesi wòle dzɔdzɔmee. Woyɔa esia be hydronephrosis . Woate ŋu akpɔ esia nyuie le ultrasound me.

Le vidzĩa dzidzi vɔ megbe gɔ̃ hã la, ɖɔktawo ate ŋu aɖe gbe be woawɔ dodokpɔ vovovowo atsɔ akpɔ alesi ayikuawo le aɖuɖɔ wɔm nyuie hele eɖem ɖa. Esiawo dometɔ aɖewoe nye:

• Ʋu kple aɖuɖɔ dodokpɔ (`(Ʋu dodokpɔ kple aɖuɖɔ me dzodzro)`). Dodokpɔwo abe `(Ʋu Urea Nitrogen - BUN)` kple `(Creatinine Clearance)` ateŋu aɖe alesi ayikuwo le ʋua ƒom nyuie la afia.
• Dodokpɔ si woyɔna be ``Intravenous Pyelogram - IVP'' bia be nàdo amadede tɔxɛ aɖe ɖe ʋuka aɖe me le wò alɔnu eye nàɖe ``X-ray'' fotowo. Emegbe woateŋu akpɔ amadedea ne ele mɔ zɔm to ayiku, ``Renal Pelvis'', kple ``Ureter'' me be woakpɔe ɖa be xexe aɖe li hã.
• Ayikuwo ƒe Dɔwɔɖoɖo. Le dodokpɔ sia me la, wodoa keklẽŋusẽ sue aɖe ɖe ʋuka aɖe me eye wozãa fotoɖemɔ̃ tɔxɛ aɖe tsɔ léa ŋku ɖe eŋu wòto ayikuawo me. Esia ate ŋu ana míanya alesi ayikuawo le dɔ wɔm nyuie kple alesi gbegbe woxe mɔe.
• Ultrasound, CT scan, kple MRI. Nɔnɔmetata dodokpɔ siawo ate ŋu akpɔ ayiku, tsinyegoe, kple tsinyegoe ƒe wɔwɔme, kpakple mɔxenu ɖesiaɖe si le ayikuawo me nyuie.

Aleke wowɔa nu ɖe ​​`(UPJ Mɔxexeɖedɔa)` ŋui?

Esia nɔ te ɖe nɔnɔmea dzi ŋutɔŋutɔ. Ne UPJ Obstruction le viwòa ŋu la, ate ŋu anyo le eɖokui si ɣeaɖewoɣi le eƒe agbemeɣleti 18 gbãtɔwo me. Le ɣeyiɣi sia me la, viwòa ƒe ɖɔkta awɔ ultrasound scan kple dodokpɔ bubuwo edziedzi be yeakpɔe ɖa be xexea megale nu gblẽm le eŋu o.

Gake ne ɖevia mete ŋu le aɖuɖɔ ƒom le ɣleti 18 megbe o, si fia be xexea gakpɔtɔ li la, anɔ eme be ahiã be woawɔ dɔ nɛ si woyɔna be ``Open Pyeloplasty'' . Le esia me la, ɖeviwo ƒe tsinyegoeŋutinunyala aɖe lãa nu gã aɖe, ɖea akpa si xe la ɖa, eye wògatsɔa ``Ureter'' la doa ka kple ayiku la, si wɔnɛ be ʋua keke vie. ``Open Pyeloplasty'' xɔa gaƒoƒo ʋee aɖewo zi geɖe, eye eƒe dzidzedzekpɔkpɔ ƒe agbɔsɔsɔme anɔ abe 95% ene.

Le go aɖewo me la, amekola ate ŋu awɔ amekoko sia to mɔnu aɖe si woyɔna be `(Minimally invasive pyeloplasty)`, si nye robot mɔnu (`(surgical robot)`) zazã me . Emegbe, woɖea nu sue aɖe eye wowɔa `(Laparoscope)` kple amekokodɔwɔnu bubuwo to robot dzi. Mɔnu sia ƒe dzidzedzekpɔkpɔ sɔ kple `(Open Pyeloplasty) tɔ.` Gake esia bia be amekolaa nanya mɔ̃ɖaŋununya geɖe wu. Enɔ te ɖe ƒe si ɖevia xɔ kple eƒe lolome hã dzi.

Tiatia bubu enye dɔwɔwɔ si woyɔna be ``Endopyelotomy''.Le esia me la, amekola la tsɔa dɔwɔnu aɖe si woyɔna be ``Endoscope`` (tube tsɛ aɖe si me fotoɖemɔ̃ le) toa tsinyegoe me (``Urethra``), to ``Ureter``, eye wòléa ŋku ɖe nusi xe la ŋu. Emegbe la, wotsɔa ka aɖe toa mɔ aɖe me le ``Endoscope`` me, tsɔa lã si xe mɔa la, eye wotsɔa ``tsidzɔƒe``, si nye mɔ̃ aɖe, dana ɖe afima. Wogblẽa ``tsidzɔƒe`` sia ɖe teƒea kwasiɖa geɖe vaseɖe esime wòhaya. Le ``Endopyelotomy`` me la, mehiã be woatsoe o, eye ele bɔbɔe wu amekoko eve bubuawo. Gake dzidzedzekpɔkpɔ ƒe agbɔsɔsɔme le ʋɛ vie. Ɣeaɖewoɣi la, ahiã be woawɔ esia wu zi ɖeka.

Aleke gbegbee nye lãme asẽ kaba le atikewɔwɔ vɔ megbe?

Enɔ te ɖe atikewɔwɔ si nèxɔ ɖe wò UPJ Mɔxexeɖedɔa ta dzi. Ame akpa gãtɔ hayana le kwasiɖa eve va ɖo ene megbe. Gake wò ŋutilã ya to vovo, eyata ɣeyiɣi si nàhaya ate ŋu ato vovo. Wò ɖɔkta ana nàkpɔ esia ƒe susu nyuitɔ kekeake.

Ðe woate ŋu axe mɔ ɖe UPJ Mɔxexeɖedɔ nua?

Atikewɔlawo mekpɔ kadodo aɖeke le nuɖuɖu kple nunyiame le fufɔɣi kple UPJ Obstruction ƒe dzɔdzɔ le fugboe me dome haɖe o. Esia fia be naneke meli míate ŋu awɔ atsɔ axe mɔ na UPJ Obstruction be wòagadzɔ le vidzidzi me o.

Gake le ame tsitsi siwo womedzi kple UPJ Obstruction o gome la, nu siwo gbɔna ƒoƒo asa na ate ŋu akpe ɖe wo ŋu woaɖe afɔku sia dzi akpɔtɔ:

• Mɔxexe ɖe ayiku me kpewo ƒe dzɔdzɔ nu .
• Ametakpɔkpɔ tso aɖuɖɔtoe me dɔlélewo (UTI) me .
• Ƒo asa na nuveviwɔame le wò ayikuwo ŋu .

Nukae nye nɔnɔme `(UPJ Obstruction)` ƒe mɔkpɔkpɔ?

Ne wokpɔ dɔlélea kaba eye wodae nyuie la, UPJ ƒe Mɔxexe ƒe mɔkpɔkpɔ nyo ŋutɔ. Ðevi akpa gãtɔ mekpɔa kuxi siwo nɔa anyi didi o. Azɔ hã, ne wokpɔ dɔlélea do ŋgɔ na vidzidzi la, ate ŋu atso ɣeaɖewoɣi atike aɖeke manɔmee.

Gake ne wokpɔe be UPJ Obstruction le ŋuwò le wò agbe me emegbe la, ke ayiku ate ŋu agblẽ le ŋuwò vie. Le nɔnɔme sesẽwo me la, ne womewɔ atike na UPJ Obstruction o la, ate ŋu ana ayiku nawɔ dɔ nyuie o eye wòaku gɔ̃ hã. Esia tae dɔlélea didi kple edada kaba le vevie ŋutɔ ɖo.

Ɣekaɣie wòle be nàkpɔ ɖɔkta?

Ne dzesi siawo dometɔ aɖe le ŋuwò alo viwòa ŋu la, yi ɖɔkta gbɔ enumake:

• Ne ʋu le aɖuɖɔ me (`(Hematuria)`) .
• Ne elé wò asi abe dɔdzẽ le wò dɔgbo me ene.
• Ne èle veve sem le ƒodo si le etame alo akɔta (`(Flank pain)`) .
• Ne asrã le ŋuwò.
• Ne ɖevia ƒe tsitsi tsi megbe (`(Tsitsi ƒe ʋuʋu / kpododonu le dzidzedzekpɔkpɔ)`) .

Ɣekaɣie wòhiã be nàyi Atikewɔwɔ Kpata ƒe Dɔwɔƒe (ETU) ?

Ne màte ŋu aɖu aɖuɖɔ o la, yi xɔ si te ɖe ŋuwò kpata me enumake.Esia menye nusi woahe ɖe megbe o.

Nya kawoe wòle be nàbia ɖɔktaa?

Àte ŋu abia ɖɔktaa nya siawo abe esiawo ene:

• Aleke nàwɔ anya nɔnɔme sia `(Ureteropelvic Junction Obstruction)`?
• Èsusu be vinye ƒe UPJ Obstruction la anyo ɖe edzi ne womewɔ atike nɛ oa?
• Nukawoe nye atikewɔmɔnu siwo woate ŋu azã?
• Ne ehiã be woawɔ dɔ na ame la, mɔnu kae nèkafu?
• Nukae nye mɔnukpɔkpɔ si li be UPJ Mɔxexe nadzɔ ake?

Vovototo kae le `(Ureteropelvic Junction Obstruction)` kple `(Ureterovesical Junction - UVJ) Obstruction` dome?

Kpuie ko la, Ureteropelvic Junction (UPJ) kple Ureterovesical Junction (UVJ) ƒe mɔxenuwo siaa dzɔna le wò tsinyegoe (ureter) ƒe nuwuwu. UVJ nye afisi wò tsinyegoe doa ka kple wò tsinyegoe. UVJ ƒe mɔxenu aɖe dzɔna le afima. Gake UPJ ƒe mɔxexe aɖe dzɔna le Ayiku ƒe Akɔta, afisi tsinyegoea doa ka kple wò ayiku le.

Eyata gbedasi kae wòle be míatsɔ ayi aƒeme tso nusiawo katã me?

Enye nusi sɔ be nàvɔ̃ ne èse be kuxi sia ate ŋu anɔ viwòa ŋu, eɖanye le fotoɖeɖe me esime viwòa gakpɔtɔ le vidzidɔ me alo le edzidzi megbe o. Ðewohĩ àse le ɖokuiwò me be yeabu fɔ ye ɖokui, anɔ ɖokuiwò biam be, ‘Ðe mewɔ nu gbegblẽ aɖea? Ðe nane li mate ŋu awɔ hafi esia nagadzɔ oa?’ Gake le nyateƒe me la, nɔnɔme sia si woyɔna be `(Ureteropelvic Junction Obstruction)` nye nusi dzɔna ko ɣeaɖewoɣi. Ðɔktawo gɔ̃ hã mate ŋu agblɔ nusi tututu gbɔ wòtso o.

Nu vevitɔ enye be ame geɖewo ateŋu ahaya tso `(UPJ Obstruction)` nɔnɔme sia me. Eya ta, mègavɔ̃ be yeayi ɖɔkta gbɔ aƒo nu kplii o. Wosea biabia kple vɔvɔ̃ siwo katã le susu me na wò la gɔme. Woakpe ɖe ŋuwò le mɔ ɖesiaɖe si woate ŋui nu eye woaɖo wò biabiawo katã ŋu. Dɔlélea didi kaba kple edada nyuie nye nu vevitɔ kekeake le afisia.

` Ayiku, Aɖuɖɔtoe, UPJ Mɔxexe, Ðeviwo ƒe Dɔléle, Aɖuɖɔtoe, Amekoko, Ureteropelvic Junction Mɔxexe