Pono ʻoe i makaʻu nui a pūʻiwa hoʻi i ka wā i haʻi aku ai ke kauka iā ʻoe he hoʻokahi wale nō puka o kāu pēpē hānau hou kahi e pono ai ke kahe o ka ʻōpū, ka urethra, a me ka anus. He mea maʻamau loa ia. ʻAʻohe mea i mākaukau e lohe i kekahi mea e like me kēia. Akā, mai hopohopo. He kīnā hānau kakaikahi loa kēia e hiki ke hoʻoponopono pono ʻia me ke ʻoki kino. E kamaʻilio kākou e pili ana i nā mea āpau me ka maʻalahi a me ka maopopo.
I ka ʻōlelo maʻalahi, he aha ka Cloacal Malformation?
He kīnā hānau laha ʻole ka Cloacal Malformation e pili wale ana i nā kaikamahine. ʻO ka maʻamau, pono i ka ʻāpana genital a me ka anus o ke kaikamahine (kapa mākou i kēia wahi ʻo ka perineum) ʻekolu mau puka . ʻO lākou,
1. Urethra ( ka ʻōmole e puka ai ka mimi)
2. ʻO ka vagina , kahi e hana ai ka menstruation a me ka moekolohe.
3. ʻO ka anus ( ke ala e puka ai ka feces)
Eia nō naʻe, hoʻokahi wale nō puka o ke keiki me ka Cloacal Malformation ma kahi o kēia mau mea ʻekolu. ʻO ke ʻano kēia, puka ka mimi, ka ʻōpala, a me nā mea huna o ka wahine mai ke kino aku ma o kēia puka hoʻokahi. He kūlana kūikawā kēia no ka hui o nā kīnā hānau i kapa ʻia ʻo `(Anorectal Malformation)`.
E noʻonoʻo, i nā pule mua o ka ulu ʻana o kahi pēpē i ka wā hāpai, ua pili nā ʻōnaehana ʻekolu—ka ʻōnaehana ʻōpū, ka ʻōnaehana mimi, a me ka ʻōnaehana hānau keiki—i kahi keʻena maʻamau i kapa ʻia ʻo "cloaca." I ka ulu ʻana o ka pēpē, ua māhele mālie kēia keʻena i ʻekolu ʻāpana, e hana ana i nā puka ʻekolu a mākou i ʻōlelo ai ma mua. I kekahi manawa, ʻaʻole hana pono kēia kaʻina hana mahele. ʻO ia ka manawa e pili ai nā ʻōnaehana ʻekolu i kahi ʻōmole maʻamau, e wehe ana i waho o ke kino ma o hoʻokahi puka.
ʻO ke ʻano lapaʻau no kēia maʻi, ʻo ia ke hana ʻoki ʻana i ʻekolu mau puka kaʻawale ma kahi o kēia puka maʻamau. Hana pinepine ʻia kēia ʻoki ʻana i loko o ka makahiki mua o ke ola o ke keiki.
Aia kekahi mau ʻano like ʻole o kēia ʻano maʻi?
ʻAe. Hoʻoholo ʻia ke koʻikoʻi o ke kūlana Cloacal Malformation e ka lōʻihi o ke "kahawai maʻamau" e hoʻopili ai i nā ʻōnaehana ʻekolu a mākou i kūkākūkā ai. Hiki i kēia kahawai maʻamau ke loaʻa mai 1 kenimika a 10 kenimika ka lōʻihi. Hoʻoholo kēia lōʻihi i ka paʻakikī o ke ʻoki kino e pono ai ke keiki.
- Loaʻa ʻana o kahi Kahawai Pōkole: ʻO kēia ka manawa e hui pū ai nā ʻōnaehana ʻekolu kokoke loa i ka puka ma waho o ke kino. ʻO ke ʻano kēia he pōkole ke kahawai maʻamau. I ia mau hihia, ʻoi aku ka maʻalahi o ka puka ʻana o nā ʻōpala mai ke kino aku. He maʻalahi hoʻi ke ʻoki ʻana. Eia kekahi, ʻoi aku ka maikaʻi o ke olakino o ke keiki i ka wā e hiki mai ana.
- Loaʻa kahi Kahawai Maʻamau Loa:ʻO kēia ke kūlana paʻakikī loa. Maanei, hui pū nā ʻōnaehana ʻekolu i loko o ke kino. No laila, ʻoi aku ka lōʻihi o ke kahawai maʻamau. Hoʻolilo kēia i mea paʻakikī no ka ʻōpala e haʻalele i ke kino. Lilo pū kekahi i mea paʻakikī ke ʻoki kino.
He mea kākaʻikahi loa kēia ʻano, ʻike ʻia ma kahi o hoʻokahi i loko o 25,000 a 50,000 mau pēpē hānau hou.
He aha nā hōʻailona o kēia maʻi a me nā pilikia ʻē aʻe e pili ana me ia?
ʻO ka hiʻohiʻona nui a maopopo loa, ʻo ia ka hānau ʻana o kahi keiki wahine me hoʻokahi wale nō puka ma kahi o nā ʻekolu e pono ai ke kū. Eia kekahi, hiki i kēia kūlana ke hana i nā pilikia olakino ʻē aʻe. E nānā kākou iā ia ma kēia papa.
| Hōʻailona/pilikia pili | He wehewehe maʻalahi |
|---|---|
| Hiʻohiʻona nui | He puka hoʻokahi ma kahi o ka anus, ka vagina, a me ka urethra. |
| Hoʻonui ʻia ʻo Clitoris | Hiki i kekahi mau vagina o nā keiki ke like me ka penis o ke keikikāne. |
| ʻAno ʻē ka rectum | Ka loli ʻana i ke kūlana o ka anus a i ʻole kahi hiʻohiʻona ʻē. |
| Nā pilikia o ka ʻōnaehana hānau | I kekahi manawa aia paha ma mua o hoʻokahi vagina, uterus, a cervix paha. |
| Nā pilikia o ka ʻōnaehana mimi | Hiki ke loaʻa nā pilikia like ʻole i loko o nā puʻupaʻa, nā ureters, a i ʻole ka ʻōpū mimi. |
| Nā pilikia ma nā ʻōnaehana ʻē aʻe | Aia kekahi pilikia o nā pilikia ʻē aʻe me ka puʻuwai, ka iwi kuamoʻo, a i ʻole ka ʻōnaehana hoʻoheheʻe. |
No ke aha i hiki mai ai kēia i kaʻu keiki? He aha ke kumu?
He mea maʻamau ka hiki ʻana mai o kēia nīnau i kou manaʻo. Akā, ʻaʻole maopopo loa i nā kauka ke kumu. Manaʻo nā kānaka noiʻi he hanana ulia wale nō ia, me ke kumu ʻole.
ʻAʻole kēia kou hewa iki. Mai manaʻo ʻino ʻoe ua hana ʻia kēia kūlana e kekahi mea āu i hana ai a i ʻole i hana ʻole ai i kou wā hāpai. He mea hewa loa ia.
Pehea e ʻike ai i kēia maʻi?
Hiki ke ʻike ʻia kēia maʻi ma mua a ma hope o ka hānau ʻana.
Ma mua o ka hānau ʻana (i ka wā hāpai)
I kekahi manawa, hiki ke ʻike ʻia kēia ʻano i ka wā o kahi scan ultrasound, kahi i hana ʻia ma kahi o 20 mau pule o ka hāpai ʻana. Manaʻo nā kauka i kēia inā hōʻike ka scan i kahi ʻeke piha i ka wai a pehu i loko o ka vagina o ke pēpē. No ka hōʻoia ʻana i kēia kānalua, hiki ke hana ʻia kahi hoʻāʻo Magnetic Resonance Imaging (MRI) i ka wā hāpai.
Ma hope o ka hānau ʻana
Hoʻomaopopo pinepine ʻia kēia maʻi ma hope o ka hānau ʻana o ka pēpē. E ʻike ke kauka lapaʻau e nānā ana i ka pēpē he hoʻokahi wale nō puka ma kahi o ʻekolu. Hiki i ka pēpē ke loaʻa kahi ʻōpū pehu. A laila, e hana ʻia kekahi mau hoʻāʻo e hoʻomaopopo pono i ka mea e hana nei i loko o ke kino.
- ʻO ke nānā ʻana i ka ultrasound: E nānā i ke kūlana o nā puʻupaʻa o ke pēpē, ka ʻōpū mimi, a me ka iwi kuamoʻo.
- Nā kukuna X: Hiki ke hoʻohana ʻia nā ʻano hana kukuna X kūikawā, e like me ka fluoroscopy, e ʻike ai pehea e hana ai ka ʻōnaehana mimi.
- Echocardiogram: Hana ʻia kēia hoʻāʻo e ʻike inā he mau pilikia me ka puʻuwai.
Pehea e mālama ʻia ai? E aʻo kākou e pili ana i ke ʻoki kino
ʻO ke ʻoki kino ka lāʻau lapaʻau no ka Cloacal Malformation. ʻO ka pahuhopu nui ka hana ʻana i ʻekolu mau puka kaʻawale (anus, vagina, a me urethra) ma kahi o ka puka hoʻokahi. ʻO ka pahuhopu ka hāʻawi ʻana i ke keiki i ka hiki ke hoʻokahe a mimi maʻamau a e kāohi iā lākou.
ʻAʻole hiki ke hana ʻia kēia me kahi ʻoki hoʻokahi. ʻO ka maʻamau, pono e hana ʻia kekahi mau ʻoki. No kēia, he mea nui e ʻimi i ke kōkua o ke kauka ʻoki keiki a me ke kauka urologist pediatric.
Hiki ke hoʻokaʻawale ʻia ke kaʻina hana lapaʻau i ʻekolu mau ʻanuʻu nui.
KaʻAnuʻu Hana 1: ʻO ke ʻoki kino mua (i loko o 48 mau hola o ka hānau ʻana)
ʻO ka pahuhopu nui o kēia, ʻo ia ka hana ʻana i ala no ka ʻōpala (feces a me ka mimi) e puka pono ai mai ke kino o ke keiki.
- Colostomy: No ka mea, ʻaʻohe ala o ke keiki e hoʻokahe ai i ka ʻōpū, hana ʻia ke kaʻina hana ʻoki e hana i kahi puka ma ka ʻōpū ma ka lawe ʻana mai i kahi ʻāpana o ka ʻōpū i ka ʻili o ka ʻili. Hoʻopili ʻia kahi ʻeke i kēia puka, e ʻae ana i ka ʻōpala e hōʻiliʻili.
- ʻO ka incontinence mimi: Hoʻohana ʻia kahi catheter e hoʻokahe i ka mimi no ka mea ua pehu a paʻa paha ka ʻōpū mimi.
- Vagina: Inā he hōʻiliʻili wai i loko o ka vagina, e wehe ke kauka ʻoki i ka wai.
KaʻAnuʻu Hana 2: ʻO ke ʻoki kino nui (ma waena o 6 a me 12 mau mahina o ka makahiki)
Hana ʻia kēia ʻoki kino nui ma hope o ka ʻelemakule iki ʻana o ke keiki a ua paʻa kona olakino. ʻO ka mea e hana ʻia ma ʻaneʻi, ua māhele ʻia ke kahawai maʻamau i mau ʻāpana, e hana ana i kahi anus, vagina, a me ka urethra kaʻawale. Inā pōkole ke kahawai maʻamau, ua maʻalahi kēia ʻoki kino. Inā lōʻihi ke kahawai maʻamau, e lilo ke ʻoki kino i mea paʻakikī.
KaʻAnuʻu Hana 3: Hoʻohuli ʻia o ke colostomy
Ma hope o ke ʻoki kino nui, ke ola ka anus i hana hou ʻia, wehe ʻia ka colostomy mua. ʻO ke ʻano kēia, ua pani ʻia ka puka i hana ʻia ma ka ʻōpū a ua hoʻopili hou ʻia nā ʻōpū i ko lākou kūlana maʻamau. A laila hiki i ke keiki ke hoʻomoe ma o ka anus i hana hou ʻia.
Pono paha kekahi mau keiki i ke ʻoki kino hou aʻe i ka wā e hiki mai ana, a na kāu kauka e wehewehe iā ʻoe.
Pehea lā ke ʻano o ke keiki i ka wā e hiki mai ana?
ʻO kēia ka nīnau nui loa ma ka manaʻo o kēlā me kēia mākua. ʻO ka nūhou maikaʻi, ʻo ka hopena maʻamau he maikaʻi loa ia .
- Ka mana o ka ʻōpū a me ka ʻōpū mimi: ʻO nā keiki me kahi ala pōkole maʻamau, kahi i emi iki ka paʻakikī, he 90% ka manawa e loaʻa ai ka mana piha o ko lākou ʻōpū a me ka ʻōpū mimi. ʻO ke ʻano kēia hiki iā lākou ke hoʻomaʻamaʻa maʻamau i ka lua. ʻOiai nā keiki me kahi ala lōʻihi maʻamau, kahi i ʻoi aku ka paʻakikī, he 70% ka manawa e loaʻa ai ka mana maikaʻi. Hiki i kekahi mau keiki ke pilikia i ka kaohi ʻana i ko lākou mimi (urinary incontinence). I ia mau hihia, pono paha lākou e hoʻohana i kahi ʻōmole i nā manawa he nui i ka lā e hoʻokahe i ko lākou ʻōpū mimi.
- Ke ola moekolohe a me ka hāpai ʻana: Hiki i nā keiki he nui me kēia maʻi ke loaʻa nā ola moekolohe maʻamau a ʻoluʻolu hoʻi i ka wā makua. Hiki nō hoʻi iā lākou ke hāpai. Eia nō naʻe, ʻoi aku ka paʻakikī ma mua o ka wahine maʻamau. Inā hāpai lākou, ua ʻōlelo pinepine ʻia ka ʻoki cesarean (C-section) e hānau i ka pēpē.
He aha kāu e hiki ai ke hana ma ke ʻano he makua?
He mea nui loa kāu kōkua ma kēia huakaʻi.
- E hana pū me ka hui lapaʻau: E noho mau i ka launa pū ʻana me ke kauka lapaʻau o kāu keiki, urologist, a me pediatrician.
- E hōʻoia e hele no nā hoʻokolohua hahai:Ma hope o ke ʻoki ʻana, pono kāu keiki e hele pinepine i ke keʻena lapaʻau e hōʻoia i ka hana pono ʻana o ko lākou mau ʻōnaehana kino. Mai poina i kekahi o lākou.
- E kākoʻo i kāu keiki: I ka ulu ʻana o kāu keiki, inā he pilikia me ka kaohi ʻana i ka mimi a i ʻole ka ʻōpū, mai hilahila a haʻi aku i ke kauka e pili ana i ia mea.
- E nīnau i nā nīnau: E nīnau i kāu kauka i nā nīnau a hopohopo paha āu e loaʻa ai. ʻO kāu kuleana ia.
ʻO kekahi mau nīnau hiki iā ʻoe ke nīnau i ke kauka:
- Pehea e hana ʻia ai kēia ʻoki kino? I ka makahiki hea?
- Ke ʻeha nei kaʻu keiki?
- He aha kaʻu e manaʻo ai i ka wā e hoʻōla hou ai kaʻu keiki ma hope o ke ʻoki ʻana?
- E pono anei ke keiki i nā ʻoki kino hou aku i kona wā e ulu ana?
- E loaʻa anei nā pilikia me ka anus, urethra, a i ʻole vagina i ka wā e hiki mai ana?
- E hiki anei i kaʻu keiki ke hānau keiki me ka palekana i ka wā e hiki mai ana?
ʻAʻole hiki ke hōʻike ʻia ka haʻalulu, ka makaʻu, a me ka hopohopo e hele mai me ke aʻo ʻana i kahi mea e like me kēia ma nā huaʻōlelo. Akā e hoʻomanaʻo, ua holomua loa ka ʻepekema lapaʻau i kēia lā. Hiki i ke ʻoki kino ke hoʻoponopono pono i kēia kūlana, e hāʻawi ana i kāu keiki i ka manawa kūpono e ola i kahi ola maʻamau a hauʻoli e like me nā keiki ʻē aʻe.
Leka Lawe-Home
- He kīnā hānau kakaikahi loa ka Cloacal Malformation e loaʻa wale ana i nā pēpē wahine.
- ʻAʻole kēia kou hewa a ʻaʻole hoʻi kou hoa. Mai hopohopo no ia mea.
- ʻO ka lāʻau lapaʻau e pili ana i kahi moʻo o nā ʻoki kino, kahi e hana ai i ʻekolu mau puka kaʻawale i loko o ke keiki.
- Hoʻopōmaikaʻi pinepine nā hopena o ka lāʻau lapaʻau, ʻoiai ma nā hihia i ʻoi aku ka paʻakikī.
- He mea nui loa ka launa pū ʻana me nā kauka a me ka hele ʻana i nā keʻena lapaʻau no ke olakino o ke keiki i ka wā e hiki mai ana.
- He nui nā keiki me kēia maʻi e ola maʻamau, olakino, a hauʻoli hoʻi.
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