Loaʻa i kāu pēpē kekahi mau pilikia mimi hānau? (Congenital Urinary Abnormalities) E kamaʻilio kākou e pili ana i kēia!

ʻAuē, ke manaʻo nei kāu keiki liʻiliʻi he mea ʻē ke mimi ʻo ia? I kekahi manawa, haʻi mai nā kauka iā mākou ma o nā scan ma mua o ka hānau ʻana o ka pēpē he mau loli liʻiliʻi i loko o ka ʻōnaehana mimi o ka pēpē. He mea maʻamau ka makaʻu ke lohe ʻoe i kēia. Akā, mai hopohopo, e kamaʻilio maʻalahi kākou e pili ana i kēia. I kēia lā e nānā kākou i ke ʻano o kēia mau kūlana, no ke aha lākou e hana ai, pehea e ʻike ai iā lākou, a pehea e mālama ai iā lākou.

He aha kēia mau 'ʻano ʻē o ka ʻōnaehana mimi hānau'?

I ka ʻōlelo maʻalahi, ʻo nā ʻano maʻi urinary congenital he mau loli a kīnā paha i ka ʻōnaehana urinary o kāu pēpē a i kekahi manawa nā ʻōnaehana genitourinary i loaʻa i ka wā hānau, ʻo ia hoʻi ke kū nei lākou i ka wā e ulu ana ke pēpē i loko o ka ʻōpū. Ua kapa ʻia kēia mau mea he mau ʻano maʻi urinary congenital.

ʻO nā ʻōpū i hiki ke hoʻopilikia nui ʻia e kēia mau kūlana:

• Nā puʻupaʻa: E like me kou ʻike, kānana nā puʻupaʻa ʻelua i loko o ko kākou kino i ka paʻakai, ka wai, nā mea ʻawahia, a me nā huahana ʻōpala mai ke koko a hana i ka mimi . ʻElua puʻupaʻa ko ka hapa nui o ka poʻe.
• ʻŌpū mimi: ʻO kēia ka ʻōkana e like me ka ʻeke elastic e mālama ai i ka mimi .
• Nā Ureters: ʻO kēia nā ʻōmole ʻelua e lawe ana i ka mimi mai nā puʻupaʻa a i ka ʻōpū mimi.

He aha nā ʻano like ʻole i maʻa mau ʻia?

Aia kekahi mau ʻano o ia mau ʻano ʻē. E nānā kākou i kekahi o lākou:

• Hydronephrosis: ʻO kēia ka wā e pehu ai kekahi a i ʻole nā ​​puʻupaʻa ʻelua. E noʻonoʻo e ālai ana kekahi mea i ke ala o ka mimi mai nā puʻupaʻa a i ka ʻōpū mimi, e hoʻopiha a pehu ai ka mimi i loko o nā puʻupaʻa. Ua like ia me kahi paipu wai e paʻa ana a piha i ka wai.
• ʻO nā testicles i iho ʻole (cryptorchidism): ʻO ka maʻamau, ulu nā testicles o kahi pēpē keikikāne i loko o ka ʻōpū ʻoiai ʻo ia i loko o ka ʻōpū. A laila iho mālie lākou i loko o ka scrotum, ka ʻeke kahi i loaʻa ai nā testicles. Eia nō naʻe, aia kekahi mau pēpē i hoʻokahi a ʻelua paha o kēia mau testicles i iho ʻole i loko o ka scrotum no kekahi manawa ma hope o ka hānau ʻana.
• ʻO Hypospadias: He kūlana kēia e hoʻopilikia ai i nā pēpē kāne. ʻO ka puka ma ka urethra, ka ʻōmole e puka ai ka mimi a me ka sperm, pono e waiho ma ka piko o ka penis. Eia nō naʻe, i kēia hihia, aia ka puka ma kahi ʻē aʻe ma lalo o ka penis.
• Spina bifida: He ʻano paʻakikī iki kēia. Hana ʻia ia i ka wā ʻaʻole i ulu piha ka lolo, ke kaula iwi kuamoʻo, a/a i ʻole nā ​​membrane pale a puni ke kaula iwi kuamoʻo (meninges) i ka wā e ulu ana ka pēpē i loko o ka ʻōpū. I nā hihia koʻikoʻi, hiki i kēia ke hana i ka maʻi lolo hapa a piha paha. Hiki iā ia ke hana i ka ʻōpū neurogenic a me nā pilikia ʻē aʻe.
• ʻO ka reflux Vesicoureteral (VUR):ʻO ka maʻamau, hele ka mimi mai nā puʻupaʻa ma o nā ureters a i ka ʻōpū mimi, a laila puka i waho ma o ka urethra. Eia nō naʻe, ma kēia kūlana (VUR), kahe hou ka mimi i loko o ka ʻōpū mimi i luna ma o nā ureters, i kekahi manawa hoʻi i loko o nā puʻupaʻa.
• ʻO ka exstrophy bladder: He maʻi kakaikahi loa kēia. Ma kēia ʻano, ulu ka ʻōpū o ka pēpē ma ke ʻano e hōʻike ʻia ai ka ʻaoʻao o loko, ʻo ia hoʻi, ua hōʻike ʻia ka ʻaoʻao o loko. A laila mimi ka pēpē ma kahi puka ma ka ʻōpū lalo, ma mua o ka urethra.
• ʻO ka maʻi ʻōpū ʻōpala (Eagle-Barrett syndrome): He maʻi laha ʻole kēia. ʻO ka hōʻailona nui o kēia, ʻo ia ka nāwaliwali a nalowale paha o nā ʻiʻo ʻōpū, ka mea e like ai ka ʻōpū me ka plum maloʻo. Me kēia, hiki i nā testicles ke iho i lalo a nalowale, a aia paha nā mea ʻē aʻe i loko o ka ʻōnaehana mimi.
• ʻO ka valve urethral hope (PUV): Hoʻopilikia kēia maʻi i nā pēpē kāne. ʻO kahi flap (valve) keu ma ke kua o ka urethra e ālai i ke kahe ʻana o ka mimi. Hiki i kēia ke hoʻihoʻi i ka mimi i loko o ka ʻōpū mimi, e pehu ai. Hiki i kēia ke hōʻino i ka urethra a me nā puʻupaʻa.

He aha nā kūlana maʻamau?

ʻO nā testicles i iho ʻole ʻia ka maʻi maʻamau o ke ala mimi i nā keikikāne.

ʻO ka Vesicoureteral reflux (VUR) kahi maʻi maʻamau i waena o nā kaikamahine.

He aha nā hōʻailona o kēia mau ʻano like ʻole?

ʻOkoʻa kēia ma muli o ke ʻano o ka maʻi ʻē. I kekahi mau hihia, ʻaʻohe paha he ʻeha a he mau hōʻailona ʻike ʻia. I kēia mau hihia, hiki i ke kauka ke ʻike i kēia mau mea ma o nā hoʻokolohua e like me nā scan. Eia nō naʻe, eia kekahi o nā hōʻailona maʻamau:

• ʻEha ma ka ʻaoʻao, ka ʻōpū, a i ʻole ke kua.
• ʻEha a wela paha i ka wā e mimi ai (dysuria).
• Ka hoʻohuli ʻana i ka mimi , a i ʻole ke kahe ʻana o ka mimi nāwaliwali.
• Ke kahe ʻana o ka mimi ma mua o ka maʻamau.
• Ke koko i loko o ka mimi (hematuria).
• Ka luaʻi a me ka luaʻi .
• ʻUlūlū .
• Loaʻa pinepine ʻia nā maʻi ʻaʻai mimi (UTI).
• ʻAʻole ulu olakino ke pēpē e like me ka mea i manaʻo ʻia.

No ke aha lā kēia e hana nei? He aha nā kumu o kēia?

He mea paʻakikī loa ke kuhikuhi i hoʻokahi kumu no kēia. He mea paʻakikī iki. ʻO ka hapa nui o ka manawa, ʻo kēia mau ʻano ʻē o ka ʻōnaehana mimi ke kumu o ka hui pū ʻana o nā mea pili i ke kaiapuni a me nā hoʻololi genetic .

ʻO nā kumu kaiapuni e hiki ke hoʻopilikia:

• Loaʻa i koʻu makuahine ka maʻi diabetes .
• Ka nele o kekahi mau huaora a me nā minelala, e like me ka folate a me ka hao, i ka wā hāpai.
• Hiki i kekahi mau lāʻau lapaʻau a ka makuahine e lawe ai (no ka laʻana, kekahi mau lāʻau lapaʻau no ka maʻi ʻepilepsy) ke hoʻopilikia maikaʻi ʻole i nā puʻupaʻa.

ʻO nā hoʻololi nui o ka genetic e pili ana i kēia mau ʻano ʻē, ʻo ia nā genes PAX2 a me HNF1B. Kōkua kēia mau genes i nā puʻupaʻa, ka ʻōnaehana mimi, a me nā ʻiʻo ʻē aʻe i ka wā o ka ulu ʻana o ka fetal.

ʻO wai ka mea i hoʻopilikia nui ʻia e kēia mau kūlana?

ʻO ka mea maʻamau, inā ua loaʻa i kekahi o ka ʻohana (pili pili kino) nā pilikia o nā puʻupaʻa a i ʻole ka ʻōnaehana mimi ma mua , ʻoi aku ka nui o ka loaʻa ʻana o kēia ʻano maʻi ʻōnaehana mimi hānau i ka pēpē.

Pehea ʻoe e ʻike ai i kēia mau mea? Pehea e ʻike ai i ka maʻi?

ʻO ka hapa nui o ka manawa, ʻike nā kauka i kēia mau ʻano ʻino o ka mimi hānau i ka wā o nā ultrasounds prenatal. ʻIke ʻoe, nānā kēia mau scan i ke olakino a me ka ulu ʻana o ka pēpē. Hiki iā lākou ke ʻike i nā mea e like me oligohydramnios, ʻo ia hoʻi ka nele o ka wai amniotic a puni ka pēpē. ʻO ka maʻamau, ma hope o 20 mau pule o ka hāpai ʻana, ʻo ka hapa nui o kēia wai amniotic he mimi . No laila, inā ʻaʻole lawa ka wai amniotic, manaʻo nā kauka he hewa kekahi mea me ka ʻōnaehana mimi o ka pēpē.

Inā no kekahi kumu ʻaʻole hiki ke ʻike ʻia kēia ma mua o ka hānau ʻana o ka pēpē, hiki i ke kauka ke kānalua i kēia ma hope o ka hānau ʻana o ka pēpē a i ʻole ma muli o nā hōʻailona a ka pēpē e hōʻike ai i ka wā kamaliʻi. A laila, hana ʻia nā hoʻokolohua like ʻole e hōʻoia i kēia kūlana. ʻO kēia mau hoʻokolohua:

• ʻO ke scan Ultrasound: He hoʻāʻo ʻeha ʻole kēia e hoʻohana ana i nā nalu kani e lawe i nā kiʻi a i ʻole nā ​​​​wikiō o nā ʻōpū a me nā ʻiʻo i loko o ke kino.
• Urinalysis / hoʻāʻo mimi: Hiki i kēia ke hōʻoia i nā mea e like me ka loaʻa ʻana o kahi maʻi ʻaʻai mimi.
• Nā hoʻāʻo koko: Hiki i kēia ke nānā i nā mea e like me ke ʻano o ka kānana ʻana o nā puʻupaʻa i ke koko (manaʻo ʻia ka glomerular filtration rate - eGFR).
• CT scan (computed tomography scan): He hoʻāʻo ʻeha ʻole kēia. Pono nā kukuna X he nui i ka lālani e hana i nā kiʻi kikoʻī o nā iwi a me nā ʻiʻo i loko o ke kino.
• MRI Scan (MRI / Magnetic resonance imaging): He hoʻāʻo ʻeha ʻole kēia. Hoʻohana ia i kahi magnet, nā nalu lekiō, a me ke kamepiula e kiʻi i nā kiʻi kikoʻī o nā ʻōpū a me nā mea i loko o ke kino.
• ʻO ka Voiding cystourethrogram (VCUG): He hoʻāʻo kūikawā kēia e lawe i nā kiʻi kikoʻī o ka ʻōpū mimi i ka wā e hoʻopiha ana a hoʻokahe ana ma hope o ka mimi ʻana .
• ʻO ke scan Renal: He hana kiʻi lāʻau lapaʻau nukelea kēia e hoʻohana ana i kahi liʻiliʻi o nā mea radioactive e kiʻi i nā kiʻi kikoʻī o nā puʻupaʻa.
• Ka hoʻāʻo ʻana o ka Urodynamic: Pili kēia i ka hoʻokomo ʻana i kahi hāmeʻa, e like me ka catheter, e ʻike ai pehea ka hana maikaʻi o ka ʻōpū.

Pehea e mālama ʻia ai kēia?

ʻO ke ʻano o ka lāʻau lapaʻau e pili ana i ke ʻano o ka maʻi ʻē aʻe o ka pēpē. ʻAʻole paha e pono kekahi mau maʻi i kekahi lāʻau lapaʻau. Pono paha nā maʻi ʻē aʻe i nā lāʻau lapaʻau like ʻole. Eia kekahi laʻana:

• Nā lāʻau antibiotic (inā loaʻa kahi maʻi)
• Dialysis (ke hana pono ʻole nā ​​​​puʻupaʻa)
• Ka hoʻoili ʻana o nā puʻupaʻa ( inā loaʻa ka hāʻule ʻana o nā puʻupaʻa)

E nānā hou ke kime lapaʻau o kāu pēpē i ka mōʻaukala olakino piha o kāu pēpē, e loiloi pono i ko lākou kūlana o kēia manawa, a e hoʻomohala i ka hoʻolālā olakino maikaʻi loa a kūpono hoʻi no kāu pēpē.

Aia kekahi mau ala e pale aku ai i kēia mau kūlana?

ʻO kaʻoiaʻiʻo, ʻaʻole hiki ke pale aku i kēia mau ʻano ʻino o ke ala mimi. Eia nō naʻe, hiki i ka hāpai ʻana ke kōkua i ka hōʻemi ʻana i kou pilikia i kekahi ʻano. ʻO ia hoʻi:

• E ʻike i ke kauka i ka manawa kūpono, e kiʻi i ka ʻōlelo aʻo, a hele i nā keʻena lapaʻau i hoʻonohonoho ʻia.
• E kamaʻilio me kāu kauka e pili ana i nā lāʻau lapaʻau a me nā wikamina āu e lawe nei.
• E lawe i kahi huaora prenatal i loaʻa ma ka liʻiliʻi he 400 micrograms o ka folic acid i kēlā me kēia lā.
• Mai hoʻohana i ka waiʻona, ka paka, a i ʻole nā ​​​​lāʻau lapaʻau i kauoha ʻole ʻia e ke kauka.

He aha ka mea e hana ai inā loaʻa i kaʻu pēpē kahi pilikia hānau ʻana o ka mimi e like me kēia? He aha ka mea e hiki mai ana?

Pili maoli kēia i ke ʻano o ka maʻi mimi o kāu pēpē a me ke koʻikoʻi o nā hōʻailona. Pono paha kekahi mau keiki i ka mālama olakino maʻamau no ke koena o ko lākou ola. Akā , mai hopohopo , e hana pū ka hui lapaʻau o kāu pēpē me ʻoe e hana i kahi hoʻolālā pilikino e kōkua i kāu pēpē e noho palekana, olakino, a kūʻokoʻa e like me ka hiki.

I ka ulu ʻana o kahi pēpē, hiki i ka wā ʻōpio, a komo i ka wā ʻōpio, hiki ke kū mai kekahi mau pilikia olakino a me ke ʻano o ke ola. Eia kekahi laʻana:

• Ke paʻakikī i ka kaohi ʻana i ka mimi a me ka ʻōpala (urinary and bowel incontinence).
• Nā maʻi ʻōpū mimi pinepine (UTI).
• Ka hōʻino ʻana i ka ʻōpū mimi, nā puʻupaʻa, a me/a i ʻole ke ala mimi.
• Hiki i ka hōʻino nui ʻana o nā puʻupaʻa ke alakaʻi i ka hāʻule ʻana o nā puʻupaʻa. I kēlā hihia, pono paha ka dialysis a i ʻole ka hoʻoili puʻupaʻa.
• Hiki i kēia kūlana ke hoʻopilikia i ka hana a me ke ʻano o ko lākou mau ʻōpū, hiki ke hoʻopilikia i ko lākou hiki ke loaʻa nā keiki i ka wā e hiki mai ana.

Hiki i kēia mau ʻano ʻē o ka ʻōnaehana mimi hānau ke hoʻopilikia i kāu pēpē i ka naʻau a me ka nohona (pehea e ʻike ai kekahi poʻe iā ia, pehea ʻo ia e noʻonoʻo ai iā ia iho, a pēlā aku), akā hiki i kāu hui lapaʻau ke hāʻawi i ke kākoʻo no kēia mau mea āpau, e kōkua ana i kāu pēpē e neʻe i ka wā makua me ke kaumaha ʻole.

Āhea wau e lawe ai i kaʻu pēpē i ke kauka? He aha kaʻu e hana ai i ka wā pilikia?

He mea nui e hoʻonohonoho i nā manawa kūpono me ke kauka o kāu pēpē. Na lākou e nānā i kāu pēpē i ka wā kamaliʻi, ka wā kamaliʻi, ka wā ʻōpio, a me ka wā makua.

Inā loaʻa i kāu pēpē kahi maʻi urinary tract a hōʻike i kekahi o nā hōʻailona ma lalo nei, e hele koke i ka keʻena pilikia o ka haukapila kokoke loa :

• Inā loaʻa koke iā ʻoe ka ʻeha nui a hiki ʻole ke hoʻomanawanui ma kou ʻōpū, kua, a ʻaoʻao paha.
• Inā loaʻa iā ʻoe ke kuni ma luna o 100.5 degere Fahrenheit (38 degere Celsius).
• Inā ʻike ʻoe i kahi loli i ke ʻano o kou mimi ʻana (e laʻa, ka nui aʻe a emi mai paha o ka mimi ma mua o ka maʻamau, ʻaʻole hiki ke mimi iki, ka ʻeha i ka wā e mimi ai , ke kahe ʻana o ke koko i loko o ka mimi ).

He aha nā nīnau koʻikoʻi e nīnau aku ai i ke kauka?

Mai poina e nīnau i kēia mau nīnau ke kipa aku ʻoe i ke kauka o kāu pēpē:

• "He aha ke ʻano kūpono ʻole o ka ʻōnaehana mimi hānau i loaʻa i kaʻu pēpē?"
• "Pehea lā e pili ai kēia kūlana i kona ola i ka wā e hiki mai ana?"
• "Ke piʻi nei ka pilikia o kaʻu pēpē i nā pilikia olakino ʻē aʻe ma muli o kēia kūlana?"
• "Pono anei kaʻu pēpē i ka lāʻau lapaʻau?"
• "No laila, he aha ka lāʻau lapaʻau maikaʻi loa?"
• "He aha nā pilikia e pono iaʻu e makaʻala nui?"
• "He aha nā hopena lōʻihi o kēia maʻi i kaʻu pēpē?"

ʻO nā mea nui loa e pono ai mākou e hoʻomanaʻo

ʻO kekahi o nā makaʻu nui o nā mākua he nui, ʻo ia ka loaʻa ʻana o kahi maʻi a i ʻole ke kūlana e hiki ke hoʻopilikia i ko lākou ola. Ua like kēia mau ʻano ʻino o ke ala mimi hānau, a hiki ke hana ʻia i ka wā e ulu ana ke pēpē i loko o ka ʻōpū a i ʻole ma hope koke iho o ka hānau ʻana. ʻAʻole hiki ke pale piha ʻia kēia mau kūlana he nui. Eia nō naʻe, ma ka loaʻa ʻana o kahi hāpai olakino,(ʻO ia hoʻi, ʻo ka ʻai ʻana i ka meaʻai momona, ka lawe ʻana i nā huaora i ʻōlelo ʻia e nā kauka, ka noho ʻana mai nā mea ʻino, a me ka hele ʻana i nā kūkākūkā lapaʻau a me nā keʻena lapaʻau i ka manawa kūpono) hiki ke hōʻemi i ka pilikia o ia mau maʻi i kekahi ʻano.

Inā ʻike ʻoe he maʻi ʻē aʻe ko kāu pēpē i ke ala mimi, mai hopohopo . E hana ke kime lapaʻau i kahi hoʻolālā lapaʻau e pili pono ana i kāu pēpē a kūpono loa iā ia. Ua ʻike lākou i ka paʻakikī a me ke kaumaha o kēia no ʻoe ma ke ʻano he makua. ʻO ia ke kumu ua mākaukau lākou e wehewehe iā ʻoe i nā hoʻokolohua a me nā lāʻau lapaʻau e pono ai kāu pēpē, a pane i nā nīnau āu e loaʻa ai. ʻO ka mea nui loa hiki iā ʻoe ke hana i kēia manawa, ʻo ia ke hahai pololei i nā ʻōlelo a kāu kauka a hilinaʻi i kāu kauka.

Nā ʻano ʻino o ka ʻōnaehana mimi hānau, nā ʻano ʻino o ka mimi hānau, nā pilikia mimi o ka pēpē, nā maʻi puʻupaʻa, nā pilikia o ka ʻōpū mimi, ke olakino o ke keiki, ke olakino o ka hāpai ʻana