Ke ʻike nei ʻoe i kekahi manawa i ka ʻeha nui ma kou ʻaoʻao, ʻōpū, a i ʻole ke kua i lalo, me ka nausea? Malia paha ke hakakā nei ʻoe me ka ʻeha i ka wā e mimi ai a i ʻole ke ʻike ʻana i ke koko i loko o kou mimi? He mau hōʻailona paha kēia o ka pehu ʻana o nā puʻupaʻa, kahi maʻi i ʻike ʻia ma ke ʻano lapaʻau ʻo Hydronephrosis. E wehewehe kākou i ke ʻano o kēia ma nā huaʻōlelo maʻalahi.
He aha ka Hydronephrosis?
I ka ʻōlelo maʻalahi, hana ʻia ka Hydronephrosis i ka wā e pale ai kahi poloka i loko o ke ala mimi i ka mimi mai ke kahe ʻana mai kou mau puʻupaʻa a i kou ʻōpū mimi, e hoʻoulu ai i kekahi a i ʻole nā puʻupaʻa ʻelua e pehu. E noʻonoʻo iā ia e like me ka kink i loko o ka hose māla—hoʻi hou ke wai, e hoʻonui ana i ke kīʻaha. I kekahi manawa kapa nā kauka i kēia ʻo 'upper urinary tract dilation.'
E nānā pōkole kākou pehea e hana ai kāu ʻōnaehana mimi ma ke ʻano he kānana kūlohelohe a me ka pūnaewele hoʻohemo ʻōpala o kou kino:
- ʻElua mau puʻupaʻa: Kānana kēia mau ʻōpū koʻikoʻi i nā mea ʻawahia a me nā huahana ʻōpala mai kou koko.
- ʻElua Ureters: ʻO kēia nā ʻōmole e lawe i ka mimi mai nā puʻupaʻa a i ka ʻōpū mimi.
- ʻŌmole mimi: He ʻeke mālama e paʻa ai ka mimi a hiki i kou mākaukau e hoʻokahe.
- Urethra: ʻO ka ʻōmole e lawe ana i ka mimi mai loko mai o kou kino.
Hana ʻia ka Hydronephrosis ke loaʻa kahi mea pale ma kekahi wahi ma kēia ala, ma waena pono o ka puʻupaʻa a me ka ureter.
Hiki i kēia ʻano ke hōʻike ʻia ma nā ʻano like ʻole. Hiki ke koke (ʻoi) a i ʻole e ulu mālie i ka hala ʻana o ka manawa (mau) . Hiki ke hapa a piha paha ka paʻa ʻana. Inā hoʻokahi wale nō puʻupaʻa e pili ana, ua kapa ʻia ʻo 'unilateral hydronephrosis'; inā pili ia i nā mea ʻelua, ʻo ia hoʻi 'bilateral hydronephrosis.' Hiki nō hoʻi ke ʻano o ka pehu ʻana mai ka liʻiliʻi a i ka nui.
Pehea ka maʻamau o kēia ʻano?
Hiki i ka Hydronephrosis ke hoʻopilikia i nā kānaka o kēlā me kēia makahiki. Ua manaʻo ʻia ma kahi o 1 i loko o 100 mau mākua e ʻike i kēia maʻi i kekahi manawa o ko lākou ola.
I nā pēpē, hiki ke hana ʻia i loko o ka ʻōpū, kahi kūlana i kapa ʻia ʻo 'antenatal hydronephrosis.' ʻIke ʻia ia ma kahi o 1% o nā hāpai ʻana. ʻO ka mea pōmaikaʻi, i nā hihia he nui, hoʻopau ia ma kāna iho ma mua o ka hānau ʻana o ka pēpē.
He aha nā hōʻailona o ka Hydronephrosis?
ʻO ka maʻamau, hilinaʻi nā hōʻailona o ka Hydronephrosis i ke kumu kumu. I ka manawa pinepine, ʻaʻohe hōʻailona iki . E like me ka mea i ʻōlelo ʻia, ʻo nā pēpē me ka antenatal hydronephrosis ʻaʻole hōʻike pinepine i nā hōʻailona ma hope o ka hānau ʻana.
Eia nō naʻe, inā ʻike ʻia nā hōʻailona, hiki iā lākou ke komo pū me:
- ʻEha koke a koʻikoʻi: Ma kou ʻaoʻao, ʻōpū, a i ʻole ke kua i lalo.
- Ka luaʻi a i ʻole ka luaʻi ʻana .
- ʻEha ka mimi ʻana.
- Koko i loko o ka mimi.
- Nā maʻi ʻōpū mimi hou ( UTI ).
- He manaʻo mau e ʻaʻole i hakahaka loa kou ʻōpū mimi ma hope o ka mimi ʻana.
- Nā loli i ke alapine (frequency) a i ʻole ka nui o ka mimi.
Ma muli o ka paʻa ʻana o ka mimi, hiki i ka bacteria ke hoʻonui, e hoʻonui ana i ka pilikia o ka UTI. Inā loaʻa kahi maʻi, e ʻike paha ʻoe:
- Kuni, anuanu, a me ka luhi.
- Nā manaʻo kuni a ʻeha paha i ka wā e mimi ai.
- Mimi ʻeleʻele a ʻano ʻē paha.
He aha ke kumu o ka Hydronephrosis?
ʻO ke kumu nui o ka Hydronephrosis he mea e ālai ʻia ai a i ʻole 'pale ʻana' ma nā wahi āpau o ke ala mimi. Aia kekahi mau kumu kūpono:
Nā kumu maʻamau i nā mākua:
- Nā pōhaku puʻupaʻa:Nā waihona paʻa i hana ʻia me ka calcium a me ka oxalate hiki ke noho i loko o nā puʻupaʻa a i ʻole nā ureters.
- Ka ālai ʻana o ka ureter: Nā ālai ʻana i loko o nā ureters ponoʻī.
- Nā puʻupuʻu: Nā ulu ʻana i loko o ka ʻōpū mimi, ka prostate gland, ka uterus , a i ʻole nā ʻōpū e pili kokoke ana e kau i ke kaomi ma ke ala mimi.
- ʻO ka Benign prostatic hyperplasia (BPH): He prostate i hoʻonui ʻia i loko o nā kāne e hiki ke hoʻopaʻa i ka urethra, e paʻakikī ai ke hoʻokuʻu i ka ʻōpū mimi.
- Nā koʻikoʻi Urethral: Ka hāiki ʻana o ke ala urinary ma muli o ka hōʻeha, ka maʻi, a i ʻole ke ʻoki mua ʻana.
- Nā pilikia neurological a i ʻole nā pilikia ʻiʻo: Nā pilikia e hoʻopilikia i ka hana maʻamau o nā puʻupaʻa a i ʻole nā ureters.
- Ka paʻa ʻana o ka mimi: ʻO ka hiki ʻole ke hoʻokuʻu piha i ka ʻōpū mimi.
- ʻO ka reflux vesicoureteral: Ke kahe nei ka mimi i hope mai ka ʻōpū mimi i nā puʻupaʻa.
- Ureterocele: ʻO ke kūlana kahi e pehu ai ka ʻaoʻao haʻahaʻa o ka ureter i loko o ka ʻōpū mimi.
Nā kumu kūikawā i nā wahine:
- Hāpai keiki: I ka ulu ʻana o ke keiki i loko o ka ʻōpū, hoʻonui ʻia ka ʻōpū, kahi e hiki ai ke hoʻopaʻa i nā ureters a ālai i ke kahe ʻana o ka mimi.
- ʻO ka prolapse o ka ʻōpū: Ke neʻe ka ʻōpū mai kona kūlana maʻamau.
- Cystocele (ʻōpū mimi hāʻule): Ke nāwaliwali ka paia ma waena o ka ʻōpū mimi a me ka vagina, e hoʻoulu ai i ka ʻōpū mimi e puʻupuʻu i loko o ka vagina.
Nā kumu i loko o ka pēpē (Antenatal):
- Ka hoʻonui ʻia o ka hana ʻana o ka mimi fetal.
- Nā ālai ʻana o ka hānau ʻana i loko o ke ala mimi.
- Ke kahe hou ʻana o ka mimi mai ka ʻōpū mimi a i nā puʻupaʻa.
He aha nā pilikia e hiki ke loaʻa?
Inā ʻaʻole mālama ʻia, hiki i ka Hydronephrosis koʻikoʻi ke alakaʻi i ka hōʻino ʻana o nā puʻupaʻa a, i ka hopena, ka hāʻule ʻana o nā puʻupaʻa. I ia mau hihia, pono paha nā hana e like me ka dialysis a i ʻole ka hoʻoili puʻupaʻa.
Eia naʻe, mai hopohopo! Hoʻōla piha ka poʻe he nui mai ka Hydronephrosis me ka ʻole o ka hōʻino mau ʻana o ka puʻupaʻa. ʻO ka hana nui loa, ʻo ia ke noho mālie a ʻimi i ka mālama lapaʻau kūpono mai nā poʻe loea ma Nirogi Lanka.
Pehea e ʻike ʻia ai ka Hydronephrosis?
He mea nui e ʻike i ke kauka a loaʻa koke kahi hōʻailona, no ka mea, hiki i ka hydronephrosis ke hōʻeha i nā puʻupaʻa i ka wā lōʻihi inā ʻaʻole mālama ʻia.
E ʻike pinepine kāu kauka i ke kūlana ma o kēia mau hana:
- Hoʻokolohua Kino: E nīnau kāu kauka e pili ana i kāu mau hōʻailona a nānā i kou ʻōpū a me nā wahi pelvic no ka palupalu a i ʻole ka pehu ʻana. E nānā lākou i kāu mōʻaukala olakino a nīnau inā he mōʻaukala ʻohana o nā kūlana like. I nā kāne, hiki ke hana ʻia kahi hoʻokolohua rectal e nānā inā ua hoʻonui ʻia ka gland prostate. I nā wahine, hiki ke hana ʻia kahi hoʻokolohua pelvic e kāpae i nā pilikia me ka uterus a i ʻole nā ovaries.
- Urinalysis: E nānā ʻia kahi hāpana mimi e nānā i ke koko, nā pōhaku, nā bacteria, a i ʻole ka maʻi. I kekahi mau hihia, pono paha kāu kauka e hoʻohana i kahi catheter e kiʻi i kahi hāpana sterile.
- Nā Hoʻāʻo Koko: Hiki ke hana ʻia kahi Helu Koko Piha (CBC) e ʻike ai i nā maʻi. Eia kekahi, hana pinepine ʻia nā hoʻāʻo e like me ka creatinine, eGFR, a me BUN e loiloi i kāu hana puʻupaʻa.
- Nā Kaʻina Hana Kiʻi: ʻO ka ultrasound scan ka mea hana diagnostic mua. Ma muli o kāu mau pono, pono paha kahi CT scan a i ʻole MRI no ka ʻike kikoʻī.
Ua ʻike anei ʻoe hiki ke ʻike pinepine ʻia ka hydronephrosis i loko o kahi pēpē i hānau ʻole ʻia i ka wā mua o ka trimester mua ma o ka ultrasound? ʻIke pinepine ʻia ia i ka wā o ka scan anatomy 20-pule maʻamau. Inā ʻike ʻia, e nānā kāu kauka i ka pēpē me nā ultrasounds hahai; akā naʻe, hoʻopau pinepine kēia ʻano ma kāna iho ma mua a i ʻole ma hope koke iho o ka hānau ʻana.
He aha nā koho lapaʻau no ka Hydronephrosis?
ʻO ka pahuhopu nui o ka mālama ʻana, ʻo ia ke hoʻihoʻi i ke kahe maʻamau o ka mimi a hoʻomaha i ke kaomi a me ka pehu ʻana i loko o kou mau puʻupaʻa. Aia wale nō ka mālama ʻana i ke kumu.
I nā hihia palupalu, ʻaʻole pono ka lāʻau lapaʻau, a hiki i kāu kauka ke kuhikuhi i kahi ala 'kali a ʻike'. ʻO ke ʻoki ʻana kekahi koho a kāu kauka e noʻonoʻo ai. He mea nui e kamaʻilio ākea me kāu mea mālama ola e pili ana i nā ala lapaʻau āpau i loaʻa.
Inā loaʻa koke iā ʻoe ka hydronephrosis ma muli o kahi ālai ʻana, hiki i kāu kauka ke hoʻokomo i kahi ʻōmole nephrostomy ma kou ʻili e hoʻokahe i ka mimi keu mai ka puʻupaʻa. A i ʻole, hiki iā lākou ke kau i kahi ʻōmole palaki palupalu i kapa ʻia he ureteral stent i loko o kāu ureter e mālama iā ia e wehe a hōʻoia i ke kahe pololei ʻana o ka mimi.
Inā he pōhaku i loko o kou mau puʻupaʻa a i ʻole nā ureters ke kumu, hiki ke noʻonoʻo ʻia nā koho aʻe:
- ʻO Shock Wave Lithotripsy: He lāʻau maʻamau kēia no nā pōhaku puʻupaʻa. Hoʻohana ʻia nā nalu haʻalulu ikehu kiʻekiʻe e wāwahi i nā pōhaku i mau ʻāpana liʻiliʻi a hiki ke hoʻokele ʻia e hiki ke hele ma ke ʻano kūlohelohe.
- Ureteroscopy: Hoʻokomo ʻia kahi ʻōuli lahilahi ma o kou urethra e ʻimi a wehe a wāwahi paha i nā pōhaku. Hoʻohana pinepine ʻia kēia no nā pōhaku i loaʻa i loko o ka ʻōpū mimi a i ʻole ka ʻaoʻao haʻahaʻa o nā ureters.
- ʻOki kino: Inā nui loa nā pōhaku puʻupaʻa a paʻakikī paha e wehe, pono paha ke komo ʻana i ke ʻoki kino. Pono paha ke ʻoki kino e hoʻoponopono i nā mea keakea ʻē aʻe e like me nā puʻupuʻu a i ʻole nā ʻiʻo ʻeha.
Inā loaʻa kou maʻi i kahi maʻi ʻaʻai mimi (UTI) a i ʻole kahi stricture (narrowing) ma muli o ka maʻi, e kuhikuhi kāu kauka i nā antibiotics e hoʻomaʻemaʻe i ka pilikia kumu.
Hiki ke pale ʻia ka Hydronephrosis?
ʻOiai ke kumu o ka hydronephrosis e nā kūlana kumu, ʻo ka pale ʻana e pili ana i ka mālama ʻana a i ʻole ka hoʻokele ʻana i kēlā mau kumu kumu i ka wā mua. ʻO ka ʻike ʻana i kāu mau kumu pilikia he ʻanuʻu koʻikoʻi ia i ka pale ʻana.
ʻO nā kūlana e hoʻonui ai i kou pilikia o ka hoʻomohala ʻana i ka hydronephrosis:
- Nā pōhaku puʻupaʻa.
- He moʻolelo o nā maʻi ʻaʻai o ke ala mimi.
- Nā hana ʻoki kino ma mua ma ke ala mimi.
- Nā maʻi ʻōpū mimi hou (UTIs).
- Nā ʻūpā koko.
- Ka nui o ka ʻōpū prostate.
- Hāpai (ma muli o ke kaomi ma luna o nā ureters).
He pilikia nui anei ka Hydronephrosis?
ʻAe, hiki ke lilo i mea koʻikoʻi inā waiho ʻole ʻia. Eia nō naʻe, ʻo ka hapa nui o nā hihia he akahai a kaulike paha a ʻaʻole ia e alakaʻi i nā pilikia olakino koʻikoʻi no ka wā lōʻihi. Mai hopohopo; ʻo ke komo mua ʻana ke kī.
Pono anei au e hopohopo e pili ana i kaʻu hōʻailona Hydronephrosis?
Mai hopohopo nui e pili ana i ka maʻi hydronephrosis. I ka hapanui o nā hihia, me ka mālama kūpono, hiki iā ʻoe ke ola i kahi ola maʻamau me ka ʻole o nā pilikia lōʻihi. E kūkākūkā i kāu mau nīnau e pili ana i kou hoʻōla ʻana, nā hoʻololi ʻana i ke ʻano o ka nohona, a me ka manawa hoʻōla i manaʻo ʻia me kāu kauka ma Nirogi Lanka.
Āhea wau e ʻike ai i ke kauka?
Pono ʻoe e ʻike koke i ke kauka inā ʻike ʻoe i kēia mau hōʻailona:
- ʻEha koke a nui ma kou ʻaoʻao a i ʻole ke kua.
- Ka luaʻi mau ʻana.
- Nā loli i ka mimi ʻana: ʻOi aku ka nui a emi mai paha o ka mimi ma mua o ka maʻamau, ʻeha ka mimi ʻana, a i ʻole ke koko i loko o kou mimi.
- He kuni ma mua o 100.5°F (38°C).
Nā Manaʻo Hope Loa
I ka hōʻuluʻulu manaʻo, ʻo ka hydronephrosis kahi maʻi kahi e pehu ai nā puʻupaʻa ma muli o ka hōʻiliʻili ʻana o ka mimi. Hiki iā ia ke hoʻopilikia i kekahi. ʻO ka mea pōmaikaʻi, inā ʻike ʻia a mālama koke ʻia, hiki iā ʻoe ke pale i nā pilikia mau loa. Inā ʻike ʻoe i nā hōʻailona ʻē e like me ka ʻeha ʻaoʻao a ʻōpū paha, ka nausea, ka luaʻi ʻana, a i ʻole nā loli i kāu mau ʻano mimi, e ʻoluʻolu e hoʻokaʻaʻike aku i kahi loea. Ke ʻike ʻia ke kumu, e alakaʻi kāu kauka iā ʻoe ma o nā koho lapaʻau maikaʻi loa. ʻAʻohe pono e makaʻu; ʻo ka mālama olakino kūpono kāu pale maikaʻi loa.
