Ua loaʻa anei iā ʻoe kahi ʻeha koke a hiki ʻole ke hoʻomanawanui ma kou kua a i ʻole ka ʻōpū lalo, me ka paʻakikī o ka mimi ʻana? A i ʻole he koko kou i loko o kou mimi? Inā loaʻa iā ʻoe kēia mau hōʻailona, aia paha he mau pōhaku puʻupaʻa kou. Mai hopohopo, e ʻike hou kākou e pili ana i kēia i kēia lā.
He aha kēia mau pōhaku puʻupaʻa?
I ka ʻōlelo maʻalahi, he mau ʻano paʻakikī nā pōhaku puʻupaʻa, e like me ka pōhaku e hana ʻia i loko o ko kākou mau puʻupaʻa. Hoʻokumu ʻia kēia mau pōhaku i ka wā e hui pū ai kekahi mau mea i loko o ko kākou mimi, e like me nā minelala a me nā waikawa. Hiki iā lākou ke liʻiliʻi e like me kahi hua one, a i ʻole kakaikahi loa, hiki iā lākou ke nui e like me ka pōpō kolepa. Kāhea pū nā kauka i kēia mau mea he "renal calculi."
E noʻonoʻo, inā he liʻiliʻi loa ka pōhaku i loko o kou puʻupaʻa, ʻaʻohe ou hōʻailona a puka pū me kāu mimi. Eia nō naʻe, inā nui iki aʻe, paʻa paha i loko o ka ʻōmole e lawe ana i ka mimi mai ka puʻupaʻa a i ka ʻōpū mimi, ʻo ia hoʻi ka ureter. ʻO ia ka manawa e hoʻomaka ai nā pilikia. ʻAʻole kahe pono ka mimi a hoʻomaka e hōʻiliʻili, ʻaʻole hiki i nā puʻupaʻa ke hana i kā lākou hana o ka kānana pono ʻana i nā ʻōpala, a i kekahi manawa aia paha ke kahe ʻana o ke koko.
ʻO ka maʻamau, ʻekolu pule ka lōʻihi o ke kahe ʻana o kahi pōhaku e like me kēia ma o ka mimi ma kāna iho. Eia nō naʻe, hiki i nā pōhaku liʻiliʻi ke hana i ka ʻeha hiki ʻole ke hoʻomanawanui. Pono paha e wāwahi ʻia nā pōhaku nui e ke kauka a i ʻole e wehe ʻia ma ke ʻoki ʻana.
Pehea ka maʻamau o nā pōhaku puʻupaʻa?
He ʻano maʻamau kēia ma mua o kou manaʻo. Ma ka awelika, ma kahi o hoʻokahi o ka ʻumi mau kānaka e loaʻa i nā pōhaku puʻupaʻa i ko lākou ola. He mea maʻamau kēia ʻano i nā kāne ma waena o 30 a me 40 mau makahiki.
He aha nā hōʻailona o nā pōhaku puʻupaʻa?
ʻO ka hōʻailona maʻamau ka ʻeha nui ma ke kua haʻahaʻa, ka ʻaoʻao o ka ʻōpū, a i ʻole ka ʻūhā. Hiki ke mau kēia ʻeha a hele mai a hele aku. I kekahi manawa ua kapa ʻia ʻo ia he "ʻeha colicky" no ka mea e hele mai ana ia ma nā nalu.
Ma waho aʻe o kēia ʻeha, aia paha nā hōʻailona ʻē aʻe:
- Ka luaʻi a me ka luaʻi.
- Koko i loko o ka mimi (hiki i ka mimi ke ʻulaʻula, poni, a ʻeleʻele paha).
- Ke ʻeha nei i ka wā e mimi ai.
- ʻAʻole hiki ke mimi a i ʻole ka liʻiliʻi loa o ka mimi.
- ʻO ka manaʻo o ka mimi pinepine ʻana.
- Kuni a me nā ʻūlū (hiki ke lilo kēia i hōʻailona o kahi maʻi).
- Ka mimi ʻeleʻele ke kala a i ʻole he ʻala pilau.
E hoʻomanaʻo, inā he mau pōhaku liʻiliʻi loa kou, ʻaʻole paha ʻoe e loaʻa i ka ʻeha a i ʻole nā hōʻailona ʻē aʻe.
No ke aha i hana ʻia ai kēia mau pōhaku puʻupaʻa?
Aia i loko o ko kākou mimi nā mea like ʻole e like me ka calcium, sodium, oxalate, a me ka uric acid. Ke inu mākou i ka wai liʻiliʻi, a i ʻole ke nui loa kēia mau mea i loko o kā mākou mimi, pili pū lākou, hui pū, a hana i nā pōhaku. ʻAʻole hana ʻia kēia mau pōhaku i ka pō hoʻokahi, akā, mālie i loko o nā mahina, i kekahi manawa he mau makahiki.
Aia kekahi mau ʻano pōhaku puʻupaʻa like ʻole?
ʻAe, ua hoʻokaʻawale ʻia kēia mau pōhaku e like me ka mea i hana ʻia ai lākou. Aia kekahi mau ʻano nui:
- ʻO nā pōhaku calcium-oxalate a me ka calcium phosphate: ʻO kēia nā ʻano maʻamau. Hiki ke hana ʻia kēia mau pōhaku ke ʻai ʻoe i nā meaʻai he nui i ka oxalate (e like me ka spinach a me kekahi mau nati), ʻai i ka meaʻai haʻahaʻa i ka calcium, a ʻaʻole inu i ka wai lawa.
- Nā pōhaku waikawa uric: ʻO ka poʻe e ʻai nui ana i ka protein holoholona (e like me ka pipi, ka moa, ka puaʻa, ka iʻa, a me nā hua manu) ʻoi aku ka nui o ka pilikia o ka hoʻomohala ʻana i kēia ʻano pōhaku.
- Nā pōhaku Struvite: ʻO ka maʻamau, hoʻokumu ʻia kēia mau mea e nā maʻi bacteria. Inā loaʻa pinepine iā ʻoe nā maʻi urinary tract, hiki iā ʻoe ke loaʻa kahi calculus staghorn nui loa. Pono e wehe ʻia kēia mau pōhaku ma ke ʻoki ʻana.
- Nā pōhaku Cystine: He mea kākaʻikahi kēia. Hoʻokumu ʻia lākou e kahi kūlana genetic i kapa ʻia ʻo cystinuria. He ʻano amino acid ʻo Cystine.
He aha nā kumu pilikia no nā pōhaku puʻupaʻa?
ʻOi aku ka nui o ka loaʻa ʻana o nā pōhaku puʻupaʻa i kekahi poʻe. Eia kekahi mau kumu e hiki ke kōkua i kēia:
- ʻAʻole inu wai lawa: ʻO kēia ke kumu nui.
- ʻAi nui ʻana i ka ʻiʻo, ka iʻa a me nā meaʻai ʻē aʻe i waiwai i ka protein.
- ʻAi ʻana i ka meaʻai kiʻekiʻe i ka paʻakai (sodium) a me ke kō (ʻoi aku ka sucrose a me ka fructose).
- ʻO ka lawe ʻana i nā mea hoʻohui huaora C me ke kumu ʻole.
- Inā ua loaʻa i kekahi o kou ʻohana nā pōhaku puʻupaʻa (ʻano hoʻoilina).
- Loaʻa kekahi ʻano ālai i loko o ke ala mimi.
- Inā ua hana ʻia ʻoe i ke ʻoki kino ma kou ʻōpū a i ʻole nā naʻau (e laʻa me ke ʻoki bypass gastric).
- Inā ʻoe e hoʻomau i ka hoʻohana ʻana i kekahi mau lāʻau lapaʻau (e laʻa, kekahi mau diuretics, nā antacids i hoʻokumu ʻia i ka calcium, a me kekahi mau lāʻau lapaʻau no ka maʻi epilepsy).
- Loaʻa kekahi mau kūlana olakino ʻē aʻe.
Nā kūlana e hoʻonui ai i ka pilikia o nā pōhaku puʻupaʻa
Aia kekahi mau kūlana olakino e hoʻonui ai i ka pilikia o ka loaʻa ʻana o nā pōhaku puʻupaʻa. Eia kekahi mau laʻana:
- `(Fibrosis cystic)`
- ʻO Cystinuria, kahi maʻi genetic kahi e hōʻiliʻili ai ka cystine i loko o ke kino
- Maʻi diabetes
- ʻO ka ʻōpū
- Ke koko kiʻekiʻe
- Hoʻonui ʻia ka nui o ka calcium i loko o ka mimi (hypercalciuria)
- ʻO ka maʻi ʻōpū mumū (IBD)
- Nā cysts puʻupaʻa
- Momona
- ʻOsteoporosis
- Maʻi parathyroid
- `(Primary hyperoxaluria)` (kahi kūlana i hana nui ʻia ai ka oxalate)
- Nā kūlana e like me ka maʻi lolo (Hemiplegia a i ʻole paraplegia)
He aha nā pilikia e hiki mai ana mai nā pōhaku puʻupaʻa?
ʻAʻole wale nā pōhaku puʻupaʻa he mea hoʻonāukiuki, hiki iā lākou ke hana i nā pilikia nui i kekahi manawa.
- Paʻa ke ala mimi, kahe i hope ka mimi, a pehu ka puʻupaʻa (hydronephrosis).
- Ka maʻi puʻupaʻa (pyelonephritis).
- ʻEha koʻikoʻi o ka puʻupaʻa (hiki ke ho'ōla ʻia i kekahi manawa).
- Loaʻa pinepine ʻia nā maʻi ʻaʻai mimi (UTI).
- Ka pilikia o ka hoʻomohala ʻana i ka Maʻi Puʻupaʻa Mau (CKD).
Pehea ʻoe e ʻike ai inā he mau pōhaku puʻupaʻa kou?
Inā manaʻo kekahi kauka he hewa kekahi mea ma muli o kāu mau hōʻailona, e kauoha ʻo ia i kekahi mau hoʻokolohua.
- Hoʻāʻo mimi: Hiki i kēia ke nānā i ke koko i loko o ka mimi, nā kristal e hiki ke hana i nā pōhaku, a me nā hōʻailona o ka maʻi.
- Nā hoʻāʻo kiʻi: Hiki i nā kukuna X, nā scan CT (computed tomography scans), a me nā scan ultrasound ke kōkua i ka hoʻoholo ʻana i ka nui, ke ʻano, kahi, a me ka helu o nā pōhaku.
- Nā hoʻāʻo koko: Hiki i kēia ke kōkua i ka hoʻoholo ʻana i nā mea e hiki ke kōkua i ka hoʻokumu ʻana o nā pōhaku, e like me ka hana o nā puʻupaʻa, ka maʻi, a me nā pae calcium koko.
Pehea e mālama ʻia ai nā pōhaku puʻupaʻa?
Inā he pōhaku liʻiliʻi kou e hele wale ana, e haʻi aku kāu kauka iā ʻoe e makaʻala i nā hōʻailona a kali a hala. I kēia manawa, hiki iā lākou ke kuhikuhi i ka lāʻau lapaʻau e kōkua i ka hōʻemi ʻana i ka ʻeha a kōkua i ka pōhaku e hele maʻalahi.
Eia nō naʻe, inā he mau pōhaku nui, e hilinaʻi ka lāʻau lapaʻau i nā mea e like me ko lākou nui, kahi, inā paha lākou e hoʻoulu ai i ka maʻi, a me ke koʻikoʻi o nā hōʻailona. Inā ʻaʻole e hala ka pōhaku ma hope o kekahi mau pule a inā he mea paʻa, hiki i ke kauka ke ʻōlelo aku e wāwahi i ka pōhaku a wehe iā ia, a i ʻole e wehe ʻia ma ke ʻoki ʻana.
Nā lāʻau lapaʻau
No kekahi kanaka me nā pōhaku liʻiliʻi e hele wale ana ma o lākou iho a ʻaʻole i loaʻa ka maʻi, hiki i ke kauka ke kuhikuhi i nā lāʻau lapaʻau e like me kēia:
- Nā lāʻau lapaʻau e hoʻomaha ai i nā ʻiʻo i loko o ka ureter a kōkua i nā pōhaku e hele maʻalahi: no ka laʻana, nā lāʻau lapaʻau e like me tamsulosin (Flomax®) a me nifedipine (Adalat® a i ʻole Procardia®).
- Lāʻau lapaʻau e kāohi ai i ka nausea a me ka luaʻi.
- Lāʻau hoʻomalu ʻeha: ʻOiai nā pōhaku liʻiliʻi hiki ke hana i ka ʻeha nui i kekahi manawa. Hiki i ke kauka ke kuhikuhi i nā mea hoʻomaha ʻeha. Eia nō naʻe, e ʻoluʻolu e nīnau i ke kauka ma mua o ka lawe ʻana i nā lāʻau lapaʻau e like me ka ibuprofen.ʻO ka lawe ʻana i kēia mau mea ke loaʻa iā ʻoe ka ʻeha nui mai nā pōhaku puʻupaʻa e hoʻonui ai i kou pilikia o ka hoʻomohala ʻana i ka hāʻule ʻana o ka puʻupaʻa, ʻoiai inā he mau maʻi ʻē aʻe kāu.
Nā lāʻau lapaʻau kūikawā no nā pōhaku puʻupaʻa
Inā he mau pōhaku i hiki ʻole ke hele ma o lākou iho a i ʻole e ālai ana i ke ala mimi, hiki i ke kauka ke ʻōlelo i kahi hana kūikawā e wāwahi a/a i ʻole e wehe i nā pōhaku. E hilinaʻi kēia i nā mea e like me ka nui a me kahi o ka pōhaku.
- ʻO ka Shockwave lithotripsy (SWL): Pili kēia i ka hoʻohana ʻana i kahi mea hana kūikawā ma waho o ke kino e hoʻouna i nā nalu haʻalulu ikehu kiʻekiʻe e wāwahi i ka pōhaku. A laila e hoʻokuʻu maʻalahi ʻia nā ʻāpana i kuʻi ʻia i loko o ka mimi.
- Ureteroscopy: Ma kēia kaʻina hana, hoʻokomo ke kauka i kahi mea hana lahilahi i lako me ke kāmela (scope) ma o ka urethra , ma o ka ʻōpū mimi, i loko o ka ureter, a loaʻa ka pōhaku. A laila, me ka hoʻohana ʻana i nā mea hana maikaʻi ʻē aʻe i hoʻokomo ʻia ma o ka mea hana, ua wāwahi ʻia a wehe ʻia paha ka pōhaku i mau ʻāpana.
- ʻO ka nephrolithotomy Percutaneous (PCNL): Hoʻohana ʻia kēia kaʻina hana inā ʻaʻole hiki i nā ʻano hana ʻē aʻe ke wehe i ka pōhaku . Pili kēia i ka hana ʻana i kahi ʻoki liʻiliʻi ma ka ʻili, e hoʻokomo pololei i kahi paipu i loko o ka puʻupaʻa, a me ka hoʻohana ʻana i kahi mea e like me nā nalu ultrasound e wāwahi i ka pōhaku a wehe iā ia.
- ʻO ke ʻoki Laparoscopic: Pili kēia i ka hana ʻana i kekahi mau ʻoki liʻiliʻi ma ka ʻōpū a me ke komo ʻana i kahi kāmela a me nā mea hana maikaʻi e wehe i ka pōhaku. He mea kākaʻikahi loa, pono paha ke ʻoki hāmama, ʻo ia hoʻi ka hana ʻana i kahi ʻoki nui.
E nalowale anei nā pōhaku puʻupaʻa ma o lākou iho?
ʻAe, ma kahi o 80 pakeneka o nā pōhaku puʻupaʻa e puka aku ma o lākou iho me ka mimi. ʻOkoʻa ka manawa e pono ai ma muli o ka nui a me kahi o ka pōhaku. Hiki i kahi pōhaku liʻiliʻi ma mua o 4 millimeters (mm) ke puka i loko o hoʻokahi a ʻelua paha pule. ʻO kahi pōhaku nui aʻe ma mua o kēlā e hala paha ma kahi o ʻelua a ʻekolu pule. Ke hiki ka pōhaku i ka ʻōpū mimi, puka pinepine ia i loko o kekahi mau lā.
ʻO ka mea nui loa, inā manaʻo ʻoe he mau pōhaku puʻupaʻa kou, pono ʻoe e ʻike i ke kauka, e nānā iā lākou, a nānā i nā pilikia e like me ka paʻa ʻana o ke ala mimi. Inā ʻaʻole i hala ka pōhaku ma hope o ʻehā a ʻeono pule, pono ʻoe e ʻike hou i ke kauka.
Hiki ke pale ʻia nā pōhaku puʻupaʻa?
He hopena nui ko ka mea a kākou e ʻai ai a inu ai i ko kākou pilikia o ka loaʻa ʻana o nā pōhaku puʻupaʻa. E kamaʻilio me kāu kauka a i ʻole kekahi meaʻai meaʻai e pili ana i nā ala e hōʻemi ai i kou pilikia. Hiki iā lākou ke paipai i nā mea e like me:
- E inu i ka nui o ka wai: ma ka liʻiliʻi he 2-3 lita i ka lā.
- E hoʻemi i ka ʻai ʻana i nā protein holoholona (ʻiʻo, iʻa).
- E hōʻemi i nā meaʻai kiʻekiʻe i ke kō a me ka paʻakai.
- E kaupalena i nā meaʻai kiʻekiʻe i nā oxalates: Inā maʻalahi ʻoe i nā pōhaku calcium oxalate, hiki ke aʻo ʻia ʻoe e hōʻemi i kāu ʻai ʻana i nā meaʻai e like me ka spinach, peanuts, a me ka palaoa bran.
- E mālama i kahi kaumaha olakino e kūpono iā ʻoe.
- E ʻai i nā meaʻai waiwai i ka calcium: He mea kupanaha paha kēia, akā hiki i nā meaʻai waiwai i ka calcium ke kōkua maoli i ka pale ʻana i nā pōhaku puʻupaʻa. Eia nō naʻe, ʻaʻole kōkua nā mea hoʻohui calcium a me nā antacids i loaʻa ka calcium. Hiki iā lākou ke hoʻonui i ka pilikia o nā pōhaku.
- Nā lāʻau lapaʻau i kuhikuhi ʻia: Inā ʻaʻole lawa nā hoʻololi i kāu meaʻai, hiki i ke kauka ke kuhikuhi i nā lāʻau lapaʻau e kōkua i ka pale ʻana i nā pōhaku puʻupaʻa. Aia ia i ke ʻano o ka pōhaku āu.
He aha kāu e manaʻo ai inā he mau pōhaku puʻupaʻa kou?
Ma kahi o 90% o nā pōhaku liʻiliʻi ma lalo o 6 mm ka nui a ma kahi o 60% o nā pōhaku nui ma luna o 6 mm ka nui e hele wale aku. Inā he pōhaku nui a inā paha e ālai ana i ke kahe o ka mimi, pono paha e kuʻi ʻia a wehe ʻia paha. I kekahi manawa, ʻoiai nā pōhaku liʻiliʻi i manaʻo ʻia e hele wale aku hiki ke ulu mālie a nui a neʻe paha e hana i ke ālai.
Inā ua loaʻa iā ʻoe nā pōhaku puʻupaʻa i hoʻokahi manawa, ʻoi aku ka nui o ka loaʻa hou ʻana iā ʻoe i ka wā e hiki mai ana. No laila, pono ʻoe e hoʻomau i ka hana ʻana i nā hoʻololi ʻana i ka meaʻai a me ka lawe ʻana paha i nā lāʻau lapaʻau.
He aha ke ala maikaʻi loa e hoʻopau koke ai i nā pōhaku puʻupaʻa?
Inā manaʻo kāu kauka e hele wale ka pōhaku, a laila pono ʻoe e inu i ka wai he nui e kōkua iā ia e hele. E lawe i kāu lāʻau lapaʻau e like me ke kauoha. E hahai i nā ʻōlelo a kāu kauka e pili ana i ka mea e ʻai ai a me ka mea ʻaʻole e ʻai.
Hiki ke ola i kahi ola maʻamau me nā pōhaku puʻupaʻa?
ʻAʻole pono nā pōhaku puʻupaʻa e hoʻōki i kāu mau hana o kēlā me kēia lā a i ʻole e hōʻemi i kou leʻaleʻa i ke ola. ʻAʻole mau loa nā pōhaku puʻupaʻa, no ka mea, hele lākou ma ka mimi a aia nā lāʻau lapaʻau i loaʻa.
Ke kumu nei nā pōhaku puʻupaʻa i nā maʻi puʻupaʻa?
Inā he mau pōhaku puʻupaʻa kou, ua pilikia ʻoe i ka hoʻomohala ʻana i nā pōhaku hou aʻe a me ka hoʻomohala ʻana i nā maʻi puʻupaʻa mau loa.
He mea make anei nā pōhaku puʻupaʻa?
ʻAʻole. ʻAʻole make nā pōhaku puʻupaʻa.
Āhea wau e ʻike ai i ke kauka?
Inā loaʻa iā ʻoe nā hōʻailona o nā pōhaku puʻupaʻa, e ʻike koke i ke kauka. Inā loaʻa iā ʻoe kahi pōhaku, ʻo ka ʻike ʻana i kona wahi a me kona nui he mea nui loa ia e loaʻa ai ka lāʻau a pale i nā pilikia.
Āhea wau e hele ai i ka lumi pilikia?
Inā ʻaʻole hiki ke hoʻomanawanui i ka ʻeha, e hele koke i ka lumi pilikia. E hāʻawi lākou iā ʻoe i ka lāʻau lapaʻau no ka ʻeha a me kekahi nausea/luaʻi āu e loaʻa nei.
He aha nā nīnau e pono iaʻu e nīnau aku i kaʻu kauka?
Ke hālāwai ʻoe me kāu kauka, hiki iā ʻoe ke nīnau i nā nīnau e like me kēia:
- He mau pōhaku puʻupaʻa koʻu, a i ʻole he kumu ʻē aʻe no kēia mau hōʻailona?
- He aha ke ʻano o ka pōhaku puʻupaʻa i loaʻa iaʻu?
- Pehea ka nui o koʻu pōhaku puʻupaʻa?
- Ma hea ia?
- ʻEhia ka nui o nā pōhaku iaʻu?
- Pono anei au i ka lāʻau lapaʻau, a i ʻole e nalo wale kēia?
- Pono anei au e hoʻāʻo ʻia no ka maʻi puʻupaʻa?
- He aha nā hoʻololi e pono iaʻu e hana i kaʻu papaʻai?
- He aha ka lāʻau lapaʻau maikaʻi loa noʻu e wehe i nā pōhaku?
ʻO ka mea hope loa, leka lawe i ka home:
Hiki i nā pōhaku puʻupaʻa ke lilo i mea hoʻonāukiuki a ʻeha hoʻi i kekahi manawa. Eia nō naʻe, i mea e pale ai i ka ʻino ʻana o ke kūlana, he mea nui e ʻike koke i ke kauka a ʻimi i ka ʻōlelo aʻo. Hiki ke koʻikoʻi ka ʻeha, a pono paha ke ʻoki ʻana. E hoʻomanaʻo: e lawe i kāu mau lāʻau lapaʻau e like me ke kauoha, inu i ka wai he nui, a e hahai i kāu ʻai. Eia kekahi, he kūlana manawa pōkole nā pōhaku puʻupaʻa. ʻAʻole lākou e hoʻopilikia iā ʻoe no ka wā pau ʻole. E olakino!
👩🏽⚕️ Nā nīnau hou aku (FAQs)
💬 Ke ʻano maoli nei anei nā pōhaku puʻupaʻa ua like lākou me ke ʻano pōhaku?
ʻAʻole kēia he mau pōhaku maoli. Hoʻokumu ʻia lākou i ka wā e hui pū ai nā minelala e like me ka calcium, oxalate, a me ka uric acid i loko o kā mākou mimi, e hana ana i kahi puʻu e like me nā ʻāpana kō. He liʻiliʻi kekahi mau pōhaku e like me kahi hua one, aʻo kekahi e hiki ke ulu a nui e like me ka pōpō kolepa.
💬 Pehea ʻoe e ʻike ai inā he pōhaku puʻupaʻa kou?
ʻAʻole ʻeha ka pōhaku inā e waiho ana ma kahi hoʻokahi. Akā inā neʻe ka pōhaku i lalo o ka ureter, hiki iā ia ke hōʻeha i ke kua a me ka ʻōpū lalo (me ka luaʻi ʻana). Wahi a nā kauka ua like kēia ʻeha me ka ʻeha o ka hānau keiki ʻana.
💬 Pono anei au e hana i kahi ʻoki no kēia?
Inā ʻoe e inu nui i ka wai, e puka mai nā pōhaku liʻiliʻi me kou mimi. Akā inā nui ka pōhaku a paʻa i loko o ka urethra, ʻaʻole pono hou e ʻokiʻoki iā ia i mau ʻāpana nui. Aia nā ʻano hana hou e hiki ai ke wāwahi i ka pōhaku a wehe iā ia, me ka laser lithotripsy a i ʻole ma ka hoʻouna ʻana i nā nalu kani.
Nā Pōhaku Puʻupaʻa, Nā Pōhaku Puʻupaʻa, Maʻi Puʻupaʻa, Nā Pōhaku Mimi, ʻEha Kua, Calculi Puʻupaʻa, Lapaʻau Pōhaku Puʻupaʻa











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