Inā he makuahine hāpai ʻoe, ua kamaʻāina paha ʻoe i nā scan e nānā i ke olakino o kāu pēpē. I kekahi manawa, inā ʻike ʻia ka huaʻōlelo "megaureter" ma ka hōʻike scan, he mea maʻamau ke makaʻu nui a me ka hopohopo. Akā, mai hopohopo. Inā ʻike piha ʻoe i kēia kūlana, e ʻoi aku kou ikaika i ke alo ʻana iā ia. I kēia lā, e kamaʻilio kākou e pili ana i ke ʻano o ia mea, ke kumu e hana ʻia ai, a me nā mea hiki ke hana ʻia e pili ana iā ia.
I ka ʻōlelo maʻalahi, he aha kēia Megaureter?
ʻAe, e hoʻomaopopo mua kākou i kahi liʻiliʻi e pili ana i ka hana ʻana o ka ʻōnaehana mimi i loko o ko kākou kino. Loaʻa iā kākou ʻelua mau puʻupaʻa. ʻO kēia nā mea e kānana i ko kākou koko a hana i ka mimi (mimi) mai nā huahana ʻōpala pono ʻole. A laila, aia ʻelua mau ʻōmole lahilahi e lawe ana i kēia mimi i ka ʻōpū mimi. ʻO kēia mau ʻōmole ʻelua ka mea a mākou e kapa nei he ureters .
ʻO ka maʻamau, ʻo ka urethra i loko o ke kanaka olakino he ʻōmole lahilahi ma kahi o 9 ʻīniha ka lōʻihi a ma kahi o hoʻokahi ʻīniha ka laulā. Eia nō naʻe, i loko o ke kūlana i kapa ʻia ʻo "megaureter", ʻoi aku ka nui a me ka laulā o kēia urethra ma mua o ka maʻamau. I ka ʻōlelo maʻalahi, he "mega" (nui) "ureter" (ureter) e like me ka inoa e hōʻike nei.
He maʻi hānau pinepine kēia e kū mai ana i ka wā e noho ana ke pēpē i loko o ka ʻōpū. ʻO ia ke kumu e ʻike pinepine ʻia ai i ka wā o nā hoʻokolohua kiʻi prenatal. Inā ʻaʻole mālama pono ʻia, hiki i kahi maʻi koʻikoʻi i kapa ʻia ʻo "Megaureter" ke hōʻino i ka ʻōnaehana mimi o ka pēpē.
Aia kekahi mau ʻano nui o nā megaureters?
ʻAe, hiki ke hoʻokaʻawale ʻia kēia ʻano i kekahi mau ʻano nui ma muli o ke ʻano o kona hiki ʻana mai. Inā hoʻohana kāu kauka i kēia mau huaʻōlelo, e aʻo kākou e pili ana iā lākou e maʻalahi ai ke hoʻomaopopo.
| ʻAno Megaureter | He mea maʻalahi ka mea e hana ʻia. |
|---|---|
| Megaureter Hoʻihoʻi | ʻO kēia ka manawa e kahe ai ka mimi mai ka ʻōpū mimi i hope, i luna, a i lalo o ka ureter i ka puʻupaʻa. ʻO kēia kahe hope (vesicoureteral reflux) ke kumu o ka ureter e kīkoʻo a hoʻonui mālie. |
| Megaureter i ālai ʻia mua | ʻO ka mea e hana ʻia ma ʻaneʻi, ʻo ia ka paʻa ʻana o ka urethra, kahi e pili ai i ka ʻōpū mimi, a ua ʻūmiʻi ʻia. Ua like ia me ke ʻūmi ʻana i kahi paipu wai ma ka hopena. Hoʻopuka kēia i ka mimi e kahe i waho (paʻa) a hoʻopiha ʻia ka ʻōmole me ka mimi, e hoʻoulu ai i ka pehu a lilo i mea nui. |
| ʻO ka megaureter mua i ʻole keakea ʻia, ʻaʻole refluxing | I kēia hihia, ʻaʻohe o nā kumu i luna aʻe nei. ʻO ia hoʻi, ʻaʻole kahe ka mimi i hope, ʻaʻohe mea e ālai ʻia ai. Akā ua nui aʻe ka urethra. I ka hapanui o nā hihia, hoʻōla kēia maʻi iā ia iho i ka wā e ulu ana ke keiki. |
| Nā Megaureter Lua | Hoʻokumu ʻia kēia e nā kūlana olakino ʻē aʻe, e like me ka paʻa ʻana o ka urethra, prune belly syndrome , a i ʻole kahi neurogenic bladder . |
He aha nā hōʻailona e loaʻa paha i kaʻu pēpē me kēia maʻi?
ʻO ka hapa nui o ka manawa, ʻaʻohe hōʻailona o nā keiki me ka megaureter. ʻO ia ke kumu he mea nui nā scan prenatal. Eia nō naʻe, hiki i kekahi mau keiki, ʻoi aku hoʻi ma hope o ka hānau ʻana, ke loaʻa nā hōʻailona. ʻO kēia mau mea:
- ʻEha ʻaoʻao: ʻEha e puka mai ana mai ka ʻaoʻao o ke kua, ma lalo o nā iwi ʻaoʻao.
- Koko i loko o ka mimi (hematuria): Inā lilo ka mimi i poni, ʻulaʻula, a ʻeleʻele paha.
- Nā maʻi ʻōpū mimi pinepine (UTIs): Hiki i nā maʻi ʻōpū mimi ke hoʻoulu i ke kuni, nā ʻūhā, a me ke kuni i ka wā e mimi ai.
- Kuni me ke kumu ʻole.
- ʻO ka hoʻōki ʻana o ka mimi: Inā ʻoi iki aʻe kāu keiki, he mea paʻakikī paha ke kaohi i kā lākou mimi ʻana.
ʻO ka mea nui, ʻaʻole e loaʻa i kēlā me kēia keiki kēia mau ʻano āpau. Hiki ke ʻokoʻa loa nā ʻano o kekahi keiki mai kekahi.
No ke aha e hiki ai kēia i nā pēpē? He aha ke kumu?
He mea paʻakikī ke kuhikuhi i hoʻokahi kumu no kēia, akā aia kekahi mau kumu nui i ʻike ʻia.
Ke ulu nei kahi pēpē i loko o ka ʻōpū, ua hana ʻia ka urethra me kahi papa o nā ʻiʻo e hiki ke ʻūlū. ʻUlū kēia mau ʻiʻo e like me nā nalu e hoʻokuke i ka mimi mai nā puʻupaʻa i ka ʻōpū mimi. Kāhea mākou i kēia kaʻina hana he "peristalsis".
Eia nō naʻe, i kekahi manawa, ma kahi o kēia ʻiʻo, ulu kahi ʻiʻo paʻakikī, paʻa ʻole, a fibrous i loko o kahi ʻāpana o ka urethra. ʻAʻole hiki i kēia ʻāpana paʻakikī ke ʻūlū pēlā. ʻO ka hopena, ua ālai ʻia ke kahe o ka mimi, a piha ka ʻōmole me ka mimi, e lilo mālie ana i mea nui.
Eia kekahi, ʻo kahi ālai ʻana ma ke komo ʻana o ka urethra i ka ʻōpū mimi, a i ʻole kahi hewa o ka hopena o ka urethra (ureterocele), hiki ke hana i kahi kūlana i kapa ʻia ʻo "megaureter", kahi e ālai ai i ke kahe o ka mimi.
Ua ʻike ʻia e ka noiʻi ʻana he ʻehā manawa ka nui o kēia maʻi i waena o nā keikikāne ma mua o nā kaikamahine.
Pehea e ʻike ai nā kauka i kēia? He aha nā hoʻokolohua e hana ʻia ai?
E like me ka mea i ʻōlelo ʻia ma mua, ʻike pinepine ʻia kēia i ka wā hāpai ma o kahi scan ultrasound (ultrasound/sonogram) , ka mea e ʻike maopopo ai i nā puʻupaʻa o ke pēpē, nā ureters, a me ka ʻōpū mimi.
Inā hōʻike kāu pēpē i nā hōʻailona e like me nā maʻi ʻōpū mimi pinepine ma hope o ka hānau ʻana, e nānā kāu kauka i kāu pēpē a ʻōlelo i nā hoʻokolohua hou aʻe inā kānalua lākou i kēia ʻano.
- VCUG (Voiding Cystourethrogram): He ʻano X-ray kūikawā kēia. Maanei, hoʻokomo ʻia kahi paipu lahilahi loa (catheter) i loko o ka urethra o ke keiki, a hoʻokomo ʻia kahi wai kūikawā (contrast dye) ma o ia mea i loko o ka ʻōpū mimi. A laila, ke mimi ke keiki, lawe ʻia kahi X-ray e ʻike inā puka mai ka wai me ka mimi a i ʻole e piʻi hou i luna o ka urethra.
- ʻO ke kani ʻana o ka puʻupaʻa: Hiki i kēia ke kōkua i ka nānā ʻana i ka nui, ke ʻano, a me ke alo o nā mea ālai i nā puʻupaʻa a me ka ʻōpū mimi o ke keiki.
- ʻO Renal Scan: Ma kēia hoʻāʻo, ua hoʻokomo ʻia kahi liʻiliʻi loa o ka mea radioactive (radiotracer) i loko o kahi aa koko i loko o ke keiki. A laila, hoʻohana ʻia kahi scanner kūikawā e nānā i ke ʻano o ka hele ʻana o ka mea ma o nā puʻupaʻa. Hiki i kēia ke kōkua i ka hoʻoholo pono ʻana i ka hana maikaʻi o nā puʻupaʻa a inā he mau mea e ālai ana i ke kahe o ka mimi.
- Nā hoʻāʻo koko (Electrolyte panel): Nānā ʻia nā pae electrolyte i loko o ke koko e ʻike ai inā e hana pono ana nā puʻupaʻa o ke keiki.
- Urinalysis: Lawe ʻia kahi hāpana mimi a nānā ʻia no nā hōʻailona o ka maʻi ʻaʻai mimi.
Pehea e hiki ai ke mālama ʻia kēia? He mea pono anei ke ʻoki kino?
ʻOkoʻa ke ʻano o ka lāʻau no kēia mai kēlā keiki a kēia keiki. Aia ia i ka makahiki o ke keiki, ke ʻano o nā hōʻailona, a me ko lākou olakino holoʻokoʻa.
ʻO ka nūhou maikaʻi loa,ʻAʻole pono ka hapa nui o nā keiki i ka lāʻau nui a i ʻole ke ʻoki kino. Hoʻomaikaʻi pinepine ke ʻano ma kona iho i ka wā e ulu ai ke keiki.
No laila, hoʻohana mua nā kauka i kahi ala "kiaʻi-a-kali" . I loko o kēia manawa:
- Hana ʻia nā scan ultrasound maʻamau e nānā inā e ulu maʻamau ana nā puʻupaʻa o ke pēpē.
- Hiki ke hoʻomau ʻia ka lawe ʻana i nā antibiotics e hōʻemi i ka pilikia o nā maʻi ʻaʻai mimi (UTIs).
Eia nō naʻe, inā ʻaʻole e hoʻomaikaʻi ke kūlana i loko o ka makahiki mua o ke keiki, inā e nui aʻe ka urethra (dilates), inā hoʻomau nā maʻi ʻaʻai mimi, a inā pilikia ka hana o ka puʻupaʻa, a laila pono paha ke ʻoki ʻana.
ʻElua ʻano nui o ke ʻoki kino:
1. Ureterostomy: Maanei, hoʻopili ke kauka lapaʻau i ka urethra o ke keiki i kahi puka liʻiliʻi (stoma) i hana ʻia i loko o ka ʻōpū. A laila, kahe pololei ka mimi mai loko mai o ka puka i loko o ka diaper o ke keiki ma kahi o ke komo ʻana i loko o ka ʻōpū mimi. Hāʻawi kēia i ka urethra a me nā puʻupaʻa i kahi hoʻomaha a hiki iā lākou ke hoʻōla. Ma hope o kekahi mau mahina, ke hoʻi ka urethra i kona nui maʻamau, hana ʻia kekahi ʻoki kino e hoʻopili hou iā ia i ka ʻōpū mimi.
2. Pyeloplasty: ʻO kēia ʻoki kino e pili ana i ka wehe ʻana a i ʻole ka hoʻoponopono ʻana i ka ʻāpana i paʻa a i ʻole i haiki ʻia o ka urethra, a me ka hoʻopili hou ʻana i nā ʻāpana ʻelua i koe o ka urethra.
He kiʻekiʻe loa ka holomua o kēia mau ʻoki kino. No laila, ʻaʻohe pono e makaʻu. E wehewehe pono ke kauka iā ʻoe i ka lāʻau lapaʻau kūpono loa no kāu keiki.
Aia kekahi mau manawa e pono ai ʻoe e lawe i kāu keiki i ka ETU?
ʻAe. Inā loaʻa i kāu keiki kahi maʻi i kapa ʻia ʻo "Megaureter" a loaʻa iā ia kekahi o nā hōʻailona ma lalo nei me ka maʻi ʻaʻai mimi (UTI), e lawe koke iā lākou i ka ʻOihana Pilikia (ETU) o ka haukapila kokoke loa .
- ʻEha hope
- kuni kiʻekiʻe
- Ka luaʻi a me ka luaʻi
Mai noho i ka home i ka manawa e like me kēia. He mea nui loa e ʻimi koke i ke kōkua lapaʻau.
Leka Lawe-Home
- ʻO ka Megaureter kahi hoʻonui kūpono ʻole o ka ʻōmole e lawe ana i ka mimi mai ka puʻupaʻa o ke keiki i ka ʻōpū mimi. He maʻi hānau pinepine kēia.
- Mai hopohopo inā ʻike ʻoe i kēia i ka wā o kahi scan i ka wā hāpai. ʻAʻole pono ka hapa nui o nā keiki i ke ʻoki kino , a e hoʻopau wale ke ʻano i ka wā e ulu ana ke keiki.
- Inā ʻōlelo kāu kauka i ke ʻano "kali makaʻala", e lawe pono i kāu keiki no ka nānā ʻana i ka lā i hoʻonohonoho ʻia.
- ʻO nā maʻi pinepine o ke ala mimi kahi hōʻailona maʻamau o kēia maʻi. No laila, e lawe i nā lāʻau antibiotic i kuhikuhi ʻia e kāu kauka e like me ke kauoha.
- Inā pono ke ʻoki kino, kiʻekiʻe loa ka holomua, no laila, mai makaʻu pono ʻole.
- Inā loaʻa i ke keiki nā hōʻailona e like me ke kuni, ka ʻeha kua, a me ka luaʻi, e lawe koke iā ia i ka Emergency Treatment Unit (ETU) o ka haukapila.
- E nīnau i kāu kauka i nā nīnau a hopohopo paha āu e loaʻa ai. E hāʻawi lākou iā ʻoe i ka ʻike a me ke kākoʻo āpau āu e pono ai.
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