Ke pilikia nei hoʻi ʻoe i ka mimi pono ʻana? E aʻo kākou e pili ana i ka Non-Neurogenic Voiding Dysfunction!

Ke manaʻo nei ʻoe i kekahi manawa e like me ka pilikia o ka mimi ʻana ? A i ʻole ke manaʻo nei ʻoe ʻaʻole i hoʻokahe loa ʻia kou ʻōpū mimi ma hope o kou pau ʻana i ka mimi ʻana ? Malia paha ke kahe nei ʻoe i ka mimi me ka manaʻo ʻole. ʻAʻole kēia he pilikia nou wale nō, akā no nā poʻe he nui. I kēia lā, e kamaʻilio mākou e pili ana i ka incontinence urinary ʻaʻole i hoʻokumu ʻia e nā pilikia neurological . Ma ke ʻano lapaʻau, kapa mākou i kēia "Non-Neurogenic Voiding Dysfunction".

He aha ka Non-Neurogenic Voiding Dysfunction?

I ka ʻōlelo maʻalahi, he ʻano kēia kahi hiki ʻole iā ʻoe ke hoʻokahe loa i kou ʻōpū mimi. ʻO ka huaʻōlelo "non-neurogenic" ma ʻaneʻi ʻo ia hoʻi ʻaʻole i hoʻokumu ʻia ke ʻano e nā pilikia me kāu ʻōnaehana nerve, ʻo ia hoʻi, kou lolo, ke kaula spinal, a i ʻole nā ​​​​aʻalolo. ʻO "Voiding dysfunction" ʻo ia hoʻi ʻaʻole hana pono ke kaʻina hana o ka mimi.

Hiki ke loaʻa kēia ʻano maʻi i kekahi. ʻO ka hapa nui, hiki ke kumu o kēia ma muli o nā ʻiʻo ʻōpū palupalu, kahi paʻa i kekahi wahi o ka ʻōnaehana mimi, a i ʻole nā ​​​​​​ʻano maikaʻi ʻole a mākou i maʻa mau ai no ka manawa lōʻihi. Eia nō naʻe, ʻoi aku ka maʻamau o kēia ʻano ma nā keiki ʻōpio i aʻo ʻia i ka lua ma waena o nā makahiki 4 a me 6 a me nā wahine ma luna o 40 mau makahiki. E noʻonoʻo, ma kahi o hoʻokahi o ʻelima mau keiki ma waena o 4 a me 6 mau makahiki e mimi i ke ao ma muli o kēia `(Non-neurogenic voiding dysfunction)`. Eia kekahi, ʻoi aku ma mua o 6% o nā wahine ma luna o 40 mau makahiki i loaʻa i kēia ʻano.

He aha nā hōʻailona o kēia maʻi? (Nā Hōʻailona o ka Non-Neurogenic Voiding Dysfunction)

E nānā inā loaʻa iā ʻoe kekahi o kēia mau ʻano:

• He paʻakikī anei ke hoʻomaka e mimi ? A i ʻole pono ʻoe e hoʻoluhi i ka wā e mimi ai ʻoe?
• He haiki loa anei ke ala mimi ? A i ʻole e hoʻomaka ana ke ala mimi , e kū no kekahi manawa, a laila hoʻomaka hou?
• Pono anei ʻoe e hoʻopaʻa i nā ʻiʻo o kou ʻōpū i ka wā e mimi ai ? A i ʻole e paʻa i kou ʻōpū lalo me nā lima ʻelua?
• Ke manaʻo nei ʻoe ʻaʻole i hoʻokahe ʻia kou ʻōpū mimi ma hope o kou pau ʻana i ka mimi ?
• Ua paʻa kou ʻōpū? (Pili pinepine kēia i ka ʻōpū)
• Ke mimi nui nei ʻoe ma mua o ka maʻamau (mimi pinepine) a i ʻole emi mai?
• Ke hoʻokahe hewa nei ʻoe i kekahi mimi (urinary incontinence)?
• Ke manaʻo koke nei ʻoe i ka pono wikiwiki e mimi (urge incontinence)?
• Ke mimi ʻana ma mua o hoʻokahi manawa i ka pō i ka wā e hiamoe anaPono ʻoe e ala aʻe e hana ia (nocturia)?

Nā ʻano kūikawā paha i loaʻa i nā keiki liʻiliʻi:

Inā loaʻa i nā keiki ʻōpio kēia ʻano maʻi, hiki iā lākou ke hōʻike i nā mea e like me:

• Ka hoʻomaʻū ʻana i kou mau lole i ke ao (ʻoiai ma hope o ke aʻo ʻana i ka lua).
• Aia kekahi mau mea like ʻole e hiki ai ke hoʻopaʻa i ka mimi . Eia kekahi laʻana:
• Ua keʻa koʻu mau wāwae.
• Kūlou ʻana i ka wā e noho ana.
• Ke hoʻopaʻa nei lākou i ko lākou mau wāwae, me ko lākou mau lima a i ʻole me ko lākou mau kuʻekuʻe wāwae.

Inā ʻike ʻoe i kāu keiki e hana ana i kēia mau mea, pono ʻoe e hopohopo iki.

He aha ke kumu o kēia? (Nā kumu o ka Non-Neurogenic Voiding Dysfunction)

Aia kekahi mau kumu nui no kēia kūlana:

• Ka nāwaliwali o nā ʻiʻo o ka ʻōpū mimi.
• Aia kahi ālai ma kekahi wahi o kāu ʻōnaehana mimi.
• ʻŌpū mimi hana nui (ʻōpū mimi hana nui).
• ʻAʻole hana pono ka ʻōpū mimi, ʻo ia hoʻi, ʻaʻohe manaʻo o ka pono e mimi (he "ʻōpū mimi hana ʻole").
• Ka paʻa ʻana o ka ʻōpū (he kumu koʻikoʻi loa kēia).
• Nā Maʻi ʻAla Mimi (UTI).
• ʻOiai inā pono ʻoe e mimi , hoʻowahāwahā ʻoe a kali a piha kou ʻōpū mimi ma mua o ka mimi ʻana ma hope.
• I nā kāne, he ʻāpana ia o ka prostate i hoʻonui ʻia (Benign Prostatic Hyperplasia - BPH).
• Ka maʻi ʻaʻai prostate.

I nā keiki ʻōpio, hiki ke hana ʻia kēia e kahi kūlana i kapa ʻia ʻo "dysfunctional elimination syndrome," ʻo ia hoʻi ka wā e hana pono ʻole ai nā ʻiʻo a me nā aʻalolo i loko o ka ʻōpū mimi.

He aha nā pilikia e hiki mai ana o kēia maʻi?

Ke ʻole e hoʻokahe loa kou ʻōpū mimi, hiki i nā bacteria i loko o ke koena o ka mimi ke hoʻoulu i nā maʻi. No ka laʻana, nā maʻi ʻaʻai mimi (UTI). ʻOi aku ka nui o kou loaʻa ʻana i nā pōhaku puʻupaʻa a i ʻole nā ​​pōhaku ʻōpū mimi. I kekahi manawa, inā e ʻoi aku ka ʻino o kēia pilikia, hiki iā ia ke hōʻino i nā puʻupaʻa.

ʻO ka mea nui loa, ʻo ka loaʻa ʻana o kekahi ʻano pilikia me ka mimi ʻana hiki ke hoʻopilikia iā ʻoe noʻonoʻo. Hilahila a hopohopo ka poʻe he nui no ka mea ʻaʻole hiki iā lākou ke kāohi i kā lākou mimi . Hiki paha iā ʻoe ke noʻonoʻo, "He kaumaha anei wau i kekahi poʻe?" Inā pono ʻoe e hoʻōki i kāu mau hana o kēlā me kēia lā me kēia mau hōʻailona i nā manawa a pau. Inā ʻoe e noho mamao mai ka nohona ma muli o kēia, hiki paha iā ʻoe ke kū i nā kūlana koʻikoʻi e like me ka hopohopo a me ke kaumaha.

Pehea e ʻike ai nā kauka i ka hana hoʻōki wai ʻole neurogenic?

Hiki i ke kauka ke ʻike i ka hana ʻole o ka vodiding non-neurogenic ma ka nīnau ʻana e pili ana i kou mōʻaukala olakino a me ka hana ʻana i kahi hoʻokolokolo kino. Hiki iā ia ke hana i kahi hoʻokolokolo pelvic no nā wahine a i ʻole kahi hoʻokolokolo rectal digital no nā kāne.

Eia kekahi, hiki i kāu kauka ke noi iā ʻoe e mālama i kahi "diary bladder." Ma loko, e kākau ʻoe i lalo:

• ʻEhia ka wai āu e inu ai i ka lā?
• I ka manawa hea ʻoe e mimi ai ?
• ʻEhia ka nui o ka mimi āu e hoʻolei ai i ka manawa hoʻokahi?
• I ka manawa hea a pehea e liki ai ka mimi me ka manaʻo ʻole?

Me kēia ʻike, hiki i ke kauka ke hana i kekahi mau hoʻokolohua ʻē aʻe e hōʻoia i ka hōʻailona.

He aha nā hoʻokolohua e hana ʻia?

Hiki i ke kauka ke hana i hoʻokahi a ʻoi aku paha o kēia mau hoʻokolohua:

• Hoʻāʻo antigen prostate-specific (PSA): He hoʻāʻo koko kēia. Ke nānā nei ia i nā pae PSA kiʻekiʻe. Inā kiʻekiʻe nā pae PSA, aia paha he pilikia me ka prostate gland.
• Urinalysis: Hiki i kēia ke kōkua i ka hoʻoholo ʻana inā loaʻa iā ʻoe kahi maʻi ʻōpū urinary (UTI).
• ʻO ke kiʻi ʻana o ka ultrasound: Nānā kēia i ka nui o ka mimi i koe i loko o kou ʻōpū mimi ma hope o kou mimi ʻana . Hiki iā ia ke nānā inā ua hoʻopilikia ke ʻano i kou mau puʻupaʻa.
• Ka hoʻāʻo ʻana o Urodynamic: Ke ana kēia mau hoʻokolohua i ka nui o ka mimi e hiki ai i kāu ʻōpū ke paʻa a pehea ka maikaʻi o ka hana pū ʻana o nā ʻiʻo i loko o kāu ʻōpū, urethra, a me ka papahele pelvic.
• Cystoscopy: Ma kēia hoʻāʻo, hoʻokomo ke kauka i kahi mea lōʻihi a lahilahi (me kahi kāmela i hoʻopili ʻia) ma o kou urethra e nānā i nā pilikia i loko o kou urethra a me ka ʻōpū mimi.

No nā keiki ʻōpio, ʻaʻole pinepine kēia mau hoʻokolohua i ka invasive. Hiki i ke kauka ke noi iā ʻoe e mālama i kahi puke moʻolelo mimi, a hiki ke ʻōlelo wale aku i kahi hoʻāʻo koko, kahi urinalysis, kahi ultrasound, a me kekahi mau hoʻokolohua urodynamic.

Pehea e mālama ʻia ai kēia? (Pehea e mālama ʻia ai?)

ʻOkoʻa ka mālama ʻana no kēia kūlana (Non-neurogenic voiding dysfunction) ma muli o ke kumu. Hiki i ka mālama ʻana ke komo pū me:

1. Ke aʻo ʻana i ka ʻōpū mimi

Hiki iā ʻoe ke hoʻomaʻamaʻa i nā ʻiʻo o kou ʻōpū mimi e paʻa i ka mimi no ka manawa lōʻihi. ʻO ke ʻano kēia, pono ʻoe e hele i ka lua i nā manawa maʻamau i ka lā, ʻoiai inā ʻaʻole ʻoe e manaʻo e pono ʻoe. Hiki i kēia ke kōkua i ka pale ʻana i ka piha ʻana o kou ʻōpū mimi. Hiki i kahi mea hoʻoponopono kino i loea i nā pilikia papahele pelvic ke kōkua iā ʻoe me kēia.

2. Nā hoʻomaʻamaʻa ʻiʻo papahele pelvic (Pelvic floor therapy)

Hiki i kahi mea hoʻōla kino i aʻo kūikawā ʻia ke aʻo iā ʻoe pehea e hoʻomaha ai i kou mau ʻiʻo papahele pelvic i hiki iā ʻoe ke mimi maʻalahi. Hiki iā lākou ke kau i nā "biofeedback sensors" i loko o kou vagina a i ʻole rectum e hōʻoia i ka hoʻomaʻamaʻa ʻana i nā ʻiʻo kūpono.

E aʻo pū lākou iā ʻoe i nā hoʻomaʻamaʻa Kegel e hoʻoikaika i kou mau ʻiʻo papahele pelvic. Kōkua nā ʻiʻo papahele pelvic ikaika i ka pale ʻana i ka hoʻōki ʻana o ka mimi a me ke koi ʻana i ka hoʻōki ʻana o ka mimi.

3. Nā lāʻau lapaʻau

Aia nā lāʻau lapaʻau e hiki ke kōkua i ka hoʻomaikaʻi ʻana i nā pilikia mimi. Nā laʻana:

• ʻO nā mea pale Alpha, no ka laʻana ʻo tamsulosin (Flomax®).
• Nā lāʻau antispasmodics mimi, e like me oxybutynin (Ditropan®) a me tolterodine (Detrol®).

4. ʻO ka mea ʻawahia Botulinum

Hiki i kāu kauka ke hoʻokomo i ka botulinum toxin (Botox®) i loko o kou ʻōpū mimi. Hoʻomaha kēia i nā ʻiʻo o ka ʻōpū mimi a hōʻemi i ka hoʻōki ʻana o ka inu ʻana.

5. Hoʻoulu ʻana o ke aʻalolo tibial percutaneous (PTNS)

I kekahi manawa, pono ʻoe e hāʻawi i kou mau aʻalolo i kahi "hoʻoikaika" iki e hoʻoulu i kou mau ʻiʻo ʻōpū mimi. Ma PTNS, kau kāu kauka i kahi electrode kokoke i kou aʻalolo tibial i loko o kou kuʻekuʻe wāwae. A laila, hoʻouna lākou i nā hōʻailona uila mālie loa i ka electrode. Hoʻoulu kēia i ke aʻalolo tibial, a laila hele i nā aʻalolo sacral i loko o kou pelvis. Hoʻōki kēia i nā hōʻailona maʻamau ʻole mai nā aʻalolo sacral i ka urinary sphincter, ka ʻōpū mimi, a me nā ʻiʻo papahele pelvic, e kōkua iā ʻoe e hoʻihoʻi i ka mana o ka ʻōpū mimi.

6. Hoʻoulu ʻana o ke aʻalolo Sacral

Ma kēia kaʻina hana, e kau ʻoki ana kāu kauka i nā electrodes ma lalo o ka ʻili ma luna pono o kou mau puʻupuʻu. Hoʻouna kēia mau electrodes i nā hōʻailona uila mālie i ke aʻalolo sacral ma o kahi uea lahilahi (probe) e hele ana ma lalo o ka ʻili. Hoʻoulu kēia mau hōʻailona i nā ʻiʻo i loko o kou ʻōpū mimi e ʻaelike.

7. Hoʻokomo ʻana iā ʻoe iho i ka catheter

Hiki iā ʻoe ke hoʻokomo i kahi catheter urinary i loko o kou ʻōpū mimi i nā manawa maʻamau a hōʻiliʻili i kāu mimi i loko o kahi ʻeke. E hōʻike kāu kauka iā ʻoe pehea e hana ai i kēia (self-catheterization).

8. ʻOki kino

Inā ʻaʻole holo pono nā lāʻau ʻē aʻe, e paipai paha kāu kauka i ke ʻoki hoʻonui ʻana i ka ʻōpū mimi (cystoplasty). Hoʻonui kēia ʻoki i kou ʻōpū mimi i hiki iā ia ke paʻa i ka mimi hou aku.Hiki iaʻu ke lawelawe i nā mea he nui.

He aha nā lāʻau lapaʻau mua no ka ʻōpū mimi overactive non-neurogenic?

ʻO kēia nā lāʻau lapaʻau mua no kēia ʻano:

• Ka hōʻemi ʻana i nā meaʻai a me nā mea inu e hōʻino ai i ka ʻōpū mimi (kī, kope, waiʻona, meaʻai ʻala a ʻakika paha).
• Hoʻomaʻamaʻa ʻana i ka ʻōpū mimi.

Inā ʻaʻole kōkua kēia mau loli ʻano, hiki i nā kauka ke kuhikuhi i nā lāʻau lapaʻau e like me kēia, ma muli o ke ʻano o ka hana ʻole o ka hana hoʻohemo ʻana i ka ʻōpū:

• Nā lāʻau anticholinergic
• Nā mea pale Alpha
• Nā agonists receptor Beta 3

Pehea e mālama ʻia ai kēia maʻi i nā keiki ʻōpio?

Hiki i nā lāʻau pale Alpha a me nā lāʻau anticholinergic ke kōkua i ka mālama ʻana i ka ʻōpū mimi overactive i nā keiki ʻōpio. Hiki ke aʻo ʻia kekahi mau keiki e hana i nā hoʻoikaika kino papahele pelvic.

Hiki paha i ke kauka ke paipai i ke aʻo ʻana i ka ʻōpū mimi. Eia kekahi laʻana, e paipai ana i ke keiki e hele i ka lua i nā manawa i hoʻonohonoho ʻia a e aʻo iā lākou i ke kūlana kūpono ma ka lua.

ʻEhia ka manawa e ʻoi aku ai koʻu maikaʻi ma hope o ka lāʻau lapaʻau?

ʻOkoʻa ia ma muli o ka lāʻau lapaʻau. Hiki i ke aʻo ʻana i ka ʻōpū mimi a me nā hoʻomaʻamaʻa papahele pelvic ke hoʻomaka e hana i loko o kekahi mau pule a i ʻole mau mahina. Hoʻomaka ka hoʻoulu ʻana o ke aʻalolo e hana i loko o kekahi mau pule. Pono nā lāʻau lapaʻau e hoʻomaka e hana i loko o kekahi mau lā a i ʻole mau pule. E hāʻawi kāu kauka iā ʻoe i kahi manaʻo maikaʻi no kēia.

Āhea wau e ʻike ai i ke kauka?

E kamaʻilio me ke kauka ke hoʻomaka mua ʻoe e ʻike i kēia mau pilikia me ka hele ʻana i ka lua:

• ʻAʻole hiki ke mimi no ka manawa lōʻihi.
• Nā loli i loko o kou mimi : No ka laʻana, he ʻala ikaika, he kala ʻeleʻele, a he koko paha i loko o ka mimi (hematuria).
• ʻEha i ka wā e mimi ai (dysuria).
• Nā hōʻailona mau o ka constipation.
• Nā hōʻailona o ka maʻi: kuni, anuanu, ʻeha poʻo.

Ke ʻike ʻoe i ke kauka, hiki iā ʻoe ke nīnau i kēia mau nīnau:

• Pehea ʻoe i ʻike ai he `(Non-neurogenic voiding dysfunction)` koʻu?
• He aha ke kumu o koʻu kūlana?
• He aha ka lāʻau lapaʻau āu e paipai mai ai iaʻu?
• He aha nā hopena ʻaoʻao o kēlā lāʻau lapaʻau?
• Pehea ka lōʻihi e ʻike ai i nā hopena mai kēlā lāʻau lapaʻau?
• He aha nā hoʻololi o ke ʻano o ka nohona āu e ʻōlelo nei e hōʻemi i kaʻu mau hōʻailona?
• He aha nā pilikia e pono iaʻu e makaʻala ai?
• Pono anei au e ʻike i kahi urologist?

Hiki ke pale ʻia kēia?

Hiki iā ʻoe ke kōkua i ka pale ʻana i kēia kūlana (Non-neurogenic voiding dysfunction) ma ka hoʻololi ʻana i kou nohona a me kāu meaʻai. Hiki i kēia mau mea ke komo pū me:

• Ka hōʻemi ʻana i nā meaʻai a me nā mea inu e hōʻino ai i ka ʻōpū mimi: ʻO nā mea inu caffeine (kofe, kī), nā hua citrus (e like me nā ʻalani, lime), nā meaʻai ʻala, a me ka waiʻona hiki ke hoʻoulu i ka ʻōpū mimi a hoʻoulu i nā pilikia mimi .
• ʻAi ʻana i nā meaʻai momona i ka fiber: Hiki i ka paʻa ʻana ke hoʻoulu a hoʻonui paha i kēia ʻano. Hiki iā ʻoe ke loaʻa ka fiber ma ka ʻai ʻana i nā pīni, nā huaʻai, nā mea kanu, a me nā palaoa piha (berena palaoa piha, oats, quinoa, laiki ʻeleʻele, a me ka pasta palaoa piha). Hiki iā ʻoe ke lawe i nā laxatives (` laxatives ') no ka paʻa ʻana. Eia nō naʻe, pono ʻoe e kamaʻilio me kāu kauka ma mua o ka lawe ʻana i nā laxatives a hāʻawi paha iā lākou i kahi keiki.
• Ka mālama ʻana i ke kaumaha olakino nou: Inā ʻoi aku ka nui o kou kino (BMI) ma mua o 25 (ke kaumaha nui), hiki iā ia ke kau i ke kaomi ma luna o kou ʻōpū mimi a hoʻoheheʻe i ka mimi .
• Ke hoʻōki ʻana i ka puhipaka: ʻO ka nikotine, ka mea nui i loko o ka paka, hiki ke hoʻoulu i nā ʻiʻo i loko o ka ʻōpū mimi. ʻOi aku ka nui o ka poʻe puhipaka i ka maʻi ʻū mau, hiki ke kau i ke kaomi ma luna o ka ʻōpū mimi.

He aha kaʻu e manaʻo ai inā loaʻa iaʻu ka hana hoʻōki wai non-neurogenic?

Maikaʻi ka nānā ʻana no ka poʻe me kēia maʻi. Me ka mālama ʻana, hiki i ka hapa nui o ka poʻe ke kāohi i ko lākou ʻōpū mimi. ʻAʻole pono pinepine ke ʻoki ʻana e hoʻonui i ka ʻōpū mimi (cystoplasty).

He aha ka ʻokoʻa ma waena o ka Non-neurogenic Voiding Dysfunction a me ka Neurogenic?

ʻO ka neurogenic voiding dysfunction (i ʻike ʻia hoʻi ʻo ka neurogenic bladder) he kūlana ia e hoʻopilikia ai i kāu ʻōnaehana nerve. ʻO ia hoʻi, ʻaʻole hiki iā ʻoe ke kaohi i kāu ʻōpū mimi ma muli o kahi pilikia me kou lolo, nā aʻalolo, a i ʻole ke kaula spinal.

Eia nō naʻe, ʻo ka "Non-neurogenic voiding dysfunction" a mākou i kamaʻilio ai i kēia lā he kūlana ia e kū mai ana me ka ʻole o ke komo ʻana o ka ʻōnaehana nerve.

ʻO ka mea nui e hoʻomanaʻo ai: ʻO ka Non-Neurogenic voiding dysfunction (NNOVD) he maʻi hoʻoweliweli ola e hiki ke hoʻopilikia i nā keiki a me nā pākeke. Hiki ke hilahila a ʻoluʻolu ʻole. Hiki iā ia ke hana iā ʻoe e like me ʻaʻole ʻoe e mimi i ka wā e pono ai. Eia naʻe, ʻaʻole ʻoe makemake e ʻae i kēia maʻi e hoʻopilikia i kou ʻano ola. Inā ʻoe a i ʻole kahi mea aloha e ʻike nei i kēia mau hōʻailona, ​​​​e kamaʻilio me ke kauka. Hiki iā lākou ke kōkua iā ʻoe e ʻike i ke kumu a mālama iā ia.

Hōʻuluʻulu Manaʻo (Leka Lawe-Home)

ʻAe, i kēia manawa ua maopopo iā ʻoe ka mea a mākou i kamaʻilio ai i kēia lā, ʻo "Non-Neurogenic Voiding Dysfunction". ʻAʻohe mea ʻē aʻe kēia ma mua o kahi kīnā i loko o ka ʻōnaehana nerve.ʻO kēia ka mea nui loa. ʻO ka nāwaliwali o nā ʻiʻo o ka ʻōpū mimi, nā keʻakeʻa i loko o ka ʻōnaehana mimi, nā ʻano maikaʻi ʻole, a me ka paʻa ʻana o ka ʻōpū ke kumu o kēia.

• Nā Hōʻailona: Paʻakikī i ka mimi ʻana , paʻa ʻole o ka mimi , ka hoʻokaʻawale piha ʻole ʻana o ka ʻōpū mimi, ka mimi ʻana me ka makemake ʻole, ka mimi ʻana i ke ao i nā keiki, a pēlā aku.
• ʻIke ʻia: Ma o nā hoʻokolohua lapaʻau, ka puke pai mimi, ka ultrasound, a me ka hoʻāʻo urodynamic.
• Lapaʻau: Nā hoʻololi o ke ʻano o ka nohona, ke aʻo ʻana i ka ʻōpū mimi, nā hoʻomaʻamaʻa papahele pelvic, nā lāʻau lapaʻau, a me kekahi mau lāʻau lapaʻau kikoʻī.
• Mea nui: Inā loaʻa iā ʻoe nā hōʻailona, ​​mai hilahila a e ʻimi i ke aʻo lapaʻau. ʻO ka hoʻomaka mua ʻana i ka lāʻau lapaʻau hiki ke pale i nā pilikia.

Inā he mau nīnau hou aku kāu e pili ana i kēia, mai kānalua e nīnau i ke kauka. E noho olakino!

ʻO ka hana ʻole o ka hoʻokahe ʻana i ka mimi, ka ʻōpū mimi, nā maʻi ʻaʻai mimi, ka paʻa ʻana o ka ʻōpū, nā pilikia mimi o nā keiki, ka hoʻomalu ʻana i ka mimi, ka ʻōpū mimi overactive, ke aʻo ʻana i ka ʻōpū mimi