No kekahi mau kāne, hiki i ka mimi ke lilo i mea ʻeha a ʻoluʻolu ʻole. Ke kahe nei ka mimi me he mea lā ua paʻa, kulu ma kēlā me kēia kulu... i kekahi manawa hiki ke ālai loa ʻia. ʻO ke kumu nui o kēia hiki ke ālai ʻia o ka urethra, ʻo ia hoʻi, he ʻūmiʻi. Ma nā ʻōlelo lapaʻau, kapa mākou i kēia ʻo ' Urethral Stricture '. No laila, i kēia lā ke kamaʻilio nei mākou e pili ana i kahi ʻoki kūikawā a nā kauka e ʻōlelo nei i ka wā ʻaʻole i holomua nā ʻano lapaʻau ʻē aʻe.
He aha ka Perineal Urethrostomy?
I ka ʻōlelo maʻalahi, he hana ʻoki kino ka Perineal Urethrostomy i hana ʻia ma nā kāne. Pili ia i ka hana ʻana i kahi puka hou, a i ʻole alahele, no ka mimi e hele ai. Hana ʻia kēia puka hou ma kahi o ka ʻili ma waena o kou scrotum a me kou anus. Kāhea mākou i kēlā wahi ʻo 'perineum'.
E noʻonoʻo, ma ke ʻano maʻamau, ʻo ka mimi e hōʻiliʻili ana i loko o kā mākou ʻōpū mimi e hele ana i lalo o kahi ʻōmole i kapa ʻia ʻo ka urethra a puka i waho ma ka piko o ka penis. Eia nō naʻe, ma muli o kekahi mau maʻi, nā ʻeha , a i ʻole nā ʻoki kino ma mua, hiki i kēia urethra ke lilo i ʻeha, haiki, a ālai ʻia paha. ʻO ia ka manawa e ālai piha ʻia ai ke kahe o ka mimi a hapa paha. Hoʻokumu kēia ʻoki kino i kahi ala hou a mau loa no ka mimi e puka ai no ka poʻe nona ka urethra i ālai ʻia a hiki ʻole iā lākou ke hele i ka mimi ma o ka penis.
No ke aha ʻoe e pono ai e hana i kēia ʻano ʻoki kino?
Hoʻomaopopo pinepine ʻia kēia ʻoki kino ke hāʻule nā lāʻau ʻē aʻe no ka urethral stricture. ʻO ia hoʻi, ke hiki ʻole ke hoʻololi hou ʻia ka urethra i puka ai ka mimi ma ka piko o ka penis. Ma hope o kēia ʻoki kino, puka ka mimi ma kahi puka hou i loko o ka perineum, no laila pono ʻoe e noho i ka wā e mimi ana.
Hiki i kēia ke lilo i koho maikaʻi no ka poʻe ʻelemakule i makemake ʻole e hana i ke ʻoki kino nui. Ua noʻonoʻo ʻia kēia ʻoki kino ma nā kūlana aʻe.
| Nā kūlana e pono ai ke ʻoki kino | He wehewehe maʻalahi |
|---|---|
| Nā ʻūmiʻi urethral paʻakikī/hoʻi hou | Nā hihia kahi e ālai ʻia ai ka urethra a ʻaʻole pane i nā lāʻau lapaʻau ʻē aʻe. |
| ʻO ka maʻi kanesa cell squamous o ka penis | Ma muli o kekahi mau maʻi ʻaʻai e kū mai ana i loko o ka penis. |
| Wehe ʻoki kino ʻana o ka penis (Penectomy) | Ke wehe loa ʻia ke penis ma muli o ke kanesa a i ʻole nā kumu ʻē aʻe. |
| Hoʻokaʻawale ʻana i ka urethra | Ke wehe ʻia ka urethra a pau a i ʻole kekahi hapa ma ke ʻoki ʻana. |
| Nā Hypospadias | He kūlana hānau kēia kahi e waiho ai ka puka urethral ma lalo o ka penis ma kahi o ka wēlau. |
| Urethroplasty i hāʻule ʻole | I ka wā i kūleʻa ʻole ai nā ʻokiʻoki mua e hoʻoponopono ai i ka urethra. |
| ʻO ka gangrene o Fournier | Ma hope o kahi maʻi nui o ka penis a me ka scrotum. |
ʻO wai ka mea kūpono ʻole no kēia ʻoki kino?
Akā, ʻaʻole hiki i nā kānaka a pau ke hana i kēia ʻoki kino. I kekahi mau hihia, hiki ke paʻakikī iki. Inā loaʻa iā ʻoe kekahi o kēia mau mea, pono ʻoe e kamaʻilio hohonu me kāu kauka e pili ana i kēia:
- Inā he momona loa ʻoe.
- Inā ua hana mua ʻia ʻoe i ke ʻoki kino ma ka ʻāpana perineum .
- Ka lāʻau lapaʻau radiation no ka maʻi kanesa prostateInā ua lawe ʻoe ia mea.
ʻO kekahi mau nīnau maʻamau āu e loaʻa ai
Ke puka mai nei ka sperm mai loko mai o ka penis ma hope o ke ʻoki ʻana?
He pilikia kēia i loaʻa i nā poʻe he nui. ʻAʻole, ma hope o kēia ʻoki kino, ʻaʻole e puka mai ka sperm mai loko mai o ka penis, akā, mai ka puka hou i hana ʻia.
E lilo anei kēia ʻoki kino i ka mana o ka mimi?
ʻO kekahi makaʻu nui, ʻo ia ka hiki ʻole iā ʻoe ke hoʻopā i ka ʻōpū. ʻAʻole ia e hana. Loaʻa iā ʻoe nā ʻiʻo e kāohi ana i kou mimi ma luna pono o kēia puka. No laila hiki iā ʻoe ke kāohi i kou mimi.
ʻAʻole e hoʻoulu kēia ʻoki kino i ka hiki ʻole ke hoʻomoe i ka wai. Mai hopohopo no kēlā. E wehewehe kāu kauka i kēia iā ʻoe me nā kikoʻī hou aku.
Pehea e hoʻomākaukau ai no ke ʻoki kino?
Ma mua o ke ʻoki ʻana, e noi aku kāu kauka iā ʻoe e hāʻawi i kahi hāpana mimi. E hoʻomaka ʻo ia iā ʻoe i nā lāʻau antibiotic e pale aku i ka maʻi. Pono paha ʻoe e lawe i kahi X-ray e nānā i ke kūlana o kou urethra.
ʻO ka mea nui loa, ʻo ia ka hoʻomaopopo ʻana i kāu kauka e pili ana i kou mau maʻi ʻē aʻe a me nā lāʻau lapaʻau āu e lawe nei.
| E hōʻoia e haʻi i kāu kauka e pili ana i kēia mau mea. | |
|---|---|
| Nā mea i hoʻokomo ʻia i loko o ke kino | Nā mea e like me nā stent, nā pani hui, nā pacemakers, nā valves puʻuwai. |
| Nā maʻi | Inā ua loaʻa iā ʻoe kahi maʻi e like me MRSA. |
| Nā mea hoʻokahe koko | Inā ʻoe e lawe nei i nā lāʻau lapaʻau e like me warfarin, aspirin, clopidogrel, rivaroxaban, a i ʻole dabigatran. |
Pehea e hana ʻia ai ke ʻoki kino a me nā mea e hana ʻia ma hope
Hana ʻia kēia ma ka haukapila, ma lalo o ka anesthesia laulā . ʻO ke ʻano kēia ua hiamoe loa ʻoe i ka wā o ke ʻoki kino. No laila, ʻaʻole ʻoe e manaʻo i kekahi mea. ʻO ka maʻamau, hoʻokahi a ʻelua paha hola ka lōʻihi o ke ʻoki kino.
Ma hope o ke ʻoki ʻana, e hoʻokomo ʻia kahi ʻōmole i loko o kou ʻōpū mimi e kōkua iā ʻoe e hoʻohele i ka mimi. Kāhea mākou iā ia he Foley catheter . E noho mau kēia catheter ma kahi no ʻelua a ʻekolu pule. I loko o kēia manawa, e hāʻawi ʻia iā ʻoe nā mea ʻeha a me nā lāʻau antibiotic e pale aku i ka maʻi.
Ma mua o kou haʻalele ʻana i ka haukapila, e wehewehe ke kauka a me nā kahu maʻi iā ʻoe pehea e mālama ai iā ʻoe iho ma ka home, pehea e mālama ai i kāu catheter, pehea e lawe ai i kāu lāʻau lapaʻau, a me ka manawa e pono ai ʻoe e hoʻi i ke keʻena lapaʻau.
Ma hope o 8-12 mau mahina, hana ʻia kahi hoʻāʻo i kapa ʻia ʻo cystourethroscopy, kahi e hoʻohana ana i kahi kāmela, e ʻike inā olakino ka urethra a inā ua ālai hou ʻia.
He aha nā pilikia e hiki mai ana?
He kiʻekiʻe loa ka holomua o kēia ʻoki kino (i hōʻike ʻia he "maikaʻi loa"). A he kakaikahi loa nā pilikia. Eia nō naʻe, he mea nui e makaʻala iā lākou inā loaʻa kekahi mea.
Inā he pilikia, hiki i nā hōʻailona ke komo pū me: ka emi ʻana o ka mimi ʻana, ka mimi e koe ana i loko o ka ʻōpū mimi ma hope o ka mimi ʻana, a i ʻole ka maʻi ʻaʻai mimi. ʻO nā pilikia ʻē aʻe e hiki ke komo pū me:
- Ke kahe koko mai ka ʻoki
- Pehu ʻana
- kuni
- Maʻi ʻaʻai mimi
- Ka hana hou ʻana o ke koʻikoʻi
- Nā pilikia cardiovascular
Inā ʻike ʻoe i kekahi o kēia mau hōʻailona, no ka laʻana, ke kahe nui ʻana o ke koko mai kahi ʻoki a i ʻole ke kuni nui, e hoʻomaopopo koke i kāu kauka a i ʻole e hele i ka Emergency Department (ETU) o ka haukapila kokoke loa.
Leka Lawe-Home
- He hana ʻoki kino holomua loa ka Perineal Urethrostomy no nā ʻūmiʻi urethral koʻikoʻi kahi i holo pono ʻole ai nā lāʻau ʻē aʻe.
- Ma hope o kēia ʻoki kino, pono ʻoe e noho e mimi. Eia kekahi, e puka mai ana ka sperm mai ka puka hou i hana ʻia.
- ʻAʻole e lilo kēia ʻoki kino i kou hiki ke kāohi i kou mimi (incontinence).
- He haʻahaʻa loa ka pilikia o nā pilikia, akā inā loaʻa iā ʻoe kekahi mau hōʻailona ʻē (ke kahe koko nui, ke kuni), e hoʻomaopopo koke i kāu kauka.
- He mea nui ka hahai ʻana i nā ʻōlelo a ke kauka (ka lawe ʻana i ka lāʻau lapaʻau, ke hele ʻana i nā keʻena lapaʻau) ma hope o ke ʻoki ʻana no ka hoʻōla koke ʻana.
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