Ke pilikia nei kāu keiki liʻiliʻi i ka mimi? Hiki paha ma muli o nā Posterior Urethral Valves (PUV)!

Ma ke ʻano he makuahine a makua paha, hopohopo nui ʻoe no ke olakino o kāu keiki liʻiliʻi, ʻeā? I kekahi manawa, ʻoiai nā maʻi liʻiliʻi loa a kā mākou mau keiki e loaʻa ai, hiki ke lilo i kumu o ke kaumaha nui. I kēia lā, e kamaʻilio mākou e pili ana i kahi kūlana e pono ai ke hopohopo, akā pono ʻoe e hoʻomaopopo me ka hopohopo ʻole. He kūlana hānau kēia e pili wale ana i nā keikikāne , a ua kapa ʻia ʻo 'Posterior Urethral Valves' a i ʻole '(PUV)'.

He aha nā kiwikā urethral hope (PUV)?

I ka ʻōlelo maʻalahi, ʻo nā 'Posterior Urethral Valves' kahi kūlana kahi e ulu ai kahi ʻāpana ʻiʻo keu i loko o ka ʻōmole e puka mai ai ka mimi o kā mākou mau keikikāne liʻiliʻi, ʻo ia ka urethra (i kapa ʻia hoʻi ʻo urethra e nā kauka), e ālai ana i ke kahe ʻana o ka mimi. E noʻonoʻo iā ia e like me kahi mea i paʻa i waenakonu o kahi paipu wai. He maʻi hānau kēia.

Ke ālai ʻia ka urethra ma kēia ʻano, ʻaʻole e hoʻokahe loa ka ʻōpū mimi. He aha ka mea e hana ʻia a laila? Hiki i ka mimi ke piʻi hou i loko o ka ʻōpū mimi a laila i loko o nā puʻupaʻa. E like me ka wā e ālai ʻia ai kahi paipu wai, e piʻi hou ia a piʻi i luna. Hiki i kēia ke hōʻino i ka ʻōpū mimi a me nā puʻupaʻa.

I kekahi manawa ʻike nā kauka i kēia kūlana i ka wā o ka ultrasound scan ʻoiai ke pēpē i loko o ka ʻōpū. A i ʻole hiki ke ʻike ʻia ma hope o ka hānau ʻana o ke pēpē a i ʻole i ka wā kamaliʻi. He mea nui e hoʻomanaʻo he pili wale kēia kūlana i nā keikikāne . Ma kekahi mau wahi, ua kapa ʻia hoʻi ʻo Congenital Obstructive Posterior Urethral Membrane (COPUM).

He mea laha ʻole anei kēia maʻi?

ʻO ka ʻoiaʻiʻo, ua hōʻike ʻia ma kahi o 500 mau pēpē i hānau ʻia ma ka honua holoʻokoʻa i kēlā me kēia makahiki e hoʻopilikia ʻia e kēia ʻano, "Posterior Urethral Valves." ʻO ia kekahi kumu nui o ka ālai ʻana o ke ala mimi i nā keikikāne.

He aha nā hōʻailona o kēia maʻi?

I kēia manawa, e nānā kākou i nā hōʻailona a ke keiki e hōʻike nei ma kēia kūlana `(PUV)`. I kekahi manawa ke ʻike ʻoe i kēia mau mea, e ʻike pū ʻoe, 'ʻĀ, hana kēia i kaʻu keiki pū kekahi, ʻeā?'

• Ua nāwaliwali loa ka lihi o ke ala mimi , a i ʻole e kulu ana: Ke ʻano nāwaliwali loa nei ka lihi i ka wā e mimi ai ka pēpē? A i ʻole e kulu ana paha ma hope o ka pau ʻana o ka mimi ʻana o ka pēpē? ʻO kēia kekahi hōʻailona.
• Nā maʻi ʻōpū mimi pinepine (UTI): Inā loaʻa i kahi keiki liʻiliʻi ke kuni, ʻaʻole inu waiū, uē nui, a paʻakikī paha i ka mimi ʻana , he UTI paha ia. ʻOi aku ka nui o ka loaʻa ʻana o kēia mau maʻi i nā keiki me nā UTI.
• ʻAʻole piʻi pono ke kaumaha o ka pēpē: ʻOiai ke inu nei kāu pēpē i ka waiū nui, inā lohi loa kona piʻi ʻana o ke kaumaha, pono ʻoe e hopohopo no kēlā.
• ʻEha i ka wā e mimi ai : He paʻakikī a ʻeha hoʻi ka mimi . Hiki i ka pēpē ke uē. Kāhea nā kauka i kēia ʻo `(Dysuria)`.
• Paʻakikī ke mimi : Ke ʻano nei kāu pēpē e hoʻoikaika nei e mimi ? A i ʻoleHe lōʻihi anei ka manawa e hoʻomaka ai e mimi ?
• ʻOligohydramnios: Ua ʻōlelo anei kāu kauka ua haʻahaʻa ka nui o ka wai amniotic a puni kāu pēpē (oligohydramnios) i kou wā hāpai? Hiki paha ke pili i kēia.
• Hydronephrosis: Hiki i nā kauka ke hōʻike aku ua ʻike ʻia nā puʻupaʻa e pehu ana (Hydronephrosis) i ka wā o ka scan , i ka wā hāpai a ma hope paha o ka hānau ʻana o ke pēpē. ʻO ke ʻano kēia ʻaʻole e kahe pono ana nā puʻupaʻa a aia ma lalo o ke kaomi.

No ke aha lā kēia e hana nei? He aha ke kumu?

ʻAe, ke noʻonoʻo nei paha ʻoe, 'No ke aha i hana ʻia ai kēia i kā mākou keiki?' He aha ke kumu maoli o kēia?

Hoʻokumu ʻia kēia mau 'Posterior Urethral Valves' e nā ʻiʻo keu e ulu ana ma ka ʻāpana o ka urethra kokoke loa i ka ʻōpū mimi i ka wā mua o ka ulu ʻana o ka pēpē. Hoʻohaiki kēia ʻiʻo keu i ka urethra, me he mea lā ua paʻa kahi paipu i loko. Ke ālai nei kēia i ke ala no ka mimi e kahe i waho.

Eia nō naʻe, ʻaʻole hiki i nā kauka ke kuhikuhi pono i ke kumu kūpono o ka ulu ʻana o kēia ʻiʻo keu ma kēia ʻano. I kēia manawa, ua manaʻo ʻia he ʻano ʻē ia o ka ulu ʻana e kū mai ana i ka wā o ka embryonic.

He aha nā pilikia ʻē aʻe e hiki ai i kēia ke hana?

Inā ʻaʻole mālama pono ʻia kēia kūlana "(PUV)", hiki iā ia ke alakaʻi i nā pilikia olakino hou aʻe. No laila he mea nui loa ka ʻike koke ʻana i kēia a hahai i ka ʻōlelo aʻo a kāu kauka.

• ʻO ka reflux Vesicoureteral (VUR) : ʻO kēia ka manawa e holo ai ka mimi mai ka ʻōpū mimi i hope ma o ka ureter i loko o nā puʻupaʻa. E noʻonoʻo i ka mea e hana ai inā piʻi ka mimi i pono e iho i lalo? Hiki iā ia ke alakaʻi i nā maʻi puʻupaʻa a me ka hōʻino lōʻihi.
• Paʻa ʻana o ka mimi: ʻO ke ʻano kēia, ʻaʻole e puka mai nā mimi a pau, a koe mau kekahi i loko. Hiki i kēia ke hoʻonui i ka ʻōpū mimi a alakaʻi i nā maʻi.
• Pehu ʻana o nā puʻupaʻa: Hiki i nā puʻupaʻa ke pehu ma muli o ke ālai ʻia ʻana o ka ʻōnaehana mimi.
• Ka hāʻule ʻana o nā puʻupaʻa: ʻO kēia ka hopena weliweli loa o kēia maʻi. I ka wā lōʻihi, hiki i nā puʻupaʻa ke hōʻino ʻia a nalowale kā lākou hana.

Pehea e ʻike ai nā kauka i kēia?

I kēia manawa, e nānā kākou pehea e ʻike pololei ai nā kauka i kēia kūlana "(PUV)", ʻo ia hoʻi, pehea e ʻike ai i ka maʻi.

• ʻO ke kiʻi ʻana o ka ultrasound i ka wā hāpai: I kekahi manawa, hiki i kahi kiʻi ultrasound i hana ʻia i ka wā e hāpai ana ʻoe i kahi pēpē ke hāʻawi i nā hōʻailona e pili ana i kēia kūlana (e laʻa, ka ʻōpū mimi nui, nā puʻupaʻa pehu, ka emi ʻana o ka wai amniotic a puni ka pēpē).
• Nā hana i hana ʻia ma hope o ka hānau ʻana o ke keiki:
• ʻO ke kiʻi ʻana i ka ʻike ʻana i ka puʻupaʻa (Ultrasound Scan):Hiki i kahi scan ultrasound i hana ʻia ma hope o ka hānau ʻana o ke pēpē ke ʻike maopopo i nā loli a i ʻole nā ​​​​mea keakea i loko o nā puʻupaʻa o ke pēpē, ka ʻōpū mimi, a me ka ʻōnaehana mimi.
• ʻO ka `Voiding Cystourethrogram (VCUG): ʻO kēia ka hoʻāʻo nui e hōʻoia i ke alo o `(PUV)`. Ma kēia, hoʻokomo ʻia kahi paipu liʻiliʻi (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 lawe ʻia kekahi mau kiʻi `X-ray` i ka wā e mimi ai ke keiki. Hōʻike kēia i ke ʻano o ka piha ʻana o ka ʻōpū mimi, pehea e hakahaka ai, kahi i ālai ʻia ai ka urethra (`valves`) a inā paha e kahe ana ka mimi i hope i loko o nā puʻupaʻa (`VUR`).
• Cystoscopy: Pili kēia i ka hoʻokomo ʻana i kahi ʻōmole liʻiliʻi a palupalu (kahi mea me ke kāmela a me ke kukui i hoʻopili ʻia - he cystoscope) i lalo o ka urethra e nānā pololei i nā valves i paʻa. ʻAe kēia i ka nānā pono ʻana a i kekahi manawa ka mālama ʻana i ka wā o ke kaʻina hana.
• Nā hoʻāʻo hana puʻupaʻa: Hana ʻia nā hoʻāʻo koko a me ka mimi e ʻike i ka hana maikaʻi o nā puʻupaʻa.

He aha nā lāʻau lapaʻau no kēia?

ʻAe, e kamaʻilio kākou e pili ana i ka lāʻau lapaʻau no kēia. Mai makaʻu i ka lohe ʻana i kēia, no ka mea, aia nā lāʻau lapaʻau maikaʻi no kēia. E hāʻawi nā kauka i kāu keiki i ka lāʻau lapaʻau maikaʻi loa.

ʻO ka pahuhopu nui o ka mālama ʻana, ʻo ia ka wehe ʻana i ka mea i ālai ʻia i loko o ke ala mimi a ʻae i ka mimi e hele maʻalahi.

• `Fulguration` (Valve ablation): Hana pinepine ʻia kēia e wehe i nā ʻiʻo (valves) e hoʻopilikia ana. I ka wā o ka `cystoscopy`, hoʻokomo ʻia kahi mea liʻiliʻi ma o ka `cystoscope` a, me ka hoʻohana ʻana i ka uila a i ʻole ke kukui laser, ua luku ʻia nā ʻiʻo keu me ka wela. Ua kapa ʻia kēia ʻo `fulguration` a i ʻole `valve ablation`. ʻO kēia ka lāʻau lapaʻau nui a mua.

Ma muli o ke kūlana o ke keiki, ke ʻano o ke ālai ʻana, a inā he mau pilikia ʻē aʻe, hiki i ke kauka ke kuhikuhi i nā lāʻau ʻē aʻe:

• Catheterization: Ke kau ʻana o kahi ʻōmole no ka manawa pōkole e hoʻokahe i ka ʻōpū mimi. I kekahi manawa hana ʻia kēia ma hope koke o ka hānau ʻana o ke pēpē e hoʻomaha i ke kaomi ma ka ʻōpū mimi a me nā puʻupaʻa.
• Hoʻonui ʻia ka urethra: I kekahi mau hihia, hiki ke hoʻonui ʻia ka urethra.
• Vesicostomy: Hiki i kekahi mau keiki, ʻoiai ka poʻe i hōʻeha nui ʻia e nā puʻupaʻa, ke hana ʻia i kahi ʻoki i kapa ʻia he vesicostomy. Pili kēia i ka hana ʻana i kahi lua liʻiliʻi i loko o ka ʻili o ka ʻōpū mai ka ʻōpū mimi pololei, e ʻae ana i ka mimi e kahe ma o ia mea. He manawa pōkole kēia a e pani ʻia ma hope.
• Nā lāʻau antibiotic: Inā loaʻa iā ʻoe kahi maʻi ʻōpū mimi, e hāʻawi ʻia ʻoe i nā lāʻau antibiotic. I kekahi manawa, hiki iā ʻoe ke hoʻomau i ka lawe ʻana i nā lāʻau antibiotic haʻahaʻa e pale aku i ka maʻi.
• ʻO ka dialysis a i ʻole ka hoʻoili ʻana o nā puʻupaʻa:ʻO ka mea pōʻino, ua hōʻino nui ʻia nā puʻupaʻa o kekahi mau keiki a hiki i ka hāʻule ʻana, e pono ai ka dialysis a i ʻole ka hoʻoili ʻana i ka puʻupaʻa.
• Nā lāʻau antispasmodics: Loaʻa paha i kekahi mau keiki nā pilikia me ka hana o ka ʻōpū mimi. Hiki ke hāʻawi ʻia nā lāʻau antispasmodics e maʻalahi ai ka mimi ʻana .

He mea kākaʻikahi loa, inā ʻike ʻia kēia maʻi i ka wā e noho ana ke pēpē i loko o ka ʻōpū, e hoʻāʻo kekahi poʻe loea e hana i ke ʻoki ʻana i ka fetal, akā he mea paʻakikī loa ia a he mea kākaʻikahi hoʻi.

He aha ka mea e hiki mai ana me kēia kūlana? (Wānana)

ʻAe, he aha ka mea e hana ʻia ma hope o ka mālama ʻana? Pehea lā ke ʻano o ke keiki i ka wā e hiki mai ana? He nīnau kēia a nā mākua he nui.

• Ka nānā ʻana i ka wā lōʻihi: Inā loaʻa i kāu keiki kahi maʻi i kapa ʻia ʻo (PUV), ʻoiai inā ua mālama ʻia lākou, pono lākou e nānā ʻia no ke koena o ko lākou ola e nānā i ka hana o kā lākou puʻupaʻa a me ke olakino o ka ʻōnaehana mimi. ʻO ia hoʻi ka hoʻomau ʻana i ka ʻike ʻana i ke kauka, loaʻa nā hoʻāʻo koko, nā hoʻāʻo mimi , a me nā scan ultrasound.
• ʻO ka paʻa ʻole o ka mimi: Loaʻa paha i kekahi mau keiki ka paʻa ʻole o ka mimi, a i ʻole ka pono e mimi pinepine , i ka wā kamaliʻi, ʻōpio, a i ʻole nā ​​mākua.
• Ka pilikia o ka hāʻule ʻana o nā puʻupaʻa: Hōʻike nā noiʻi he 15% o nā keiki me ka PUV e pilikia ana i ka loaʻa ʻana o ka hāʻule ʻana o nā puʻupaʻa i kekahi manawa o ko lākou ola . No laila he mea nui e noho ma lalo o ka nānā ʻana o ke kauka.

Akā, mai hopohopo. Me ka mālama kūpono a me ka hahai pono ʻana, hiki i ka hapa nui o nā keiki ke ola maʻamau a olakino.

Āhea wau e ʻike ai i ke kauka?

Inā loaʻa i kāu keiki liʻiliʻi kekahi o nā hōʻailona a mākou i kūkākūkā ai, e like me ka nāwaliwali o ke ala mimi , nā UTI pinepine, mai hoʻonele i ka manawa a e ʻike koke i kahi kauka pediatric a kauka pediatric paha. Inā ʻaʻole mālama ʻia, hiki i kēia kūlana ke alakaʻi i nā pilikia olakino koʻikoʻi, ʻoiai ka hōʻino ʻana o nā puʻupaʻa.

He aha nā nīnau koʻikoʻi e nīnau aku ai i ke kauka?

Ke ʻike ʻoe i kāu kauka, he mea nui e hoʻolohe i nā mea a pau āu e noʻonoʻo nei. He mea kōkua paha ke nīnau iā ʻoe iho i kēia mau nīnau:

• He aha nā koho lapaʻau i loaʻa no kaʻu keiki?
• Pehea e hana ai kēia lāʻau lapaʻau? He aha ka hopena?
• He aha kā mākou e manaʻo ai i ka wā o ka mālama ʻana a me ka hoʻōla ʻana?
• Pehea e mālama ai au i kaʻu keiki i ka wā hoʻōla? He aha kekahi mau mea e pono iaʻu e makaʻala nui ai?
• Āhea mākou e hele hou ai e ʻike i ke kauka? (Hana hou)

E Māmā a me Pāpā, e hoʻomanaʻo i kēia.

He mea maʻamau ka makaʻu, ka hopohopo, a me ke kaumaha ke ʻike ʻoe ua loaʻa i kāu pēpē kēia maʻi. Akā e hoʻomanaʻo i kēia:

ʻAʻohe mea hiki iā ʻoe ke hana e pale aku i kēia kūlana. ʻAʻole kēia no kou hewa, kahi mea āu i hana ai a i ʻōlelo ai paha, a i ʻole kahi mea āu i hana ʻole ai. He mea kēia e hele mai me ka hānau ʻana.

E kōkua a alakaʻi ke kauka a me ke kime mālama ola o kāu keiki iā ʻoe i kēlā me kēia ʻanuʻu o ke ala. E wehewehe lākou i nā mea āpau iā ʻoe, me nā mea e manaʻo ai, nā koho lapaʻau i loaʻa, a pehea e mālama ai i kāu keiki. No laila e mālama pono i nā manawa hoʻopaʻa a kāu kauka. Mai makaʻu a hilahila paha e nīnau i kāu mau nīnau, ʻaʻohe mea liʻiliʻi. He mea nui e ʻike maopopo i nā mea āpau no ka mea makemake ʻoe i ka mea maikaʻi loa no kāu keiki.

Nā Valves Urethral Hope, PUV, Nā Maʻi ʻAla Mimi i nā Keikikāne, Pale ʻAla Mimi, Nā Maʻi Pūpū, Ola Kino o ke Keiki, Nā Kīnā Hānau