Ke ʻike nei ʻoe i kekahi manawa i ka ʻeha nui a wehewehe ʻole ʻia ma kou ʻōpū haʻahaʻa a i ʻole ka ʻāpana genital? Malia paha he mea paʻakikī kēia ʻeha ke noho a hana paha i nā hana maʻamau. I kēia lā ke kamaʻilio nei mākou e pili ana i kahi ʻano lapaʻau kūikawā a nā kauka e hoʻohana ai i ia mau hihia. Ua kapa ʻia ʻo ia he Pudendal Nerve Block.
I ka ʻōlelo maʻalahi, he aha ka Pudendal Nerve Block?
He inikini maoli kēia. ʻO ka pololei, pili ia i ka inikini ʻana i kahi lāʻau hoʻomaha ʻeha i loko o kou ʻāpana pelvic kokoke i ke aʻalolo pudendal. Hiki i kēia ke hāʻawi i ka hoʻomaha ʻeha no ka manawa pōkole a i kekahi manawa lōʻihi paha.
E noʻonoʻo e pili ana i ia mea, ʻo kēia aʻalolo pudendal kahi aʻalolo nui e lawe i ka manaʻo mai ke kua o kou pelvis i nā ʻiʻo a me ka ʻili ma nā wahi e like me kou mau genitals, anus, vagina, a me ka penis. Inā ʻomi ʻia a ʻūmiʻi ʻia paha kēia aʻalolo ma kekahi ʻano, hiki iā ia ke hōʻeha i ka ʻeha pelvic mau loa . I ka lāʻau lapaʻau, kapa mākou i kēia pudendal neuralgia . Hoʻohana nui ʻia kēia poloka aʻalolo e mālama i ia mau kūlana.
He aha nā hoʻohana o kēia lāʻau pale?
Hoʻohana ʻia kēia ʻano lapaʻau no ʻekolu mau kumu nui. E nānā kākou i ke ʻano o lākou.
| Kūlana hoʻohana | He wehewehe maʻalahi |
|---|---|
| No ka hōʻoia ʻana (Diagnosis) | Inā loaʻa iā ʻoe ka ʻeha pelvic akā ʻaʻole hiki ke kuhikuhi i ke kumu, hiki i kāu kauka ke hāʻawi iā ʻoe i kēia injection. Inā hoʻomaikaʻi kou ʻeha ma hope o ka injection, hōʻoia ia he pilikia ke kumu me ke aʻalolo pudendal. Inā ʻaʻole hoʻomaikaʻi ka ʻeha, hiki i ke kumu ke kumu i kekahi mea ʻē aʻe. Hiki i kēia ke kōkua iā ʻoe e hoʻolālā i kāu lāʻau lapaʻau. |
| Ma ke ʻano he lāʻau lapaʻau | Hoʻohana ʻia kēia inikini e mālama i ka ʻeha mau loa i hoʻokumu ʻia e nā kūlana e like me ka pudendal neuralgia. ʻO ka maʻamau, pili kēia inikini i ka hoʻohui ʻana i kahi anesthetic kūloko a i kekahi manawa he corticosteroid e hōʻemi i ka pehu. |
| No ka hoʻomāʻū ʻana i kahi wahi (Regional Anesthesia) | Hoʻohana ʻia kēia inikini no ka hoʻomāʻū wale ʻana i ka wahi i ka wā o kekahi mau ʻoki kino wahine, obstetric, a me ka rectal. No ka laʻana, hoʻohana ʻia ia e hōʻemi i ka ʻeha ma ka vagina i ka wā hānau keiki, a i ka wā o ke ʻoki hemorrhoid. He koho palekana kēia i ka anesthesia piha. |
Pehea ʻoe e hoʻomākaukau ai no kēia?
ʻAʻole pono kēia i ka hoʻomākaukau nui ʻana.
Eia nō naʻe, i kekahi manawa e hoʻoholo paha kāu kauka e hoʻomoe iā ʻoe (sedation) ʻoiai ʻoe e loaʻa ana i kēia inikini. I kēia hihia, e aʻo ʻia ʻoe e kāohi i ka ʻai ʻana a i ʻole ka inu ʻana no kahi o 6-8 mau hola . He mea nui hoʻi e loaʻa i kekahi e hoʻokele iā ʻoe i ka home ma hope o ka mālama ʻana.
Eia nō naʻe, e wehewehe mua kāu kauka i kēia iā ʻoe. E hahai pololei i kēlā mau kuhikuhi. Mai makaʻu e nīnau i kāu mau nīnau.
Pehea e loaʻa ai ka lāʻau pale? He aha nā ʻano hana?
Hoʻohana ke kauka i ʻekolu mau ala nui e hāʻawi ai i kēia lāʻau pale, ma muli o ke ʻano o kou kino a me ke kumu o ka lāʻau.
Ma o ka vagina (Transvaginal approach)
Hoʻohana nui ʻia kēia ʻano hana i ka obstetrics a me ka gynecology.
- E hoʻomoe ʻia ʻoe ma luna o kahi moena kūikawā, me kou mau wāwae i hohola ʻia a kau ʻia ma luna.
- Hiki ke hāʻawi ʻia kahi iniki liʻiliʻi (sedative) i loko o kahi aa koko ma kou lima e hoʻomaha ai iā ʻoe.
- A laila, hoʻokomo ke kauka i kona lima i loko o ka vagina a kuhikuhi i kahi o ke aʻalolo.
- A laila, me ka hoʻohana ʻana i kahi mea hana kūikawā, ua hoʻokomo pono ʻia ke kui i loko o ke aʻalolo a ua hoʻokomo ʻia ka lāʻau lapaʻau. I kekahi manawa hana ʻia kēia me ke kōkua o nā ʻenehana scan e like me ka ultrasound a i ʻole fluoroscopy .
Ma o ka ʻāpana ma waena o nā ʻōpū a me ka anus (Transperineal approach)
Hoʻohana ʻia kēia ʻano hana no nā ʻoki anal a me ka ʻeha pudendal i nā kāne.
- I kēia hihia, e hoʻomoe ʻia ʻoe me ke alo i luna.
- Hoʻomaʻemaʻe ʻia ka ʻili kahi e hoʻokomo ʻia ai ka lāʻau lapaʻau me kahi hopena antiseptic.
- A laila, hoʻokomo ke kauka i kahi manamana lima i loko o ka rectum a i ʻole ka vagina e ʻike ai i kahi kikoʻī o ke aʻalolo.
- A laila, hoʻokomo ʻia ka nila inikini ma o ka ʻili mai waho a hoʻokomo ʻia ka lāʻau lapaʻau.
ʻO ke ala Perectal
Hoʻohana pinepine ʻia kēia ʻano hana no nā ʻoki anal a me ka ʻeha pudendal.
- Ma kēia, ua hoʻohuli ʻia ʻoe ma kou ʻaoʻao a ua hoʻomoe ʻia ʻoe i lalo.
- E like me nā ʻano hana ʻē aʻe, loaʻa ka wahi kikoʻī o ke aʻalolo ma ke hoʻokomo ʻana i kahi manamana lima a i ʻole ka hoʻohana ʻana i kahi mea hoʻoulu aʻalolo .
- A laila, hāʻawi ʻia ka lāʻau pale ma o ka ʻili kokoke i ka anus.
ʻO ka mea nui, ma kēia mau ʻano hana a pau, hāʻawi mua ʻia kahi inikini liʻiliʻi e hoʻomāʻū i kahi i inikini ʻia. No laila, ʻaʻole ʻoe e ʻeha nui. Eia nō naʻe, hiki iā ʻoe ke ʻeha iki i ka wā e hoʻokomo ʻia ai ka nila.
He aha nā pōmaikaʻi o kēia lāʻau lapaʻau?
- Hoʻomaha ʻeha no ka manawa pōkole a mau loa paha: Hiki i kēia ke lilo i mea hoʻomaha nui e hoʻokō maʻalahi i kāu mau hana o kēlā me kēia lā.
- Hoʻēmi i ka pehu: Hoʻēmi i ka pehu ʻana i loko o ke aʻalolo, e kōkua ana i ka ho'ōla ʻana.
- ʻIke pololei: Hiki i kēia ke kōkua iā ʻoe e hoʻoholo inā ʻo ke aʻalolo pudendal ke kumu maoli o kou ʻeha.
- Palekana: ʻOi aku ka palekana o kēia ʻano anesthesia kūloko ma mua o ka anesthesia laulā.
Loaʻa i kekahi poʻe ka hōʻoluʻolu o ka ʻeha i loko o nā minuke. Inā hāʻawi ʻia ʻoe i kahi inikini steroid, hiki ke hala i kekahi mau lā e ʻike ai i kona hopena. Eia nō naʻe, pono mākou e hoʻomanaʻo ʻaʻole kēia e hōʻoluʻolu i ka ʻeha no nā mea āpau.
Pehea ka holomua o kēia? Aia kekahi mau pilikia?
ʻOkoʻa ka nui o ka holomua o kēia lāʻau lapaʻau mai kēlā kanaka a kēia kanaka, ma muli o ke kūlana olakino kumu e hoʻoulu ai i ka ʻeha a me nā kumu ʻē aʻe. Ma ka awelika, hiki iā ʻoe ke manaʻo i kahi nui o ka holomua ma mua o 50%.
I ka ʻōlelo ʻana e pili ana i nā pilikia, he mea kakaikahi loa nā pilikia koʻikoʻi.
| ʻAno pilikia | Nā mea e hiki ke hana |
|---|---|
| Nā hopena ʻaoʻao i ʻike pinepine ʻia | Aia paha kekahi ʻeha a ʻoluʻolu ʻole paha ma kahi i inikini ʻia no kekahi mau lā. Aia paha kekahi kahe koko a i ʻole ka maʻi ma kahi i inikini ʻia. I kekahi manawa aia paha ka maneo a nāwaliwali paha no ka manawa pōkole ma ka wāwae. |
| Nā pilikia koʻikoʻi akā kakaikahi | Hiki ke hōʻino ʻia ke aʻalolo pudendal, hōʻino ʻia nā ʻōpū kokoke e like me ka ʻōpū mimi a i ʻole ka rectum, a me ka ʻawahia o ka anesthetic kūloko, akā he mea kākaʻikahi loa kēia. |
I ka manawa hea ʻoe e makemake ai e ʻike hou i ke kauka?
Inā loaʻa iā ʻoe nā hōʻailona hou ma hope o ka mālama ʻana, ʻo ia hoʻi:
- Inā pehu nui ka wahi i ini ʻia, ʻulaʻula, a i ʻole he pus kahe (nā hōʻailona o ka maʻi).
- Inā he ʻeha wela, he mae wale, a he nāwaliwali mau paha .
- Inā loaʻa iā ʻoe kahi kuni ʻē.
Inā loaʻa kekahi mea e like me kēia, e kāhea koke aku i kāu kauka.
Leka Lawe-Home
- ʻO ka Pudendal Nerve Block kahi lāʻau lapaʻau kūikawā no ka ʻeha mau loa ma ka ʻāpana pelvic a me ka genital.
- Hoʻohana ʻia kēia no ka hōʻoia ʻana, ka mālama ʻana, a me ka hoʻomāʻū ʻana i kahi wahi.
- Hana ʻia ka mālama ʻana me ke akahele loa, pinepine me ke kōkua o ka ʻenehana scan.
- ʻO ka hōʻoluʻolu āu e loaʻa ai mai kēia a me ka lōʻihi o kona mau ʻana hiki ke ʻokoʻa loa mai kēlā kanaka a kēia kanaka.
- Inā he mau makaʻu a kānalua paha kou e pili ana i kēia lāʻau lapaʻau, e kūkākūkā ākea me kāu kauka.
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