Loaʻa pinepine anei i kāu keiki liʻiliʻi nā maʻi ʻōpū mimi (UTI)? A i ʻole ua ʻōlelo paha kāu kauka i kahi mea e like me ka pehu liʻiliʻi i loko o nā puʻupaʻa o kāu pēpē i ka wā o ka scan i kou wā hāpai? ʻO kekahi kumu paha o kēia mau mea he maʻi i kapa ʻia ʻo Ureterocele. ʻAʻole paha ʻoe i lohe i kēia inoa ma mua. Akā, mai hopohopo. He mea hou kēia no nā mākua he nui. E kamaʻilio kākou e pili ana i ia mea me ka maʻalahi a me ka maopopo i kēia lā.
I ka ʻōlelo maʻalahi, he aha ka Ureterocele?
ʻAe, e hoʻomaopopo mua kākou pehea e hana ai ka ʻōnaehana mimi i loko o ko kākou kino me ka maʻalahi. Loaʻa iā kākou ʻelua mau puʻupaʻa i loko o ko kākou kino. ʻO kēia nā mea e kānana i ko kākou koko a wehe i nā mea pono ʻole e like me ka mimi, a i ʻole ka mimi . ʻO ka mimi i hana ʻia ma kēia ʻano e hōʻiliʻili ʻia i loko o ka ʻōpū mimi ma nā ʻōmole ʻelua. Ua kapa ʻia kēlā mau ʻōmole ʻelua he ureters . Ke piha ka ʻōpū mimi, manaʻo mākou i ka pono e mimi .
I kēia manawa, ma ke ʻano i kapa ʻia ʻo ureterocele, ʻo ka hopena o ka ureter, ka mea e lawe ana i ka mimi mai ka puʻupaʻa a i ka ʻōpū mimi, e pehu aʻe e like me ka pōpō. E noʻonoʻo ua pehu iki ka hopena o ka paipu wai. He mea like ia. Ma muli o kēia pehu ʻana, ʻaʻole hiki i ka mimi ke kahe pono i loko o ka ʻōpū mimi. A laila, ua hoʻihoʻi ʻia ka mimi i luna, ʻo ia hoʻi, i ka puʻupaʻa. I ka lāʻau lapaʻau, kapa mākou i kēia (Vesicoureteral Reflux) . ʻO ka hoʻi ʻana o ka mimi i loko o ka puʻupaʻa e like me kēia, ʻaʻole ia he mea maikaʻi no ke olakino o nā puʻupaʻa.
ʻO ka mea nui, he maʻi hānau ʻia ka ureterocele. ʻO ke ʻano kēia e ulu ana ia i ka wā e ulu ana ke pēpē i loko o ka ʻōpū.
Aia kekahi mau ʻano nui o ka ureterocele?
ʻAe, ua hoʻokaʻawale nā kauka i kēia maʻi i kekahi mau ʻano. ʻAʻole pono ʻoe e loaʻa ka ʻike nui e pili ana i kēia mau mea, akā maikaʻi ke loaʻa kahi ʻike maʻamau.
- Ma muli o ka ʻaoʻao i hoʻopilikia ʻia: I kekahi manawa hiki ke hana ʻia kēia ma hoʻokahi wale nō puʻupaʻa (unilateral). ʻO ia ke ʻano maʻamau. He mea kākaʻikahi loa, hiki ke hana ʻia kēia ʻano ma nā puʻupaʻa ʻelua (bilateral).
- Ma ka wahi:
- ʻO Extravesical Ureterocele: ʻO kēia ke ʻano maʻamau i nā pēpē a me nā kamaliʻi ʻōpio. Maanei, hiki i ka pehu e like me ka pōpō ke hoʻolōʻihi i lalo i ka ʻōpū mimi, me ka ʻāʻī o ka ʻōpū mimi a me ka urethra.
- ʻO ka Ureterocele Intravesical: Ma kēia ʻano, aia ka puʻupuʻu i loko o ka ʻōpū mimi. ʻAʻole ia e hoʻolōʻihi i waho o ka ʻōpū mimi.
He mea nui loa kēia mau hoʻokaʻawale ʻana no ke kauka e hoʻoholo ai i nā ʻano lapaʻau.
Pehea ka maʻamau o kēia maʻi? ʻO wai ka mea e loaʻa pinepine ai?
ʻAʻole kēia he maʻi maʻamau loa. Hoʻopilikia ia ma kahi o hoʻokahi i loko o 5,000 mau keiki. ʻOi aku ka maʻamau i nā kaikamahine ma mua o nā keikikāne.
He aha nā hōʻailona o ka ureterocele?
I ka hapanui o nā hihia, ʻaʻole paha e hōʻike kahi ureterocele liʻiliʻi i kekahi mau hōʻailona. Eia nō naʻe, hoʻomaka ka pilikia ke hiki ʻole i ka mimi ke kahe pono, e alakaʻi ana i kahi maʻi urinary tract (UTI) . Ke loaʻa i kahi keiki kahi UTI, hiki iā lākou ke hōʻike i kēia mau hōʻailona:
| Hōʻailona | Ua wehewehe maʻalahi ʻia |
|---|---|
| ʻEha/wela i ka wā e mimi ai | Inā uē ke keiki a hōʻike paha i ka ʻoluʻolu ʻole i ka wā e mimi ana . |
| Mimi pilau | He ʻoi aku ka ikaika o ka mimi a ʻoi aku ka ʻala ʻoluʻolu ʻole ma mua o ka maʻamau. |
| ʻEha ʻōpū a i ʻole kahi manaʻo puʻupuʻu | ʻEha ma ka ʻōpū lalo a i ʻole he manaʻo e like me ka puʻupuʻu ma ka lima. |
| Koko i loko o ka mimi | Ke huli nei ka mimi i ka ʻulaʻula a i ʻole ka poni. |
| Pono pinepine e mimi | Pono e mimi pinepine ma mua o ka maʻamau. |
| MimiʻAʻole hiki ke kāohi i ka mana | Ka mimi hou ʻana i loko o ke keiki i aʻo mua e kāohi i kāna mimi . |
| ʻAʻole hiki ke hoʻokuʻu loa i ka ʻōpū mimi | Manaʻo e like me he mimi lā i koe ma hope o ka mimi ʻana . |
Inā loaʻa i kāu keiki kekahi o kēia mau hōʻailona, he mea nui loa e ʻike koke i ke kauka .
No ke aha lā kēia e hana nei? He aha ke kumu o kēia?
E like me kā mākou i ʻōlelo ai ma mua, ʻo kēia no ka mea ʻaʻole i ulu pono ka hopena o ka ureter i ka wā e ulu ana ke pēpē i loko o ka ʻōpū. I kekahi manawa hiki ke ʻike ʻia nā hōʻailona i ka wā makua, akā like nō ke kumu.
Eia kekahi mea nui loa no nā makuahine a me nā makuakāne e hoʻomanaʻo. ʻAʻole kēia he mea āu i hana hewa ai i ka wā hāpai, a i ʻole kahi mea āu i ʻai ai a inu ai paha, a i ʻole kahi mea āu i hana ai. Manaʻo nā kānaka noiʻi e hana wale ʻia kēia. No laila, mai hopohopo no ia mea me ke kumu ʻole.
He koʻikoʻi anei kēia? He aha nā pilikia e hiki mai ana?
He maʻi hiki ke mālama ʻia ka Ureterocele, akā pono e lawe koʻikoʻi ʻia. Inā ʻaʻole mālama ʻia, hiki iā ia ke alakaʻi i nā pilikia koʻikoʻi.
No ka mea, ke kahe pono ʻole ka mimi a piha i loko o nā puʻupaʻa (paʻa ʻana o ka mimi), ulu aʻe nā maʻi ʻaʻai mimi (UTI). Ke hoʻomau kēia mau maʻi, hoʻomaka lākou e hōʻino i nā puʻupaʻa .
ʻO nā pilikia ʻē aʻe:
- Nā pōhaku puʻupaʻa
- Ka pōʻino o ka ʻōpū mimi
- Nā maʻi ʻōpū mimi hou (UTIs)
ʻO ka mea nui e hoʻomanaʻo ai, ʻo ka hōʻino ʻia o ka puʻupaʻa he mea hiki ʻole ke hoʻihoʻi ʻia . ʻO ke ʻano kēia, i ka wā e nalowale ai kekahi hana o ka puʻupaʻa, ʻaʻole hiki ke hoʻihoʻi ʻia. ʻO ia ke kumu he mea nui ka ʻike mua a me ka mālama ʻana e mālama i ka hana o ka puʻupaʻa.
Pehea e ʻike ai nā kauka i kēia?
ʻO ka mea pōmaikaʻi, ua ʻike ʻia ka hapa nui o Ureteroceles i ka wā o nā scan ultrasound prenatal.Hiki ke ʻike ʻia ma o ke scan ponoʻī. ʻO ka maʻamau, i ka wā o ke scan anomaly, kahi i hana ʻia ma kahi o 20 mau pule, e manaʻo ke kauka ua pehu kekahi o nā puʻupaʻa a i ʻole nā ureters o ka pēpē. A laila hiki ke hōʻoia ʻia kēia ma o nā hoʻokolohua ma hope o ka hānau ʻana o ka pēpē.
I kekahi manawa, ʻike ʻia ma hope o ka hānau ʻana o ka pēpē. ʻIke pinepine ʻia i ka wā o nā hoʻokolohua i hana ʻia ke ʻike ʻia nā hōʻailona ma mua o 2 mau makahiki. Hiki ke ʻike ʻia ma kahi hanana ʻole i ka wā o nā hoʻokolohua i hana ʻia i nā pākeke no nā pōhaku puʻupaʻa a i ʻole nā maʻi ʻōpū mimi.
Hiki i kāu kauka ke kuhikuhi i hoʻokahi a ʻoi aku paha o kēia mau hoʻokolohua:
| Hoʻāʻo | ʻO ka mea wale nō āu e hana nei |
|---|---|
| ʻO ke kani ʻana o nā puʻupaʻa | Ua nānā ʻia nā puʻupaʻa, nā ureters, a me ka ʻōpū mimi no ke ʻano a me ka pehu ʻana. |
| Hoʻāʻo VCUG (Voiding Cystourethrogram) | Hoʻokomo ʻia kahi wai kūikawā i loko o ka ʻōpū mimi, a lawe ʻia kahi X-ray i ka wā e mimi ai ke keiki e ʻike inā e kahe ana ka mimi i hope i loko o nā puʻupaʻa (reflux). |
| Nānā ʻana i ka Renal | He scan kūikawā e ʻike ai i ka maikaʻi o ka hana ʻana o nā puʻupaʻa a inā ua hōʻino ʻia. |
| ʻO ke kiʻi CT a i ʻole MRI | Hoʻohana ʻia kēia mau mea no ka loaʻa ʻana o nā kiʻi 3D ʻoi aku ka maopopo a me nā kikoʻī o ka ʻōnaehana mimi. |
| Hoʻāʻo mimi | E nānā inā he maʻi ʻaʻai mimi (UTI). |
Pehea e mālama ʻia ai ka ureterocele?
Hoʻoholo ʻia ke ʻano hana e kekahi mau kumu.
- I ka manawa hea e ʻike ʻia ai ka maʻi? (I ka wā hāpai a i ʻole i ka wā kamaliʻi?)
- Ua hoʻopilikia ʻia anei nā puʻupaʻa?
- Loaʻa iā ʻoe ka reflux vesicoureteral ?
Inā ʻike ʻia kēia i ka wā o ka scan i ka wā hāpai, hiki ke hāʻawi ʻia nā antibiotics e hōʻemi i ka pilikia o ka maʻi a hiki i ka hānau ʻana o ka pēpē. Ma hope o ka hānau ʻana o ka pēpē, e hoʻoholo ʻia ka lāʻau lapaʻau maikaʻi loa ma muli o ke kūlana o ka pēpē.
ʻO ke ʻoki kino ke ʻano lapaʻau nui.
Nā lāʻau lapaʻau
ʻO ka pahuhopu nui o ke ʻoki kino, ʻo ia ka wehe ʻana i ka pehu e like me ka pōpō pehu a hoʻomaha i ka mea e ālai ʻia ai ke ala mimi . Aia kekahi mau ʻano hana no kēia.
1. Transurethral Puncture: Ua like kēia me ke hou ʻana i kahi pōpō me kahi nila. Hoʻokomo ke kauka lapaʻau i kahi mea hana lahilahi (cystoscope) me kahi kāmela ma ke ala o ka urethra, komo i loko o ka ʻōpū mimi, a hana i kahi lua liʻiliʻi i loko o ka ureterocele pehu. ʻAe kēia i ka mimi i ālai ʻia e kahe manuahi. ʻAʻole kēia he ʻoki kino nui, a hiki iā ʻoe ke hoʻi i ka home i ka lā hoʻokahi me ka ʻole o ka noho ʻana i ka haukapila (kaʻina hana outpatient). Eia naʻe, hana ʻia kēia ma lalo o ka anesthesia laulā no nā keiki.
2. Hoʻokomo hou ʻana i ka ureter: He ʻoki kino paʻakikī iki kēia. Maanei, hana ke kauka ʻoki i kahi ʻoki liʻiliʻi ma ka ʻōpū lalo a komo i loko o ka ʻōpū mimi. A laila, ʻoki ʻia a wehe ʻia ka ʻāpana o ka ureter me ka ureterocele, a hoʻopili hou ʻia ka paipu i ka ʻōpū mimi. Hoʻololi hou ʻia ka valve flap e pale ai i ka mimi mai ke kahe ʻana i hope. He holomua loa kēia ʻoki kino ma 90% - 95% o nā hihia.
3. Upper Pole Nephrectomy: Hana ʻia kēia ʻoki kino i nā hihia kūikawā loa. Loaʻa paha i kekahi mau keiki kahi puʻupaʻa duplex . ʻO ke ʻano kēia, ua māhele ʻia kekahi puʻupaʻa ma kekahi ʻaoʻao i ʻelua ʻāpana. Inā ua hōʻino nui ʻia ka pou o luna o kēia puʻupaʻa e ka ureterocele a ʻaʻole ia e hana iki, e wehe ʻia ka ʻāpana hana ʻole ma ke ʻoki kino.
Ke kali makaʻala
Hana pinepine ʻia kēia i nā pākeke. Inā liʻiliʻi loa ka ureterocele, ʻaʻohe hōʻailona, a ʻaʻohe hōʻino i nā puʻupaʻa, hiki i ke kauka ke hoʻoholo e nānā i ke kūlana me ka ʻole o ke ʻoki ʻana.
Hiki ke ho'ōla loa ʻia kēia maʻi?
ʻAe, ʻoiaʻiʻo nō. Hiki ke ho'ōla loa ʻia ka Ureterocele me ke ʻoki kino. Ke wehe ʻia ke ālai ʻana i ke kahe o ka mimi, ua hoʻoponopono ʻia ka pilikia. Akā e like me kā mākou i ʻōlelo ai ma mua, inā ua hōʻino ʻia nā puʻupaʻa, ʻaʻole hiki ke hoʻoponopono ʻia kēlā hōʻino. ʻO ka mea maikaʻi loa e hana ai, ʻo ia ke hoʻōki i ka hōʻino hou aʻe. ʻO ia ke kumu he mea nui ka ʻike mua a me ka mālama ʻana.
Leka Lawe-Home
- ʻO ka ureterocele kahi e puka mai ai kahi pōpō liʻiliʻi mai ka hopena o ka urethra i loko o ka ʻōpū mimi.
- ʻAʻole kēia ma muli o kekahi mea āu i hana hewa ai i ka wā hāpai. He mea hiki wale mai ia me ka manaʻo ʻole.
- ʻO ka hōʻailona nui, ʻo ia nā maʻi pinepine o ke ala mimi (UTI). I kekahi manawa ʻaʻohe hōʻailona iki.
- Inā ʻaʻole mālama ʻia, hiki i ka mimi ke piʻi hou aʻe a hōʻeha mau loa i nā puʻupaʻa.
- Hiki ke ʻike pinepine ʻia kēia i ka wā o nā scan hāpai. He mea pōmaikaʻi loa ia.
- Hiki ke ho'ōla loa ʻia kēia maʻi me ke ʻoki kino. Ua holomua loa nā ʻano lapaʻau.
- Inā loaʻa i kāu keiki nā hōʻailona o ka UTI, e like me ke kuni, ka ʻeha o ka ʻōpū, a i ʻole ka ʻeha i ka wā e mimi ai , e ʻike koke i ke kauka.
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