I a tātou e pakeke haere ana, inā koa i muri i te 50-60 tau te pakeke, he raruraru hauora noa engari he āhua whakarihariha e pā ana ki te nuinga o ā tātou tāne ko te hiahia ki te mimi pinepine. Ehara i te mea i te awatea anake, engari i te pō hoki, me ara ake tātou e rua, e toru rānei ngā wā, kāore hoki e moe pai. I ētahi wā ka mimi tātou, he uaua ki te tīmata, he puhoi te rere, ā, ahakoa kua mutu, ka rite ki te mea he nui ake. E mōhio ana koe ki ēnei tohu? Ko te take matua pea mō tēnei he paku nui haere tō repe prostate, tō repe `(Prostate)` rānei. Ka kiia tēnei ko `(Benign Prostatic Hyperplasia)`, `(BPH)` rānei i roto i te pūtaiao hauora. Nō reira, i roto i tēnei tuhinga, e kōrero ana mātou mō tētahi pokanga laser hou, tino angitu e wātea ana mō tēnei mate whakarihariha.
He aha te HoLEP?
Ko te tikanga katoa o HoLEP ko `(Holmium Laser Enucleation of the Prostate)`. Ahakoa he ahua uaua te ingoa, he tino māmā noa iho te mea ka tupu i roto i tēnei. Whakaarohia kei te taha o te ngongo (`(Urethra)`) te repe prostate e puta mai ana te mimi i roto i tō pūkahukahu. Mō te BPH, ka tipu haere tēnei repe, ka ārai i taua urethra. He rite ki te tangata e pēhi ana i tētahi paipa wai. Koinā te wā ka uaua te puta mai o te mimi.
Nō reira, he pokanga te HoLEP e whakamahi ana i te hihi laser hangarau-teitei hei tango mārire i te kiko repeure nui e ārai ana i te urethra. Ko te āhuatanga nui o tēnei ko te pokanga "iti rawa te whakaekenga". Arā, ka mahia tēnei pokanga mā te whakauru i tētahi taputapu mārire mā roto i te urethra, me te kore e tapahia nui te puku. Nō reira, he iti te taumahatanga ki te tinana, ā, he tere rawa te wā whakaora.
Ko wai e hiahia ana ki te pokanga HoLEP?
Kāore e hiahiatia he pokanga mō te katoa he nui te repeure. He maha ngā tāngata ka taea te whakahaere i ō rātou tohu mā te rongoā. Heoi, i ētahi wā, ko te pokanga te mea pai rawa atu. Anei ētahi āhuatanga ka tūtohu pea tō tākuta kia pokanga:
- Mena kāore ō tohu e whakaorangia e te rongoā.
- Mena he nui te whakararuraru a ngā tohu i te oranga o ia rā.
- Mena he maha ngā mate mimi e pāngia ana e koe (UTI).
- Mena ka puta he kōhatu tōngāmimi.
- Mena ka pāngia ngā whatukuhu e te kore tika o te mimi.
Kei raro nei ētahi o ngā tohu e pāngia ana e te BPH.
| Tohu | Whakaahuatanga |
|---|---|
| Te uaua ki te mimi | Te uaua ki te tīmata mimi. |
| Te rere ngoikore o te mimi | Te tere me te rere o te mimi ka heke, ka mutu, ka turuturu. |
| Te mimi pinepine | Me ara ake koe i ngā wā maha, ina koa i te pō. |
| Te hiahia nui ki te mimi | Te hiahia ohorere ki te mimi me te mimi iti i mua i te haere ki te wharepaku. |
| Mate pāwera o te ara mimi | Te wera, te mamae rānei i te wā e mimi ana. |
Me aha koe i mua i te pokanga?
Ki te whakatau koe ki te pokanga HoLEP, ka tirotirohia koe e tō tākuta. Ko te tikanga ka uru atu ēnei ki:
- Hītori hauora: Ka pātai te tākuta mō ētahi atu mate kei a koe me ngā rongoā e tangohia ana e koe.
- Whakamātautau tinana: Ka whakahaerehia he whakamātautau motuhake hei whakatau i te rahi o te repe prostate.
- Ngā whakamātautau taiwhanga: Tērā pea ka mahia he whakamātautau toto hei tirotiro i te taumata o te PSA (Prostate-Specific Antigen) i roto i te toto me te whakamātautau mimi (Urinalysis) hei tirotiro i ngā mate mimi.
- Ētahi atu whakamātautau motuhake: I ētahi wā ka hiahiatia pea ēnei whakamātautau e whai ake nei.
| Whakamātautau | Hei whakarāpopototanga, |
|---|---|
| Ngā whakamātautau rere mimi | Inehia te tere me te rahinga o tō rerenga mimi. |
| Ngā Matawai | He matawai ultrasound, he matawai CT rānei hei tirotiro i te rahi me te āhua o te prostate. |
| Te tirotiro i te pūtau | Te whakauru i tētahi kāmera iti mā roto i te urethra hei tirotiro i te roto o te pūkahukahu me te repeure. |
| Urodynamics | He whakamātautau motuhake hei ine i te mahi me te pēhanga o te pūkahukahu. |
Ko te mea nui ko te kōrero ki tō tākuta mō ngā rongoā katoa e tangohia ana e koe, inā koa ngā rongoā whakaiti toto. Tērā pea ka tonoa koe kia mutu te tango i ēnei rongoā i mua i te pokanga. Kaua hoki koe e kai, e inu rānei i tetahi mea i muri i te waenganui pō o te rā i mua i te pokanga.
Me pēhea te mahi i te pokanga i te taahiraa i te taahiraa
Ko te pokanga HoLEP ka mahia i raro i te rongoā whakamoe whānui, arā, kei te moe katoa koe. Ko te tikanga, kāore koe e rongo i tetahi mea. Mō ētahi tāngata, ka taea te mahi mā te rongoā whakamoe tuaiwi e whakangoikore ana i te tuara o raro anake.
Koinei ngā mahi matua o te pokanga:
1. Whakamoemiti: Kia moe rawa koe, ka whakanohoia koe ki tētahi tūranga tika i roto i te rūma pokanga.
2. Te whakaurunga o te taputapu: Ka whakauruhia e te taote pokanga he taputapu angiangi e kiia nei ko te resectoscope, he kāmera kei te pito, mā roto i tō urethra. Mā tēnei kāmera ka kitea mārama te repe prostate i runga i te mata.
3. Te Whakamahinga o te Reera: Muri iho, ka tukuna he hihi reera mā roto i te taputapu. Ka whakamahia tēnei reera hei tapahi mārire i te kiko tāpiri o te repe prostate e ārai ana i te urethra, ā, hei wehe i a ia mai i te repe matua. Ka kiia tēnei ko te `(Enucleation)`. Ko tētahi painga o te reera ko te hiri i ngā oko toto e kawe ana i te toto i a ia e tapahi ana i te kiko. Nō reira, he iti rawa te toto.
4. Te tango kiko: Ka panaia ngā wahi kiko kua tapahia ki roto i te pūkahukahu, kātahi ka whakamahia tētahi atu taputapu e kiia nei ko te "Morcellator" hei tapahi i ngā wahi kia iti ake, hei waru atu.
5.Te whakamātautau kiko: Ka tukuna ngā tauira kiko i tangohia hei whakamātautau taiwhanga hei tirotiro mēnā he āhuatanga rerekē, pērā i ngā pūtau matepukupuku.
6. Te whakaurunga o te katitere: Hei whakamutunga, ka tangohia ngā taputapu pokanga katoa, ā, ka whakanohoia he katitere mimi hei āwhina i te mimiti tika o te mimi.
Ko te roa o tēnei pokanga he kotahi ki te toru hāora te roa, ka rerekē pea i runga i te rahi o tō repeure.
He aha ngā mea hei tumanakohia i muri i te pokanga?
I muri i te pokanga, ka noho koe i roto i te rūma whakaora mō ētahi haora, ā, ka taea e koe te hoki ki te kāinga i taua rā anō, i te rā e whai ake nei rānei. Me noho noa koe ki te hōhipera mō te rā kotahi, e rua rānei mēnā he toto kei roto.
He mea noa ēnei i muri i te pokanga:
- Tātari: Ka tukuna koe ki te kāinga me te tātari kei te wāhi tika. Ko te tikanga ka tangohia tēnei tātari i te aonga ake. Mena ka taea e koe te mimi pai i ngā wā e rua, e toru rānei i muri i te tangohanga o te tātari, kāore he raruraru. Ki te kore, me whakauru anō pea he tātari i roto i ētahi rā.
- Mamae me te wera: He mea noa te mamae me te wera i te wā e mimi ana i ngā rā tōmua. Ka tohua e te tākuta ngā rongoā whakamamae mamae mō tēnei.
- Te toto i roto i te mimi: He mea noa te noho o te toto iti i roto i tō mimi, ā, ka konatunatua ki te māwhero, ki te whero mārama rānei, mō ētahi wiki. Kaua e manukanuka. Ka rerekē pea tēnei i runga i te nui o te wai e inuhia ana e koe me te nui o te wai e inuhia ana e koe.
- Inumia he wai: I muri i te tango i te catheter urethral, me inu nui koe i te wai . Mā tēnei ka āwhina i te toto i roto i tō mimi kia tere te heke.
- Te Whakahaere: Tērā pea he uaua ki te whakahaere i tō mimi i te tīmatanga. Tērā pea ka turuturu ētahi pata ina kata koe, ina maremare, ina hiki rānei i tētahi mea taumaha. Ka memeha haere tēnei i roto i ētahi wiki. Ka tūtohu pea tō tākuta kia mahi i ngā mahi Kegel hei āwhina i tēnei.
- Ngā Tohu: Ko ngā tohu pēnei i te mimi pinepine me te hiahia nui, ka roa pea ētahi marama ka tino pai ake, nā te mea ka roa te wā e urutau ai te pūkahukahu ki tēnei āhuatanga hou.
Ngā painga, ngā pānga taha, me ngā mōrearea
Pērā i ngā pokanga katoa, he pai ngā painga o te HoLEP, engari he iti noa ngā mōrearea me ngā pānga taha.
| Ngā painga me ngā huakore o te pokanga HoLEP | |
|---|---|
| Ngā Painga | |
| Kāore he tapahi. | Nā te mea kāore he motu i te kiri, ka tere te ora. |
| He pai mō ngā rahi katoa | He tino whai hua ahakoa mō ngā repeure nui. |
| Kua whakaitihia te maha o ngā tāngata e noho ana ki te hōhipera. | He maha ngā wā, he nui noa te noho kotahi pō i te hōhipera. |
| He iti ake te toto | Ka whakaitihia e te hangarau taiaho te toto, ā, kāore e hiahiatia he whakawhiti toto. |
| He iti te mōrearea o te hokinga mai | Nā te mea he nui te kiko e tangohia ana, he iti rawa te tūponotanga kia mahia anō he pokanga. |
| Ngā Pānga me ngā Tūponotanga o te Taha | |
| Mumura/toto rangitahi | Ka memeha haere te werawera i te wā e mimi ana, me te toto i roto i te mimi i roto i ētahi wiki. |
| Te Putanga Whakamuri | Koinei te pānga taha tino kitea. Ina puta te purapura i te wā moe tāne, kāore te purapura e puta mai engari ka uru ki te pūkahukahu. Ka kiia hoki tēnei ko te "maroke ejaculation". Kāore he pānga ki te pai o te moe tāne, ki te whakatū rānei i te ure. Heoi, ki te mea kei te tumanako koe kia hapu he tamaiti, me kōrero koe ki tō tākuta i mua i te pokanga. |
| Ngā mate urutā | Pērā i ngā mahi pokanga katoa, he iti noa te mōrearea o te mate mimi. |
| Te ngoikore o te whakahaere mimi | Ki te nuinga o te iwi, he rangitahi tēnei, ā, kāore e roa te wā e mau ai. |
Kia pēhea te roa e ora ai?
He tere tonu te whakaoranga i muri i te pokanga HoLEP.
- Te Hīkoi me te Taraiwa: Ka taea e koe te hīkoi i taua rā anō i muri i te pokanga. Ka taea hoki e koe te tīmata taraiwa i roto i ētahi rā.
- Te hoki ki te mahi: Mena he mahi tari tāu, ka taea e koe te hoki ki te mahi i roto i te wiki, i ngā wiki e rua rānei. Mena he mahi uaua ki te tinana tāu, me okioki koe mō tētahi wā.
- Korikori tinana me te hiki taumaha: Kaua e hiki taumaha neke atu i te 5 kg mō te iti rawa e rua wiki. Kaua e whakakorikori tinana taumaha pēnei i te oma mō te iti rawa e rua wiki.
- Whakatūpato motuhake: He mea nui kia karohia ngā mahi pēnei i te eke pahikara me te motopaika mō te ono wiki pea te roa .
Āhea koe me kōrero ki te tākuta?
Ahakoa he mea noa ētahi āhuatanga i muri i te pokanga, me waea atu tonu koe ki tō tākuta mēnā ka pāngia koe e tētahi o ēnei tohu e whai ake nei:
- Mena he nui ngā toto totoka kei roto i tō mimi, ki te huri rānei tō mimi ki te whero pouri, pērā i te ranu tōmato .
- Mena he teitei ake te kirika i te 101°F (38°C).
- Mena he nui te mamae kāore e taea te whakahaere ahakoa ngā rongoā whakamamae.
- Ki te kore e taea e koe te mimi .
He aha te rerekētanga i waenga i te HoLEP me te TURP?
Kua rongo pea koe i tētahi pokanga e kiia nei ko te TURP (Transurethral Resection of the Prostate). He pokanga anō tēnei hei tango i tētahi repeure kua nui haere. Ko te rerekētanga matua ko te tikanga tango kiko. I roto i te TURP, hei utu mō te laser, ka tapahia ngā wahi kiko mā te whakamahi i tētahi waea hiko.
Ko te tikanga, e kiia ana he pai ake te pokanga HoLEP i te TURP nā te mea he iti ake te toto e puta mai ana, he poto ake te noho hōhipera, ā, he iti ake te tūponotanga o te tipu anō o te repeure me te hiahia kia pokangahia. Heoi, mā tō tākuta e whakatau ko tēhea pokanga te mea pai mōu.
Karere Tangohia ki te Kāinga
- He tino angitu, he haumaru, he hou hoki te pokanga taiaho a HoLEP mō te benign prostatic hyperplasia (BPH).
- Nā te mea kāore he tapahi nui e mahia ana i tēnei, he tere rawa te wā whakaora, ā, he iti noa ngā raruraru.
- He mea noa te kitea he toto iti i roto i tō mimi, me te ahua wera mō ētahi wiki i muri i te pokanga. Kāore he take e mataku ai.
- Ahakoa he pānga taha noa te retrograde ejaculation, kāore e pā ki te makona o te moepuku.
- Kōrero mārire ki tō tākuta i mua atu, ā, i muri hoki i te pokanga mō ō āwangawanga, ō ruarua rānei.
- Kia tino whai i ngā tohutohu a te tākuta mō te tere me te tino ora.
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