Tērā pea kua tangohia tō pūkahukahu e te pokanga nā te mate hauora. Kātahi ka puta ake he pātai nui ki tō hinengaro: me pēhea te tuku i te mimi e kohia ana i roto i te tinana? Āe, ko tētahi otinga hou ko te 'Indiana Pouch'. Ahakoa he kaupapa uaua tēnei, me kōrero ngāwari tātou, i roto i te huarahi e mārama ai koe.
He whakarāpopototanga, he aha tēnei Indiana Pouch?
He pukoro iti te putea Indiana, he mea hanga pokanga i roto i tō tinana, hei penapena me te tango i te mimi mai i tō tinana. Whakaarohia he rite ki tō pūkahukahu, he rite ki tētahi ipu iti e kohi ana, e penapena ana hoki i te mimi. Ina tangohia tō pūkahukahu mō tētahi take (e kiia ana tēnei pokanga he cystectomy), me hanga he 'pukoro mimi' hou hei whakakapi mōna.
He mea hanga tēnei pēke Indiana mai i ō ake wāhanga tinana. Arā, he mea hanga mai i tētahi wāhanga o ō whekau. Ko te mea motuhake o tēnei, he rerekē ki ētahi atu pokanga e mahia ana i muri i te tangohanga o te pūkahukahu, ka taea te kohi me te penapena i te mimi ki roto i tēnei pēke. He rite tonu ki te mea e tupu ana me te pūkahukahu.
Kātahi, he maha ngā wā i te rā, ka taea e koe te whakauru i tētahi ngongo iti (he catheter) mā roto i tētahi kōhao iti i roto i tō puku (e kiia ana tēnei he 'stoma') hei tango i te mimi kua kohia. Kia pau te mimi, ka taea e koe te tango i te ngongo.
Ko te mea nui, kāore tēnei tikanga e pai mō te katoa. Ka whakaarohia e tō rōpū hauora ētahi āhuatanga hei whakatau mēnā ka taea e koe tēnei.
He aha ngā momo āhuatanga e mahia ai tēnei pokanga?
He maha ngā take matua e tangohia ai te pūkahukahu. E taunakihia ana te whakamahi i te pēke Indiana i ēnei wā:
- Matepukupuku tōngāmimi: Koinei te take tino noa mō te pokanga.
- Te ngoikore o te uaua o te tōngāmimi: I ētahi wā, nā te rongoā irahiko, nā te kino rānei o ngā io i roto i te roro me te taurakira (te tōngāmimi neurogenic), kāore e taea e ngā uaua o te tōngāmimi te kume tika, ā, kāore e taea te tuku i te mimi.
- Ngā āhua rerekē o te pūkahukahu (Bladder exstrophy): Tērā pea ka whānau mai ētahi tamariki me ētahi raruraru pūkahukahu.
- Te mamae o te puku/te mamae o te pūkahukahu: He mate e haere tahi ana me te mamae e kore e taea te pupuri.
- Ina pakaru te pūkahukahu nā ētahi atu mate hauora nui.
Me pēhea te whakarite i mua i te pokanga?
I mua i tēnei pokanga, ka kōrero pai tō tākuta ki a koe. Māna koe e whakamārama i te tikanga Indiana Pouch me ngā kōwhiringa kē atu e wātea ana. Ka tirohia e ia tō hauora whānui, tō toto toto, me ētahi atu.
Anei ētahi mea me kōrero e koe ki tō tākuta i tēnei wā:
- Kōrerotia ki tō tākuta ngā rongoā katoa e tangohia ana e koe. Kei roto i tēnei ko ngā rongoā kua tohua e te tākuta, ngā rongoā kāore e hiahiatia he rongoā, ngā tāpiringa otaota, me ngā huaora. Ka taea e ētahi rongoā (pēnei i te aspirin me ngā rongoā whakangawari toto) te whakanui ake i te toto i te wā e pokanga ana. Kaua e mutu te tango i tētahi rongoā me te kore e pātai tuatahi ki tō tākuta.
- Kōrero mai ki a mātou mō ō mate pāwera . Arā, ko ngā mate pāwera ki ngā rongoā, ki ētahi kai, ki te rapa, me ētahi atu.
- Ka tohutohu te tākuta kia kaua e kai, e inu rānei i tetahi mea i muri i te waenganui pō i te pō i mua i te pokanga. Me whai tika koe i aua tohutohu. Mena me tino tango koe i tētahi rongoā nui, ka taea pea e koe te tango me te inu wai noa iho. Pātai atu ki tō tākuta mō tēnā.
Te āhua o te mahi pokanga
He pokanga nui tēnei e ono ki te waru hāora te roa. Kei roto i tēnei ko te tākuta mimi, te tākuta whakamoe, me te nēhi.
1. Whakamoe: Tuatahi, ka meinga koe e te tākuta whakamoe kia moe rawa ('whakamoe whānui'). Nō reira, kāore koe e mamae i te wā e pokangahia ana.
2. Te tango i te pūkahukahu: Muri iho, ka tangohia e te taote pokanga tō pūkahukahu katoa. Ka taea tēnei te mahi hei 'pokanga tuwhera', arā, ko te tapahi roa i tō puku, hei 'pokanga laparoscopic, robotic rānei', arā, ko te tapahi i ētahi tapahi iti noa iho.
3. Te Waihanga i te Pēke Indiana: Whai muri i te tango i te pūkahukahu, ka tapahia e te tākuta ngā wāhanga o tō whekau nui me tō whekau iti, ka tuitui i tētahi pūkahukahu hou (pēke) kia rite ki te āhua o te pōro.
4. Hononga: Muri iho, ka honoa ngā ngongo e rua e kawe ana i te mimi mai i ngā whatukuhu (`ureters`) ki tēnei putea hou. Ka hangaia he kōhao iti (`stoma`) ki roto i te puku, kia puta ai ki te kiri. Ka honoa anō ngā wāhanga kua tapahia o te whekau, kia kore ai tō tukanga nakunaku e haukotia.
5. Te tuitui i ngā tapahi: Hei whakamutunga, ka tuituia ngā tapahi i mahia i te wā pokanga.
I muri i te pokanga, ka haria koe ki te rūma whakaora mō te wā poto. Kia hoki mai tō māramatanga, ka hoatu he rongoā ki a koe hei whakahaere i te mamae. Me noho koe ki te hōhipera mō ētahi rā. I tēnei wā, ka ako te hunga nēhi i a koe ki te tiaki me te horoi i tō pēke Indiana hou.
Me pēhea te whakakī me te whakamakuku i tētahi putea Indiana
Koinei te mea tino nui me mahi e koe i ia rā. Tērā pea he uaua te āhua i te tīmatanga, engari i muri i ētahi rā o te mahi, ka noho hei mea noa.
| Tukanga | Me pēhea te mahi (māmā noa iho) |
|---|---|
| Te whakaurunga o te katitere |
Me mahi tēnei i te nuinga o te wā kia ono ngā wā i te rā. Ki te nui te wai e inumia ana e koe, me mahi pinepine ake pea. |
| Te horoi i te pēke (Te whakamakuku) | Nā te mea he wāhanga o te whekau te stoma, ka puta tonu mai he mea pērā i te hūpē. Ka horoia te putea hei tango i tēnei hūpē. Mā tēnei ka ārai i ngā mate me te hanganga o ngā kōhatu.
I te nuinga o te wā, he rawaka te horoi pēnei kotahi, e rua rānei i te rā. |
He aha ngā painga me ngā ngoikoretanga o tēnei tikanga?
Pērā i tētahi atu tikanga hauora, he painga, he ngoikoretanga, he mōrearea hoki tō tēnei tikanga.
| Ngā Painga | Ngā Huakore me ngā Mōrearea |
|---|---|
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Te whakaoranga me te wā e tika ai kia kite i te tākuta
Tērā pea ka roa pea ētahi marama kia tino ora ai koe i tēnei pokanga. Ka roa hoki te wā kia urutau ai tō tinana ki ngā huringa. Engari mā tō rōpū hauora koe e āwhina i roto i tēnei. Tērā pea ka taea e koe te hoki ki te mahi, ki te kura rānei, me te mahi i ngā mahi māmā i roto i ētahi wiki.
Heoi, ki te puta mai ēnei tohu, me toro atu ki tō tākuta tonu:
- Ngā tohu o te mate: kirika, makariri, mimi pouri.
- Mena he uaua ki te whakauru i te catheter, ki te horoi rānei i te putea.
- Mena he toto kei roto i te mimi (hematuria) .
- Mena ka pāngia koe e te mamae nui i roto i te puku, i te rohe rānei i waenganui i ngā rara me ngā hope.
Ētahi atu tohu
He aha i huaina ai tēnei ko te putea 'Indiana'?
I whakawhanakehia tuatahitia tēnei tikanga pokanga i te tekau tau atu i 1980 e tētahi rōpū tākuta i Te Whare Wānanga o Indiana i te Hononga o Amerika. Koia te take i tapaina ai.
He rite tonu tēnei ki te Neobladder?
Ahakoa he rite tonu, ehara i te mea kotahi. He mea hanga te neobladder mai i ngā wāhanga ōrite o tō puku. Engari e hono ana ki tō urethra. Nō reira, ka rere te mimi i te ara kotahi i mua i te pokanga. Engari me te putea Indiana, ka whakauruhia he catheter mā roto i te stoma i roto i tō puku hei tango i te mimi.
Ka tino rerekē tō oranga i muri i te pokanga Indiana Pouch. Me taunga koe ki ngā tikanga hou. Engari mā ēnei huringa, ka whai wāhi koe ki te noho i tētahi oranga whakamarie ake, pai ake hoki. Kōrerohia mā te tuwhera ki tō tākuta mō ō pātai, ō āwangawanga rānei.
Karere Tangohia ki te Kāinga
- Ko te Indiana Pouch he taputapu rokiroki mimi ka hangaia i roto i te tinana mai i ngā wāhanga o ōu ake whekau i muri i te tangohia o tō pūkahukahu.
- Me whakauru e koe he catheter, ā, me whakawātea kia maha ngā wā i te rā.
- He mea nui kia whakamakukuhia te putea ki te wai tote i ia wā hei ārai i te mate.
- Ahakoa he panonitanga nui tēnei mō te ao, he huarahi pai tēnei hei whakahaere i te mimi me te kore he pēke i waho o te tinana.
- Mēnā ka puta he raruraru, he tohu rānei pēnei i te kirika me te mamae, me whakamōhio tonu atu ki tō tākuta.
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