Kua āraia tō whatukuhu e te aukati i roto i te ureter? (Ureteropelvic Junction - UPJ Obstruction) Me kōrero tātou mō tēnei!

I ētahi wā ka rite tā tātou tamaiti ki tētahi puku iti i roto i tōna puku, ka pāngia rānei ia e ngā mate mimi maha, tika? Tērā pea he kirika. Ko tētahi take mō ēnei mea ko te aukati i te wāhi e tīmata mai ai te mimi mai i te whatukuhu. I tēnei rā, ka kōrero taipitopito tātou, he tino māmā noa iho, mō tēnei āhuatanga e kiia nei ko te `(Ureteropelvic Junction Obstruction)` `(UPJ Obstruction)` rānei.

He aha tēnei 'aukati i te hononga ureteropelvic'?

Hei whakarāpopototanga, he wāhi rite ki te hāpara kei te tihi o ō whatukuhu e rua, e kiia nei ko te `(Renal Pelvis)` . Ka kohia te mimi e rere ana mai i ngā whatukuhu ki roto i tēnei `(Renal Pelvis)`. Kātahi ka heke tēnei mimi ki raro i tētahi ngongo e kiia nei ko te `(Ureter)` ka kohia ki roto i te pūkahukahu. Ko te hononga e tūtaki ai te `(Renal Pelvis)` me te `(Ureter)` ka kiia ko te `(Ureteropelvic Junction - UPJ)`. Mena he aukati, arā, he aukati, i tēnei hononga mō tētahi take, kāore te mimi e heke tika. Koinei te mea e kiia nei e mātou ko te `(UPJ Obstruction)`.

I te nuinga o te wā, kotahi anake te `(Ureter)` o ia whatukuhu. Ka tātarihia e ō tātou whatukuhu ngā para me te wai nui mai i te toto, ka puta he mimi. Ko te mimi e puta mai ana i tēnei ara ka kohia ki roto i te `(Renal Pelvis)`, ka haere mā roto i te `(UPJ)`, ka haere mā te `(Ureter)` ki te pūhā. Ina he `(UPJ Obstruction)`, ka tino puhoi te rere o tēnei mimi, ā, i ētahi wā ka mutu rawa. Ka piki ake te mōrearea o te kino o te whatukuhu.

I te nuinga o te wā, ko tēnei āhuatanga e kiia nei ko te `(UPJ Obstruction)` he mea e kitea ana i te whānautanga (arā, `(Congenital urinary abnormality)`). Ā, kotahi anake te whatukuhu e pāngia ana. Ko ētahi atu ingoa mō tēnei ko `(UP junction obstruction)`, `(Obstruction of the ureteropelvic junction)`, `(UPJO)` rānei.

He mate kino tēnei `(UPJ Obstruction)`?

Ae, he mate kino te aukati o te UPJ. Ki te kore e rongoatia tika, ka arahi pea ki te ngoikore o te whatukuhu . Koia te mea nui kia mōhio koe ki tēnei me te mahi i ngā mahi e tika ana. Kāore he mea hei manukanuka, engari me tūpato.

E hia te auau o tēnei āhuatanga?

E ai ki ngā tatauranga, tata ki te kotahi i roto i te 1,500 pēpi e whānau mai ana he mate tēnei (UPJ Obstruction). Ko te tikanga, ahakoa ehara i te mea tino noa, ka taea e te tangata katoa te pā ki tēnei mate.

He aha ngā tohu o te `(Ureteropelvic Junction Obstruction)`?

He maha ngā tohu e kitea ana i roto i tēnei mate. Heoi, i ētahi wā, inā koa i roto i ngā pēpi nohinohi, kāore pea he tohu o waho.

• He ahua puku kei roto i te puku, inā koa kei te taha o te puku. Nā te pupuhi o te whatukuhu nā te aukati o te mimi i puta ai tēnei. He rite te ahua ki te poihau wai.
• Ngā mate pāwera auau o te ara mimi (UTI), me te kirika hoki. Mena he maha ngā mate pāwera o te tamaiti, he mea tēnei hei whakaaroaro māu.
• Mamae i te taha o te whatukuhu. He mamae tēnei e pā ana ki te tuara o te whatukuhu. I ētahi wā ka haere mai, ka haere atu tēnei mamae.
• Ngā kōhatu whatukuhu. He nui ake te tūponotanga ka puta ngā kōhatu whatukuhu ina aukatia te mimi.
• Te toto i roto i te mimi (`(Hematuria)`) .
• Whakapairuaki me te ruaki.
• Te whakaroa o te whanaketanga, te hekenga rānei o te taumaha o te tamaiti . I ētahi wā ka kitea anō hoki ēnei āhuatanga.

He aha te tino take o te aukati o te UPJ?

Kua kōrero kē ahau ko te nuinga o ngā āhuatanga aukati UPJ he mea whānau mai . Ko te tikanga, i te wā e noho ana te pēpi i roto i te kōpū, kāore i te tika te hanganga o ētahi wāhanga o te pūnaha mimi, inā koa te ureter, te whatukuhu rānei. I ētahi wā, ka puta pea tēnei aukati i te pēhanga o tētahi oko toto e haere ana i roto i te UPJ. He maha ngā wā he āhuatanga matapōkere ēnei. Heoi, ki te mea kua pāngia tētahi o tō whānau e tēnei āhuatanga, tera pea he iti ake tō tūponotanga ki te pāngia e tēnei āhuatanga.

He tino onge te pāngia o ngā pakeke e te "Ārai UPJ". Heoi, ka pā pea tēnei ki ngā pakeke nā ēnei take e whai ake nei:

• Nā te mea he kōhatu whatukuhu .
• Nā ngā mate pāwera o te ara mimi o runga (ngā mate pipi o runga) .
• I muri i te pokanga i taua wāhi.
• Nā te pupuhi (`(Pupuhi)`) i te taha whakarunga o te pūnaha mimi .

Ko wai te mea tino pāngia e tēnei āhuatanga?

E ai ki ngā raraunga o nāianei, e rua ngā wā ka nui ake te tūponotanga o te tāne ki te pāngia e te UPJ Obstruction i ngā wāhine. Kua kitea hoki e ngā rangahau he rua ngā wā ka nui ake te tūponotanga o te mate nei ki te whatukuhu maui i te whatukuhu matau.

He aha ngā raruraru ka pā mai i te aukati o te UPJ?

Ki te kore tēnei āhuatanga (UPJ Obstruction) e rongoatia tika, ka puta pea ngā momo raruraru.

• Ngā mate urutā mimi e hokihoki ana (UTI) . I ētahi wā, ka pupuhi te kiko ngako huri noa i ngā whatukuhu (perinephric stranding).
• Tērā pea ka puta he mamae mau tonu ki te wāhi e pāngia ana .
• Tērā pea ka puta mai ētahi atu kōhatu tākihi ("ngā kōhatu tākihi tuarua") .

Ko te mea nui , ki te kore e rongoatia mō te wā roa, ka taea e tēnei `(UPJ Obstruction)` te kino i ngā whatukuhu, ā, ka mutu, ka arahi atu ki te ngoikore o te whatukuhu . Koia te mea nui kia kitea wawetia, kia rongoatia hoki.

Me pēhea te tautuhi i te mate `(UPJ Obstruction)`?

I te nuinga o ngā wā,Ka taea e ngā tākuta te tātaritanga i te UPJ Obstruction i te wā e tirotirohia ana te pēpi i roto i te kōpū. Nā te mea ka pēhia te tuara o te whatukuhu e te aukati o te mimi, ka pupuhi ake i te mea noa. Ka kiia tēnei ko te hydronephrosis . Ka kitea mārama tēnei i runga i te tirotiro ultrasound.

Ahakoa kua whānau te pēpi, ka tonoa pea e ngā tākuta ētahi whakamātautau hei tirotiro i te pai o te whakaputa me te tuku mimi a ngā whatukuhu. Ko ētahi o ēnei:

• Ngā whakamātautau toto me te mimi (`(Ngā whakamātautau toto me te tātari mimi)`). Mā ngā whakamātautau pēnei i te `(Blood Urea Nitrogen - BUN)` me te `(Creatinine Clearance)` ka taea te whakaatu i te pai o te tātari a ngā whatukuhu i te toto.
• Ko te whakamātautau e kiia nei ko te "Intravenous Pyelogram - IVP" ko te werohanga i tētahi tae motuhake ki roto i tētahi uaua i roto i tō ringa, kātahi ka tangohia he pikitia "X-ray". Kātahi ka kitea te tae i a ia e haere ana i roto i te whatukuhu, te "Renal Pelvis", me te "Ureter" hei whakatau mēnā he aukati kei roto.
• Matawai i ngā Whatukuhu. I roto i tēnei whakamātautau, ka werohia he iti noa o te matū irahiko ki roto i te uaua, ā, ka whakamahia he kāmera motuhake hei mātakitaki i tōna haerenga mā roto i ngā whatukuhu. Mā tēnei ka taea te whakaatu i te pai o te mahi a ngā whatukuhu me te whānuitanga o te aukati.
• Te tirotiro ira-oro, te matawai CT, me te MRI. Ka kitea mārama e ēnei whakamātautau whakaahua te hanganga o ngā whatukuhu, ngā ureter, me te pūhā, tae atu ki ngā ārai katoa i roto i ngā whatukuhu.

Me pēhea te rongoā i te `(UPJ Abstruction)`?

Kei te āhua o te āhuatanga tēnei. Mēnā he aukati UPJ tō pēpi, ka taea e ia te ora ake i roto i ngā marama 18 tuatahi o te oranga. I tēnei wā, ka whakahaerehia e te tākuta o tō pēpi he matawai ultrasound me ētahi atu whakamātautau hei whakarite kāore te aukati e pā kino ana.

Heoi, ki te kore tonu e taea e te tamaiti te mimi i muri i te 18 marama, ko te tikanga kei te noho tonu te aukati, me mahi pea ia i tētahi pokanga e kiia nei ko te "Open Pyeloplasty" . I roto i tēnei, ka tapahia he wahi nui e te tākuta mimi tamariki, ka tangohia te wāhanga kua aukatia, ka hono anō i te "Ureter" ki te whatukuhu, ka hanga he whakatuwheratanga whānui ake. Ko te "Open Pyeloplasty" he tikanga he torutoru hāora te roa, ā, ko te ōrau angitu he tata ki te 95%.

I ētahi wā, ka taea e te taote pokanga te mahi i tēnei pokanga mā te whakamahi i tētahi tikanga e kiia nei ko te `(Minimally invasive pyeloplasty)`, he tikanga karetao (`(surgical robot)`) . Kātahi ka tapahia he iti, ā, ka whakahaerehia he `(Laparoscope)` me ētahi atu taputapu pokanga mā roto i tētahi karetao. He rite te angitu o tēnei tikanga ki te `(Open Pyeloplasty). Heoi, me nui ake te pūkenga hangarau a te taote pokanga. Kei te tau me te rahi o te tamaiti anō hoki.

Ko tētahi atu kōwhiringa he tikanga e kiia nei ko te "Endopyelotomy".I tēnei, ka tukuna e te taote pokanga he taputapu e kiia nei ko te "Endoscope" (he ngongo angiangi me te kāmera) mā roto i te urethra ("Urethra"), i te taha o te "Ureter", ka tirohia te mea kua āraia. Kātahi ka tukuna he waea mā roto i te awaawa i roto i te "Endoscope", ka tapahia te mea kua āraia ki taua mea, ā, ka whakatakotoria he "waikeri", arā, he ngongo, ki reira. Ka waiho tēnei "waikeri" ki tōna wāhi mō ētahi wiki tae noa ki te wā e ora ai. I roto i te "Endopyelotomy", kāore e hiahiatia he tapahi, ā, he māmā ake i ngā pokanga e rua atu. Heoi, he iti ake te auau angitu. I ētahi wā, me mahi pea tēnei neke atu i te kotahi.

Kia pēhea te tere o taku pai ake i muri i te maimoatanga?

Kei te maimoatanga i whiwhi koe mō tō Ārai UPJ. Ka ora te nuinga o te tangata i roto i ngā wiki e rua ki te whā. Heoi, he rerekē tō tinana, nō reira ka rerekē pea te roa o tō whakaoranga. Mā tō tākuta koe e hoatu te whakaaro pai rawa atu mō tēnei.

Ka taea te ārai i te aukati o te UPJ?

Kāore anō kia kitea e ngā kairangahau hauora he hononga i waenga i te kai me te matūkai i te wā e hapū ana me te whanaketanga o te Ārai UPJ i roto i te tamaiti i roto i te kōpū. Ko te tikanga o tēnei, kāore he mea e taea e tātou te mahi hei ārai i te Ārai UPJ i te whānautanga.

Heoi, mō ngā pakeke kāore i whānau mai me te UPJ Obstruction, mā te karo i ngā mea e whai ake nei ka āwhina pea ki te whakaiti i tēnei mōrearea:

• Te ārai i te hanganga o ngā kōhatu whatukuhu .
• Te tiaki i ngā mate urutā o te ara mimi (UTI) .
• Te karo i te whara ki ō whatukuhu .

He aha te tirohanga mō te āhuatanga `(UPJ Obstruction)`?

Ki te kitea wawetia, ā, ka rongoatia tika, he tino pai te tirohanga mō te UPJ Obstruction. Kāore te nuinga o ngā tamariki e pāngia e ngā raruraru roa. Waihoki, ki te kitea i mua i te whānautanga, ka taea te whakakore me te kore he maimoatanga.

Heoi, ki te kitea koe kei te pāngia koe e te UPJ Obstruction i muri mai i te oranga, he nui ake te tūponotanga ka pakaru tō whatukuhu. I ngā wā tino kino, ki te kore e rongoatia, ka taea e te UPJ Obstruction te arahi ki te ngoikore o te whatukuhu, tae atu ki te mate. Koia te mea he mea nui te tautuhi wawe me te maimoatanga.

Āhea koe me toro atu ki te tākuta?

Mena kei a koe, kei tō pēpi rānei ētahi o ēnei tohu, me toro atu ki te tākuta tonu:

• Mena he toto kei roto i te mimi (`(Hematuria)`) .
• Ki te mau ki tō ringa me te mea he pukupuku i roto i tō puku.
• Mena kei te mamae tō puku o runga, tō tuara rānei (`(Mamae taha)`) .
• Ki te mea he kirika tōu.
• Mena kua pōturi te tipu o te tamaiti ("(Te ngoikore o te tipu / te kore e tupu)") .

Āhea koe me haere ki te Wāhanga Maimoatanga Ohotata (ETU) ?

Ki te kore e taea e koe te mimi, haere tonu ki te rūma whawhati tata.Ehara tēnei i te mea hei whakaroa.

He aha ngā pātai me pātai atu koe ki te tākuta?

Ka taea e koe te pātai atu ki te tākuta i ngā pātai penei:

• Me pēhea te tautuhi i tēnei mate `(Ureteropelvic Junction Obstruction)`?
• Ki tō whakaaro ka ora ake te aukati UPJ o taku tamaiti me te kore he maimoatanga?
• He aha ngā kōwhiringa maimoatanga?
• Mena e tika ana te pokanga, he aha te tikanga e taunaki ana koe?
• He aha te tūponotanga ka hoki anō te aukati o te UPJ?

He aha te rerekētanga i waenga i te `(Ureteropelvic Junction Obstruction)` me te `(Ureterovesical Junction - UVJ) Obstruction`?

Ki te whakarāpopototanga, ka puta ngā aukati Ureteropelvic Junction (UPJ) me Ureterovesical Junction (UVJ) i ngā pito o tō urethra (ureter). Ko te UVJ te wāhi e hono ai tō ureter ki tō pūkahukahu. Ka puta he aukati UVJ i reira. Engari ka puta he aukati UPJ i te Renal Pelvis, te wāhi e hono ai te ureter ki tō whatukuhu.

Nā, he aha te karere e tika ana kia kawea e tātou ki te kāinga mai i ēnei mea katoa?

He mea noa te mataku ina rongo koe kei pāngia tō pēpi e tēnei raruraru, ahakoa i te wā e tirotirohia ana i a ia e noho ana i roto i te kōpū, i muri rānei i te whānautanga. Tērā pea ka hiahia koe ki te whakapae i a koe anō, me te whakaaro, 'I hē taku mahi? I taea e au te mahi i tētahi mea hei ārai i tēnei mea?' Engari i roto i te ao tūturu, ko tēnei āhuatanga e kiia nei ko te `(Ureteropelvic Junction Obstruction)` he mea ka puta noa i ētahi wā. Ahakoa ngā tākuta, kāore e taea te kī he aha te take.

Ko te mea nui ko te tokomaha o te tangata ka taea te ora mai i tēnei mate `(UPJ Obstruction)`. Nō reira, kaua e wehi ki te toro atu ki tētahi tākuta me te kōrero ki a ia. E mārama ana rātou ki ngā pātai me ngā wehi katoa kei roto i tō hinengaro. Ka āwhina rātou i a koe i ngā huarahi katoa e taea ana e rātou, ā, ka whakautua hoki ō pātai katoa. Ko te tautuhi wawe me te maimoatanga tika ngā mea tino nui i konei.

Ngā whatukuhu, te ara mimi, te aukati UPJ, te rongoā tamariki, te pūnaha mimi, te pokanga, te aukati hononga ureteropelvic