ꯌꯨꯔꯤꯅꯔꯤ ꯇ꯭ꯔꯦꯛꯇꯀꯤ ꯑꯁꯣꯛ-ꯑꯄꯟ ꯑꯃꯁꯨꯡ ꯔꯤꯀꯟꯁꯠꯔꯛꯁꯟ ꯁꯔꯖꯔꯤ (Posterior Urethral Reconstruction)

ꯅꯍꯥꯛꯅꯥ ꯑꯦꯛꯁꯤꯗꯦꯟꯇ ꯑꯃꯅꯥ ꯃꯔꯝ ꯑꯣꯏꯗꯨꯅꯥ ꯄꯦꯂꯚꯤꯛ ꯕꯣꯟ ꯑꯃꯥ (fractured pelvic bone) ꯁꯣꯀꯈꯤ ꯍꯥꯌꯅꯥ ꯈꯅꯕꯤꯌꯨ, ꯃꯁꯤ ꯕꯥꯏꯛ ꯑꯃꯗꯒꯤ ꯁꯣꯀꯄꯥ ꯌꯥꯏ ꯍꯥꯌꯅꯥ ꯈꯅꯕꯤꯌꯨ꯫ ꯅꯠꯠꯔꯒꯥ ꯅꯍꯥꯛꯅꯥ ꯄ꯭ꯔꯣꯁ꯭ꯇꯦꯠ ꯀꯦꯟꯁꯔꯒꯤ ꯂꯥꯏꯌꯦꯡ ꯆꯠꯊꯈ꯭ꯔꯦ꯫ ꯑꯁꯤꯒꯨꯝꯕꯥ ꯀꯦꯁꯁꯤꯡꯗꯗꯤ, ꯀꯔꯤꯒꯨꯝꯕꯥ ꯃꯇꯃꯗꯥ ꯅꯨꯄꯥꯁꯤꯡꯗꯥ ꯏꯎꯔꯦꯊ꯭ꯔꯥ (urethra) ꯁꯣꯟꯊꯕꯥ ꯅꯠꯠꯔꯒꯥ ꯁꯣꯟꯊꯕꯥ ꯌꯥꯏ꯫ ꯌꯨꯔꯤꯅꯔꯤꯗꯥ ꯑꯋꯥꯕꯥ ꯇꯥꯔꯀꯄꯥ ꯃꯇꯃꯗꯥ, ꯃꯗꯨ ꯕ꯭ꯂꯣꯛ ꯇꯧꯔꯀꯄꯥ ꯃꯇꯃꯗꯥ ꯊꯣꯀꯄꯥ ꯌꯥꯕꯥ ꯑꯅꯥꯕꯥ ꯑꯃꯁꯨꯡ ꯑꯁꯣꯛ-ꯑꯄꯟ ꯑꯗꯨ ꯁꯟꯗꯣꯛꯅꯥ ꯇꯥꯀꯄꯥ ꯉꯃꯗꯦ꯫ ꯉꯁꯤ ꯑꯩꯈꯣꯌꯅꯥ ꯑꯁꯤꯒꯨꯝꯕꯥ ꯃꯇꯝ ꯑꯁꯤꯗꯥ ꯗꯔꯀꯥꯔ ꯑꯣꯏꯕꯥ ꯌꯥꯝꯅꯥ ꯃꯔꯨꯑꯣꯏꯕꯥ ꯑꯃꯁꯨꯡ ꯑꯈꯟꯅꯕꯥ ꯁꯔꯖꯔꯤ ꯑꯃꯒꯤ ꯃꯇꯥꯡꯗꯥ ꯋꯥꯔꯤ ꯁꯥꯅꯔꯤ꯫

ꯌꯥꯝꯅꯥ ꯂꯥꯏꯅꯥ ꯍꯥꯌꯔꯕꯗꯥ, ꯄꯣꯁ꯭ꯇꯦꯔꯤꯌꯥꯜ ꯏꯎꯔꯦꯊ꯭ꯔꯥꯜ ꯔꯤꯀꯟꯁꯠꯔꯛꯁꯟ ꯍꯥꯌꯕꯁꯤ ꯀꯔꯤꯅꯣ?

ꯑꯣꯀꯦ, ꯃꯁꯤ ꯌꯥꯝꯅꯥ ꯂꯥꯏꯅꯥ ꯁꯟꯗꯣꯛꯅꯥ ꯇꯥꯀꯄꯗꯒꯤ ꯍꯧꯔꯁꯤ꯫ ꯅꯍꯥꯛꯀꯤ ꯕ꯭ꯂꯦꯗꯔꯗꯥ ꯈꯣꯃꯖꯤꯅꯕꯥ ꯌꯨꯔꯤꯟ ꯑꯁꯤ ꯏꯎꯔꯦꯊ꯭ꯔꯥ ꯀꯧꯕꯥ ꯇꯤꯎꯕ ꯑꯃꯒꯤ ꯈꯨꯠꯊꯥꯡꯗꯥ ꯅꯍꯥꯛꯀꯤ ꯂꯤꯅꯒꯤ ꯃꯄꯥꯟꯗꯥ ꯊꯣꯀꯏ꯫ ꯃꯁꯤ ꯏꯁꯤꯡꯒꯤ ꯇꯦꯉ꯭ꯛ ꯑꯃꯗꯒꯤ ꯄꯥꯏꯞ ꯑꯃꯥ ꯊꯣꯔꯀꯄꯒꯨꯝꯕꯅꯤ꯫

ꯃꯁꯤꯒꯤ ꯏꯎꯔꯦꯊ꯭ꯔꯥ ꯑꯁꯤꯁꯨ ꯁꯔꯨꯀꯁꯤꯡ ꯂꯩ꯫ ꯕ꯭ꯂꯦꯗꯔꯒꯥ ꯁꯝꯅꯕꯥ ꯑꯃꯁꯨꯡ ꯄ꯭ꯔꯣꯁ꯭ꯇꯦꯠ ꯒ꯭ꯜꯌꯥꯟꯗꯒꯤ ꯃꯔꯛꯇꯥ ꯆꯠꯄꯥ ꯆꯥꯎꯔꯥꯛꯅꯥ ꯏꯟꯆꯤ ꯑꯃꯗꯒꯤ ꯑꯅꯤ ꯐꯥꯎꯕꯥ ꯁꯥꯡꯕꯥ ꯁꯔꯨꯛ ꯑꯗꯨꯕꯨ ‘ꯄꯣꯁ꯭ꯇꯦꯔꯤꯌꯥꯜ ꯏꯎꯔꯦꯊ꯭ꯔꯥ’ ꯍꯥꯌꯅꯥ ꯀꯧꯏ꯫ ꯃꯁꯤ ꯏꯎꯔꯦꯊ꯭ꯔꯥꯒꯤ ꯍꯧꯔꯀꯐꯝꯅꯤ꯫

ꯄꯣꯁ꯭ꯇꯦꯔꯤꯌꯥꯜ ꯏꯎꯔꯦꯊ꯭ꯔꯥꯜ ꯔꯤꯀꯟꯁꯠꯔꯛꯁꯟ ꯍꯥꯌꯕꯁꯤ ꯄꯣꯁ꯭ꯇꯦꯔꯤꯌꯥꯜ ꯏꯎꯔꯦꯊ꯭ꯔꯥꯒꯤ ꯏꯟꯇꯤꯒ꯭ꯔꯤꯇꯤ ꯑꯗꯨ ꯑꯃꯥꯡ-ꯑꯇꯥ ꯊꯣꯀꯍꯅꯕꯥ, ꯀꯨꯄꯁꯤꯅꯕꯥ ꯅꯠꯠꯔꯒꯥ ꯁꯣꯀꯄꯥ (urethral stricture)ꯒꯤ ꯃꯇꯨꯡꯗꯥ ꯑꯃꯨꯛ ꯍꯟꯅꯥ ꯁꯦꯃꯒꯠꯄꯥ ꯁꯔꯖꯤꯀꯦꯜ ꯄ꯭ꯔꯣꯁꯤꯗ꯭ꯌꯨꯑꯣꯔ ꯑꯃꯅꯤ꯫ ꯃꯁꯤꯅꯥ ꯇꯥꯀꯄꯗꯤ ꯑꯁꯣꯀꯄꯥ ꯁꯔꯨꯛ ꯑꯗꯨ ꯔꯤꯄꯦꯌꯥꯔ ꯇꯧꯏ ꯑꯃꯁꯨꯡ ꯌꯨꯔꯤꯟ ꯐ꯭ꯂꯣ ꯑꯗꯨ ꯑꯁꯣꯛ-ꯑꯄꯟ ꯂꯩꯇꯅꯥ ꯑꯃꯨꯛ ꯍꯟꯅꯥ ꯁꯦꯃꯒꯠꯂꯀꯏ꯫

ꯀꯔꯤꯒꯤꯗꯃꯛꯇꯥ ꯁꯔꯖꯔꯤ ꯑꯁꯤ ꯃꯊꯧ ꯇꯥꯔꯤꯕꯅꯣ?

ꯁꯔꯖꯔꯤ ꯑꯁꯤ ꯇꯧꯕꯒꯤ ꯃꯔꯨꯑꯣꯏꯕꯥ ꯃꯔꯝ ꯑꯅꯤ ꯂꯩ꯫

1. ꯑꯦꯛꯁꯤꯗꯦꯟꯇꯅꯥ ꯊꯣꯀꯍꯅꯕꯥ ꯑꯁꯣꯛ-ꯑꯄꯅꯁꯤꯡ: ꯃꯔꯨꯑꯣꯏꯅꯥ ꯄꯦꯂꯚꯤꯛ ꯕꯣꯟ ꯁꯣꯀꯄꯥ ꯑꯆꯧꯕꯥ ꯑꯦꯛꯁꯤꯗꯦꯟꯇꯁꯤꯡ꯫ ꯑꯩꯈꯣꯌꯒꯤ ꯂꯩꯕꯥꯛ ꯑꯁꯤꯗꯥ ꯑꯁꯤꯒꯨꯝꯕꯥ ꯑꯁꯣꯛ-ꯑꯄꯟ ꯑꯁꯤ ꯃꯣꯇꯣꯔꯁꯥꯏꯀꯜ ꯑꯦꯛꯁꯤꯗꯦꯟꯇ, ꯑꯋꯥꯡꯕꯥ ꯃꯐꯃꯗꯒꯤ ꯂꯥꯞꯅꯥ ꯂꯩꯕꯥ, ꯑꯃꯁꯨꯡ ꯀ꯭ꯔꯣꯁꯇꯥ ꯑꯁꯣꯛ-ꯑꯄꯟ ꯊꯣꯀꯄꯅꯥ ꯃꯔꯝ ꯑꯣꯏꯗꯨꯅꯥ ꯌꯥꯝꯅꯥ ꯊꯦꯡꯅꯩ꯫ ꯑꯁꯤꯒꯨꯝꯕꯥ ꯑꯦꯛꯁꯤꯗꯦꯟꯇꯁꯤꯡꯗꯗꯤ, ꯏꯎꯔꯦꯊ꯭ꯔꯥꯒꯤ ꯁꯔꯨꯛ ꯑꯁꯤ ꯁꯣꯀꯄꯥ, ꯁꯣꯀꯄꯥ ꯑꯃꯁꯨꯡ ꯁꯣꯀꯄꯥ ꯌꯥꯏ꯫ ꯃꯇꯃꯒꯤ ꯃꯇꯨꯡꯏꯟꯅꯥ, ꯑꯀꯥꯌ-ꯑꯇꯣꯌꯁꯤꯡ ꯑꯁꯤꯅꯥ ꯏꯎꯔꯦꯊ꯭ꯔꯥ (urethra) ꯑꯗꯨ ꯀꯨꯄꯁꯤꯅꯕꯥ ꯑꯃꯁꯨꯡ ꯌꯨꯔꯤꯅꯔꯤ ꯇꯧꯕꯥ ꯉꯃꯍꯟꯗꯕꯥ ꯌꯥꯏ꯫

2. ꯄ꯭ꯔꯣꯁ꯭ꯇꯦꯠ ꯀꯦꯟꯁꯔꯒꯤ ꯂꯥꯏꯌꯦꯡ: ꯄ꯭ꯔꯣꯁ꯭ꯇꯦꯠ ꯒ꯭ꯜꯌꯥꯟꯗ ꯂꯧꯊꯣꯛꯅꯕꯥ ꯁꯔꯖꯔꯤ (ꯔꯦꯗꯤꯀꯦꯜ ꯄ꯭ꯔꯣꯁ꯭ꯇꯦꯇꯦꯛꯇꯣꯃꯤ) ꯅꯠꯠꯔꯒꯥ ꯔꯦꯗꯤꯑꯦꯁꯟ ꯊꯦꯔꯥꯄꯤꯒꯤ ꯃꯇꯨꯡꯗꯥ, ꯃꯔꯤ ꯂꯩꯅꯕꯥ ꯑꯁꯣꯛ-ꯑꯄꯅꯁꯤꯡꯅꯥ ꯃꯔꯝ ꯑꯣꯏꯗꯨꯅꯥ ꯏꯎꯔꯦꯊ꯭ꯔꯥ ꯑꯗꯨ ꯀꯨꯄꯁꯤꯅꯕꯥ ꯌꯥꯏ꯫

ꯏꯎꯔꯦꯊ꯭ꯔꯥ ꯑꯁꯤ ꯃꯑꯣꯡ ꯑꯁꯤꯅꯥ ꯀꯨꯄꯁꯤꯜꯂꯀꯄꯥ ꯃꯇꯃꯗꯥ, ꯌꯨꯔꯤꯅꯒꯤ ꯈꯣꯡꯖꯦꯜ ꯇꯞꯅꯥ ꯇꯞꯅꯥ ꯂꯥꯀꯄꯥ ꯌꯥꯏ, ꯌꯨꯔꯤꯟ ꯑꯁꯤ ꯑꯄꯤꯀꯄꯥ ꯊꯣꯡꯅꯥꯎꯁꯤꯡꯗꯥ ꯂꯤꯛ ꯑꯣꯏꯕꯥ ꯌꯥꯏ ꯅꯠꯠꯔꯒꯥ ꯃꯄꯨꯡꯐꯥꯅꯥ ꯊꯤꯡꯖꯤꯅꯕꯥ ꯐꯥꯎꯕꯥ ꯌꯥꯏ꯫ ꯃꯁꯤ ꯌꯥꯝꯅꯥ ꯅꯨꯡꯉꯥꯏꯇꯕꯥ ꯑꯃꯁꯨꯡ ꯈꯨꯗꯣꯡꯊꯤꯅꯤꯉꯥꯏ ꯑꯣꯏꯕꯥ ꯀꯟꯗꯤꯁꯟ ꯑꯃꯅꯤ꯫

ꯅꯍꯥꯛꯅꯥ ꯁꯔꯖꯔꯤ ꯑꯁꯤ ꯃꯊꯧ ꯇꯥꯕ꯭ꯔꯥ ꯍꯥꯌꯕꯗꯨ ꯗꯣꯛꯇꯔꯅꯥ ꯀꯔꯝꯅꯥ ꯂꯦꯄꯀꯅꯤ?

ꯀꯔꯤꯒꯨꯝꯕꯥ ꯅꯍꯥꯛꯅꯥ ꯂꯥꯏꯑꯣꯡꯁꯤꯡ ꯑꯁꯤ ꯂꯩꯔꯕꯗꯤ, ꯅꯍꯥꯛꯀꯤ ꯗꯣꯛꯇꯔꯅꯥ ꯇꯧꯒꯗꯕꯥ ꯑꯍꯥꯅꯕꯥ ꯊꯕꯛ ꯑꯗꯨꯗꯤ ꯑꯆꯨꯝꯕꯥ ꯀꯟꯗꯤꯁꯟ ꯑꯗꯨ ꯀꯅꯐꯥꯔꯝ ꯇꯧꯅꯕꯥ ꯇꯦꯁ꯭ꯠ ꯈꯔꯥ ꯇꯧꯕꯅꯤ꯫ ꯃꯁꯤ ꯇꯧꯅꯕꯒꯤꯗꯃꯛꯇꯥ ꯃꯈꯣꯌꯅꯥ ꯃꯈꯥꯗꯥ ꯄꯤꯔꯤꯕꯥ ꯇꯦꯁ꯭ꯇꯁꯤꯡ ꯑꯁꯤꯒꯤ ꯃꯅꯨꯡꯗꯥ ꯑꯃꯥ ꯅꯠꯠꯔꯒꯥ ꯑꯃꯗꯒꯤ ꯍꯦꯅꯕꯥ ꯄꯥꯡꯊꯣꯀꯄꯥ ꯌꯥꯏ:

• ꯔꯦꯠꯔꯣꯒ꯭ꯔꯦꯗ ꯏꯎꯔꯦꯊ꯭ꯔꯣꯒ꯭ꯔꯥꯝ: ꯃꯁꯤꯅꯥ ꯑꯈꯟꯅꯕꯥ ꯂꯤꯛꯌꯨꯏꯗ (ꯀꯟꯠꯔꯁ꯭ꯠ ꯗꯥꯏ) ꯑꯃꯥ ꯑꯃꯁꯨꯡ ꯑꯦꯛꯁ-ꯔꯦ ꯁꯤꯖꯤꯟꯅꯗꯨꯅꯥ ꯏꯎꯔꯦꯊ꯭ꯔꯥꯗꯥ ꯕ꯭ꯂꯣꯀꯦꯖ ꯑꯗꯨ ꯀꯗꯥꯏꯗꯥ ꯑꯃꯁꯨꯡ ꯀꯌꯥꯝ ꯁꯥꯡꯅꯥ ꯂꯩꯕꯒꯦ ꯍꯥꯌꯕꯗꯨ ꯈꯪꯗꯣꯀꯏ꯫ꯃꯁꯤꯕꯨ ꯑꯆꯨꯝꯕꯥ ꯃꯑꯣꯡꯗꯥ ꯌꯦꯡꯁꯤꯅꯕꯥ꯫
• ꯚꯣꯏꯗꯤꯡ ꯁꯤꯁ꯭ꯇꯣꯌꯨꯔꯦꯊ꯭ꯔꯣꯒ꯭ꯔꯥꯝ: ꯃꯁꯤꯅꯥ ꯕ꯭ꯂꯦꯗꯔꯗꯒꯤ ꯌꯨꯔꯤꯟ ꯑꯁꯤ ꯀꯔꯝꯅꯥ ꯊꯣꯛꯂꯀꯄꯒꯦ ꯍꯥꯌꯕꯗꯨ ꯌꯦꯡꯅꯕꯒꯤꯗꯃꯛ ꯀꯟꯠꯔꯁ꯭ꯠ ꯗꯥꯏ ꯑꯃꯁꯨ ꯁꯤꯖꯤꯟꯅꯩ꯫ ꯃꯁꯤꯅꯥ ꯕ꯭ꯂꯣꯀꯦꯖꯒꯤ ꯆꯥꯡ ꯑꯗꯨ ꯂꯦꯄꯊꯣꯀꯄꯗꯥ ꯃꯇꯦꯡ ꯄꯥꯡꯕꯥ ꯉꯃꯒꯅꯤ꯫
• ꯁꯤꯁ꯭ꯇꯣꯁ꯭ꯀꯣꯄꯤ: ꯃꯁꯤꯗꯥ, ꯏꯎꯔꯦꯊ꯭ꯔꯥ ꯑꯃꯁꯨꯡ ꯕ꯭ꯂꯦꯗꯔꯒꯤ ꯃꯅꯨꯡꯗꯥ ꯍꯀꯊꯦꯡꯅꯅꯥ ꯌꯦꯡꯁꯤꯟꯅꯕꯥ ꯀꯦꯃꯦꯔꯥꯅꯥ ꯁꯦꯝꯕꯥ ꯑꯄꯤꯀꯄꯥ ꯇꯤꯎꯕ (ꯁ꯭ꯀꯣꯞ) ꯑꯃꯥ ꯏꯎꯔꯦꯊ꯭ꯔꯥꯒꯤ ꯃꯈꯥꯗꯥ ꯄꯥꯁ ꯇꯧꯏ꯫
• MRI (ꯃꯦꯒ꯭ꯅꯦꯇꯤꯛ ꯔꯤꯖꯣꯅꯦꯟꯁ ꯏꯃꯦꯖꯤꯡ) ꯁ꯭ꯀꯦꯟ: ꯑꯈꯟꯅꯕꯥ ꯀꯦꯁ ꯈꯔꯗꯗꯤ, ꯀꯔꯤꯒꯨꯝꯕꯥ ꯍꯦꯟꯅꯥ ꯀꯨꯞꯄꯥ ꯏꯅꯐꯣꯔꯃꯦꯁꯟ ꯃꯊꯧ ꯇꯥꯔꯕꯗꯤ MRI ꯁ꯭ꯀꯦꯟ ꯑꯃꯥ ꯄꯥꯡꯊꯣꯀꯄꯥ ꯌꯥꯏ꯫

ꯁꯔꯖꯔꯤꯒꯤ ꯃꯃꯥꯡꯗꯥ ꯅꯍꯥꯛꯅꯥ ꯀꯔꯝꯅꯥ ꯁꯦꯝ-ꯁꯥꯒꯗꯒꯦ?

ꯁꯔꯖꯔꯤꯒꯤ ꯃꯃꯥꯡꯗꯥ ꯅꯍꯥꯛꯅꯥ ꯁꯦꯝ-ꯁꯥꯕꯁꯨ ꯃꯊꯧ ꯇꯥꯏ꯫ ꯈꯣꯡꯊꯥꯡꯁꯤꯡ ꯑꯁꯤ ꯆꯞ ꯆꯥꯅꯥ ꯏꯅꯕꯁꯤ ꯁꯔꯖꯔꯤꯒꯤ ꯃꯥꯌꯄꯥꯀꯄꯒꯤꯗꯃꯛ ꯌꯥꯝꯅꯥ ꯃꯔꯨꯑꯣꯏ꯫

ꯁꯔꯖꯔꯤ ꯑꯁꯤ ꯇꯁꯦꯡꯅꯥ ꯀꯔꯝꯅꯥ ꯊꯣꯀꯄꯒꯦ?

ꯃꯁꯤꯒꯤ ꯁꯔꯖꯔꯤ ꯑꯁꯤ ꯖꯦꯅꯦꯔꯦꯜ ꯑꯦꯅꯥꯁ꯭ꯇꯦꯁꯤꯌꯥꯒꯤ ꯃꯈꯥꯗꯥ ꯄꯥꯡꯊꯣꯀꯏ, ꯃꯁꯤꯅꯥ ꯇꯥꯀꯄꯗꯤ ꯅꯍꯥꯛꯅꯥ ꯀꯔꯤꯒꯨꯝꯕꯥ ꯑꯃꯠꯇꯥ ꯐꯥꯑꯣꯔꯣꯏ, ꯅꯍꯥꯛꯅꯥ ꯇꯨꯝꯕꯥ ꯌꯥꯔꯣꯏ꯫

ꯁꯔꯖꯔꯤꯁꯤꯡꯅꯥ ꯁꯤꯖꯤꯟꯅꯔꯤꯕꯥ ꯈ꯭ꯕꯥꯏꯗꯒꯤ ꯀꯃꯟ ꯑꯣꯏꯕꯥ ꯊꯧꯑꯣꯡ ꯑꯁꯤ ꯑꯦꯅꯥꯁ꯭ꯇꯣꯃꯣꯇꯤꯛ ꯏꯎꯔꯦꯊ꯭ꯔꯣꯞꯂꯥꯁ꯭ꯇꯤ ꯍꯥꯌꯅꯥ ꯀꯧꯏ . ꯃꯁꯤ ꯌꯥꯝꯅꯥ ꯏꯆꯝ ꯆꯝꯕꯥ ꯊꯧꯑꯣꯡ ꯑꯃꯅꯤ꯫

ꯏꯎꯔꯦꯊ꯭ꯔꯥꯒꯤ ꯑꯁꯣꯀꯄꯥ, ꯁꯣꯀꯄꯥ ꯅꯠꯠꯔꯒꯥ ꯀꯨꯄꯁꯤꯜꯂꯕꯥ ꯁꯔꯨꯛ ꯑꯗꯨ ꯀꯀꯊꯠꯇꯨꯅꯥ ꯂꯧꯊꯣꯀꯏ, ꯑꯃꯁꯨꯡ ꯍꯀꯁꯦꯜ ꯐꯕꯥ ꯃꯊꯛ ꯑꯅꯤꯗꯨ ꯑꯃꯨꯛ ꯍꯟꯅꯥ ꯁꯦꯃꯖꯤꯜꯂꯤ꯫ ꯃꯁꯤ ꯆꯦꯟꯊꯔꯀꯄꯥ ꯄꯥꯏꯄꯀꯤ ꯁꯔꯨꯛ ꯑꯃꯥ ꯂꯧꯊꯣꯛꯇꯨꯅꯥ ꯂꯦꯃꯍꯧꯔꯤꯕꯥ ꯑꯐꯕꯥ ꯄꯣꯠꯁꯛ ꯑꯅꯤ ꯑꯗꯨ ꯑꯃꯨꯛ ꯍꯟꯅꯥ ꯁꯝꯅꯍꯅꯕꯒꯥ ꯃꯥꯟꯅꯩ꯫

ꯑꯗꯨꯕꯨ, ꯈꯅꯕꯤꯌꯨ ꯃꯗꯨꯗꯤ ꯁ꯭ꯀꯥꯔ ꯇꯤꯁ꯭ꯌꯨ ꯑꯗꯨ ꯂꯧꯊꯣꯛꯂꯕꯥ ꯃꯇꯨꯡꯗꯥ, ꯂꯦꯃꯍꯧꯔꯤꯕꯥ ꯍꯀꯆꯥꯡ ꯐꯅꯥ ꯂꯩꯕꯥ ꯃꯐꯝ ꯑꯅꯤꯒꯤ ꯃꯔꯛꯇꯥ ꯂꯩꯕꯥ ꯑꯔꯥꯞꯄꯥ ꯑꯗꯨ ꯈꯔꯥ ꯍꯦꯟꯅꯥ ꯆꯥꯎꯏ, ꯃꯔꯝ ꯑꯗꯨꯅꯥ ꯃꯈꯣꯌꯕꯨ ꯄꯨꯟꯅꯥ ꯁꯦꯃꯖꯤꯅꯕꯗꯥ ꯑꯋꯥꯕꯥ ꯑꯣꯏꯍꯜꯂꯤ꯫ ꯀꯔꯤꯒꯨꯝꯕꯥ ꯃꯗꯨ ꯑꯣꯏꯔꯕꯗꯤ ꯅꯍꯥꯛꯅꯥ ꯀꯔꯤ ꯇꯧꯒꯅꯤ?

ꯁꯔꯖꯔꯤꯒꯤ ꯃꯇꯨꯡꯗꯥ ꯀꯔꯤ ꯊꯣꯀꯏ ꯑꯃꯁꯨꯡ ꯀꯔꯤ ꯔꯤꯁ꯭ꯀꯁꯤꯡ ꯂꯩꯕꯒꯦ?

ꯁꯔꯖꯔꯤꯒꯤ ꯃꯇꯨꯡꯗꯥ ꯑꯗꯣꯝꯕꯨ ꯍꯣꯁ꯭ꯄꯤꯇꯥꯂꯗꯥ ꯆꯥꯎꯔꯥꯛꯅꯥ ꯄꯨꯡ ꯲꯴ ꯃꯣꯅꯤꯇꯔ ꯇꯧꯒꯅꯤ꯫ ꯑꯄꯤꯀꯄꯥ, ꯇꯔꯨ-ꯇꯅꯥꯅꯕꯥ ꯀꯦꯇꯦꯒꯣꯔꯤ ꯑꯃꯥ ꯅꯍꯥꯛꯀꯤ ꯂꯤꯅꯒꯤ ꯈꯨꯠꯊꯥꯡꯗꯥ ꯅꯍꯥꯛꯀꯤ ꯕ꯭ꯂꯦꯗꯔꯗꯥ ꯆꯦꯟꯊꯈꯤꯒꯅꯤ, ꯃꯗꯨ ꯇꯞꯅꯥ ꯇꯞꯅꯥ ꯅꯨꯃꯤꯠ 3-4ꯅꯤ ꯆꯪꯒꯅꯤ꯫ ꯃꯁꯤ ꯈꯔꯥ ꯅꯨꯡꯉꯥꯏꯇꯕꯥ ꯑꯃꯅꯤ, ꯑꯗꯨꯕꯨ ꯔꯤꯄꯦꯌꯥꯔ ꯑꯗꯨ ꯃꯑꯣꯡ ꯆꯨꯝꯅꯥ ꯐꯒꯠꯍꯟꯅꯕꯒꯤꯗꯃꯛꯇꯥ ꯌꯥꯝꯅꯥ ꯃꯔꯨꯑꯣꯏ꯫ ꯅꯨꯃꯤꯠ 3-4ꯅꯤꯒꯤ ꯃꯇꯨꯡꯗꯥ, ꯔꯤꯄꯦꯌꯥꯔ ꯑꯗꯨ ꯐꯒꯠꯂꯕ꯭ꯔꯥ ꯍꯥꯌꯕꯗꯨ ꯌꯦꯡꯁꯤꯟꯅꯕꯥ ꯑꯦꯛꯁ-ꯔꯦ ꯂꯧꯒꯅꯤ, ꯑꯃꯁꯨꯡ ꯀꯦꯇꯦꯒꯣꯔꯤ ꯑꯗꯨ ꯂꯧꯊꯣꯛꯀꯅꯤ꯫

ꯁꯔꯖꯔꯤ ꯑꯃꯍꯦꯛꯇꯒꯨꯝꯅꯥ, ꯃꯁꯤꯒꯤꯁꯨ ꯑꯄꯤꯀꯄꯥ ꯔꯤꯁ꯭ꯛ ꯈꯔꯥ ꯂꯩ꯫

• ꯏ ꯊꯣꯀꯄꯥ꯫
• ꯏꯅꯐꯦꯛꯁꯅꯁꯤꯡ ꯂꯩꯕꯥ꯫
• ꯔꯤꯀꯣꯔꯗ ꯑꯣꯏꯕꯥ ꯁ꯭ꯠꯔꯤꯛꯆꯔ꯫

ꯌꯨꯔꯤꯅꯔꯤ ꯏꯅꯀꯟꯇꯤꯅꯦꯟꯁ ꯑꯁꯤ ꯔꯤꯁ꯭ꯛ ꯑꯃꯅꯤ ꯑꯃꯁꯨꯡ ꯀꯔꯤꯒꯨꯝꯕꯥ ꯁꯔꯖꯔꯤ ꯇꯧꯔꯕꯗꯤ ꯌꯥꯝꯅꯥ ꯅꯦꯝꯃꯤ꯫ ꯑꯗꯨꯝ ꯑꯣꯏꯅꯃꯛ, ꯀꯔꯤꯒꯨꯝꯕꯥ ꯀꯦꯟꯁꯔ ꯂꯥꯌꯦꯡꯂꯕꯥ ꯃꯇꯨꯡꯗꯥ ꯁꯔꯖꯔꯤ ꯇꯧꯔꯕꯗꯤ ꯔꯤꯁ꯭ꯛ ꯑꯁꯤ ꯈꯔꯥ ꯍꯦꯅꯒꯠꯂꯀꯄꯥ ꯌꯥꯏ꯫

ꯑꯇꯣꯞꯄꯥ ꯃꯔꯨꯑꯣꯏꯕꯥ ꯋꯥꯐꯝ ꯑꯃꯗꯤ ꯏꯔꯦꯛꯇꯥꯏꯜ ꯗꯤꯁꯐꯉ꯭ꯀꯁꯟ (ED) . ꯅꯨꯄꯥ ꯈꯔꯗꯤ ꯁꯔꯖꯔꯤ ꯑꯁꯤꯒꯤ ꯃꯃꯥꯡꯗꯥ, ꯄꯦꯂꯚꯤꯛ ꯐ꯭ꯔꯦꯀꯆꯔ ꯅꯠꯠꯔꯒꯥ ꯀꯦꯟꯁꯔ ꯂꯥꯌꯦꯡꯂꯕꯥ ꯃꯇꯨꯡꯗꯥ ꯀꯟꯗꯤꯁꯟ ꯑꯁꯤ ꯂꯩꯔꯝꯕꯥ ꯌꯥꯏ꯫ ꯃꯁꯤꯒꯤ ꯁꯔꯖꯔꯤ ꯑꯁꯤꯅꯥ ꯏ.ꯗꯤ. ꯃꯁꯤ ꯇꯨꯡꯗꯥ ꯑꯇꯣꯞꯄꯥ ꯂꯥꯏꯌꯦꯡꯁꯤꯡ ꯃꯊꯧ ꯇꯥꯕꯥ ꯌꯥꯏ꯫ ꯃꯁꯤꯒꯤ ꯃꯇꯥꯡꯗꯥ ꯅꯍꯥꯛꯀꯤ ꯗꯣꯛꯇꯔꯒꯥ ꯑꯃꯨꯛꯇꯪ ꯋꯥꯔꯤ ꯁꯥꯕꯤꯌꯨ꯫

ꯁꯔꯖꯔꯤ ꯃꯥꯌꯄꯥꯀꯄꯥ ꯑꯃꯁꯨꯡ ꯐꯒꯠꯂꯀꯄꯥ꯫

ꯃꯁꯤ ꯈ꯭ꯕꯥꯏꯗꯒꯤ ꯐꯕꯥ ꯄꯥꯎꯅꯤ꯫ ꯃꯁꯤꯒꯤ ꯁꯔꯖꯔꯤ ꯑꯁꯤ ꯌꯥꯝꯅꯥ ꯋꯥꯡꯕꯥ ꯃꯥꯌ ꯄꯥꯀꯄꯒꯤ ꯆꯥꯡ ꯑꯃꯥ ꯑꯣꯏꯈꯤ꯫ꯃꯁꯤ ꯃꯔꯨꯑꯣꯏꯅꯥ ꯑꯦꯛꯁꯄꯔꯤꯌꯦꯟꯁ ꯂꯩꯕꯥ ꯁꯔꯖꯔꯤ ꯑꯃꯅꯥ ꯄꯥꯡꯊꯣꯀꯄꯥ ꯃꯇꯃꯗꯥ ꯌꯥꯝꯅꯥ ꯐꯕꯥ ꯐꯜ ꯂꯩꯕꯥ ꯁꯔꯖꯔꯤ ꯑꯃꯅꯤ꯫

• ꯑꯦꯛꯁꯤꯗꯦꯟꯇ ꯑꯃꯗꯥ ꯁꯣꯀꯍꯜꯂꯕꯥ ꯑꯁꯣꯛ-ꯑꯄꯅꯁꯤꯡꯒꯤ ꯁꯔꯖꯔꯤꯒꯤ ꯃꯥꯌ ꯄꯥꯀꯄꯒꯤ ꯆꯥꯡ ꯑꯁꯤ ꯹꯲% - ꯹꯷% ꯒꯤ ꯃꯔꯛꯇꯥ ꯂꯩ꯫
• ꯀꯦꯟꯁꯔ ꯂꯥꯌꯦꯡꯂꯕꯥ ꯃꯇꯨꯡꯗꯥ ꯁꯔꯖꯔꯤꯒꯤ ꯃꯥꯌ ꯄꯥꯀꯄꯒꯤ ꯆꯥꯡ ꯑꯁꯤ ꯷꯰% - ꯸꯵% ꯒꯤ ꯃꯔꯛꯇꯥ ꯂꯩ .

ꯅꯣꯔꯃꯦꯜ ꯂꯥꯏꯐꯇꯥ ꯍꯜꯂꯀꯄꯥ...

• ꯗ꯭ꯔꯥꯏꯚꯤꯡ: ꯀꯔꯤꯒꯨꯝꯕꯥ ꯅꯍꯥꯛꯅꯥ ꯄꯦꯅꯀꯤꯂꯔꯁꯤꯡ ꯁꯤꯖꯤꯟꯅꯗꯕꯥ ꯑꯣꯏꯔꯕꯗꯤ ꯑꯃꯁꯨꯡ ꯀꯦꯇꯦꯒꯣꯔꯤꯒꯤ ꯇꯤꯎꯕ ꯑꯗꯨ ꯂꯧꯊꯣꯛꯂꯕꯥ ꯃꯇꯨꯡꯗꯥ ꯅꯍꯥꯛꯅꯥ ꯗ꯭ꯔꯥꯏꯚꯤꯡ ꯇꯧꯕꯥ ꯍꯧꯕꯥ ꯌꯥꯏ꯫
• ꯊꯕꯛꯇꯥ ꯍꯜꯂꯀꯄꯥ: ꯃꯤꯑꯣꯏ ꯑꯌꯥꯝꯕꯅꯥ ꯀꯦꯇꯦꯒꯣꯔꯤ ꯑꯗꯨ ꯂꯧꯊꯣꯛꯂꯕꯥ ꯃꯇꯨꯡꯗꯥ ꯊꯕꯛꯇꯥ ꯍꯜꯂꯀꯏ, ꯑꯗꯨꯕꯨ ꯅꯨꯃꯤꯠ 6-8ꯅꯤꯒꯤ ꯑꯣꯏꯅꯥ ꯂꯥꯏꯠ ꯗ꯭ꯌꯨꯇꯤ ꯑꯣꯏꯕꯥ ꯊꯕꯛ ꯈꯛꯇꯃꯛ ꯔꯦꯀꯃꯦꯟꯗ ꯇꯧꯏ .
• ꯑꯦꯛꯁꯔꯁꯥꯏꯖ ꯇꯧꯕꯥ: ꯁꯔꯖꯔꯤꯒꯤ ꯃꯇꯨꯡꯗꯥ ꯈꯣꯡꯅꯥ ꯆꯠꯄꯥ ꯑꯁꯤ ꯐꯩ, ꯑꯗꯨꯕꯨ ꯅꯨꯃꯤꯠ 6-8ꯅꯤ ꯐꯥꯎꯕꯥ ꯑꯔꯨꯝꯕꯥ ꯂꯧꯊꯣꯀꯄꯥ ꯅꯠꯠꯔꯒꯥ ꯒꯜꯐ ꯁꯥꯟꯅꯕꯒꯨꯝꯕꯥ ꯑꯀꯅꯕꯥ ꯊꯕꯛ ꯊꯧꯔꯃꯁꯤꯡ ꯇꯧꯔꯣꯏꯗꯕꯅꯤ .
• ꯁꯦꯛꯁꯨꯑꯦꯜ ꯑꯦꯛꯇꯤꯚꯤꯇꯤ: ꯅꯍꯥꯛꯅꯥ ꯁꯔꯖꯔꯤꯒꯤ ꯃꯇꯨꯡꯗꯥ ꯅꯨꯃꯤꯠ 8ꯅꯤꯒꯤ ꯃꯇꯨꯡꯗꯥ ꯁꯦꯛꯁꯨꯑꯦꯜ ꯑꯦꯛꯇꯤꯚꯤꯇꯤ ꯑꯃꯨꯛ ꯍꯟꯅꯥ ꯍꯧꯕꯥ ꯌꯥꯏ꯫