Ngaba nawe unengxaki yokuchama kakuhle? Masifunde ngeNon-Neurogenic Voiding Dysfunction!

Ngaba ngamanye amaxesha uziva ngathi unengxaki yokuchama ? Okanye uziva ngathi isinyi sakho asikaphumi ngokupheleleyo emva kokuba ugqibile ukuchama ? Mhlawumbi ude uvuza umchamo ngokungalindelekanga. Oku akuyongxaki kuwe kuphela, kodwa nakubantu abaninzi. Namhlanje, siza kuthetha ngokungakwazi ukuzibamba komchamo okungabangelwa ziingxaki zemithambo-luvo . Ngokwezonyango, oku sikubiza ngokuba yi-"Non-Neurogenic Voiding Dysfunction".

Yintoni i-Non-Neurogenic Voiding Dysfunction?

Ngamafutshane, le yimeko apho ungakwazi ukukhupha yonke into kwisinyi sakho. Igama elithi "non-neurogenic" apha lithetha ukuba le meko ayibangelwa ziingxaki zenkqubo yakho yemithambo-luvo, oko kukuthi, ingqondo yakho, umqolo, okanye imithambo-luvo. "Ukungasebenzi kakuhle kwemithambo-luvo" kuthetha ukuba inkqubo yokuchama ayenzeki kakuhle.

Le meko inokwenzeka nakubani na. Ngokuqhelekileyo, oku kubangelwa kubuthathaka kwemisipha yesinyi, ukuvaleka kwenye indawo kwinkqubo yomchamo, okanye imikhwa emibi ebesiqhelene nayo ixesha elide. Nangona kunjalo, le meko ixhaphake kakhulu kubantwana abancinci abaye baqeqeshwa kwindlu yangasese abaneminyaka ephakathi kwemi-4 neyi-6 kunye nabasetyhini abaneminyaka engaphezu kwama-40. Khawuthelekelele, malunga nomnye kubantwana abahlanu abaneminyaka ephakathi kwemi-4 neyi-6 kufuneka bachame emini ngenxa yale `(ukungasebenzi kakuhle kwe-neurogenic voiding)`. Kwakhona, ngaphezulu kwe-6% yabasetyhini abaneminyaka engaphezu kwama-40 banale meko.

Zithini iimpawu zale meko? (Iimpawu zokungasebenzi kakuhle kwe-Non-Neurogenic Voiding Dysfunction)

Jonga ukuba unayo na enye yezi mpawu:

• Ngaba kunzima ukuqala ukuchama ? Okanye kufuneka uzibhokoxe xa uchama ?
• Ingaba indlela yomchamo incinci kakhulu? Okanye indlela yomchamo iqala, ime okwethutyana, ize iphinde iqale kwakhona?
• Ngaba kufuneka uqinise izihlunu zesisu sakho xa uchama ? Okanye kufuneka ubambe isisu sakho esisezantsi ngezandla zombini?
• Ngaba uvakalelwa kukuba isinyi sakho asikaphumi nasemva kokuba ugqibile ukuchama ?
• Ngaba unesifo sokuqhinwa ? (Oku kudla ngokunxulumene)
• Ingaba uchama kakhulu kunesiqhelo (uchama rhoqo) okanye ngaphantsi?
• Ingaba ngempazamo uvuza umchamo (ukungakwazi ukuzibamba komchamo)?
• Ngaba ngequbuliso uziva ufuna ukuchama ngokukhawuleza (ukucela ukuba ungachithi)?
• Ukuchama ngaphezu kwesihlandlo esinye ebusuku ngelixa uleleNgaba kufuneka uvuke ukuze uyenze loo nto (i-nocturia)?

Iimpawu ezikhethekileyo abanokuba nazo abantwana abancinci:

Ukuba abantwana abancinci banale meko, banokubonisa izinto ezifana nezi:

• Ukumanzisa impahla yakho emini (nasemva koqeqesho lokuya ngasese).
• Kukho izinto ezahlukeneyo ezinokwenziwa ukugcina umchamo . Umzekelo:
• Imilenze yam inqamleziwe.
• Ukuquleka phantsi ngelixa uhleli.
• Babambe imilenze yabo kunye, nokuba ngezandla zabo okanye ngezithende zabo.

Ukuba ubona umntwana wakho esenza ezi zinto, kufuneka ukhathazeke kancinci.

Yintoni ebangela oku? (Izizathu zokungasebenzi kakuhle kwe-Non-Neurogenic Voiding)

Kukho izizathu ezininzi eziphambili zale meko:

• Ubuthathaka bemisipha yesinyi.
• Kukho ukuvaleka kwenye indawo kwinkqubo yakho yomchamo.
• Isinyi esisebenza kakhulu (isinyi esisebenza kakhulu).
• Isinyi asisebenzi kakuhle, nto leyo ethetha ukuba akukho mvakalelo yokuba kufuneka uchame ("isinyi esingasebenzi kakuhle").
• Ukuqhinwa (esi sisizathu esibaluleke kakhulu).
• Iintsholongwane zoMchamo (UTIs).
• Nangona kufuneka uchame , awuyinaki uze ulinde de isinyi sakho sigcwale ngaphambi kokuba uchame kamva.
• Kumadoda, yi-prostate gland ekhulisiweyo (i-Benign Prostatic Hyperplasia - BPH).
• Umhlaza weprostate.

Kubantwana abancinci, oku kunokubangelwa yimeko ebizwa ngokuba yi-"dysfunctional elimination syndrome," apho izihlunu kunye nemithambo-luvo kwisinyi zingasebenzi kakuhle.

Ziziphi iingxaki ezinokubakho ngenxa yale meko?

Xa isinyi sakho singaphumi ngokupheleleyo, iintsholongwane ezikumchamo oseleyo zinokubangela usulelo. Umzekelo, usulelo lwendlela yomchamo (UTIs). Usesichengeni sokuba namatye ezintso okanye amatye esinyi. Ngamanye amaxesha, ukuba le ngxaki iba mandundu, inokubangela nomonakalo wezintso.

Eyona nto ibalulekileyo kukuba ukuba nengxaki ethile yokuchama kunokukuchaphazela ngengqondo. Abantu abaninzi baziva beneentloni kwaye bexhalabile kuba bengakwazi ukulawula umchamo wabo. Usenokucinga, "Ngaba ndingumthwalo kwabanye?" Ukuba kufuneka uyeke imisebenzi yakho yemihla ngemihla ngezi mpawu ngalo lonke ixesha. Ukuba uhlala kude noluntu ngenxa yoku, unokujongana neemeko ezinzima ezifana nokuxhalaba kunye nokudakumba.

Oogqirha bafumanisa njani ukungasebenzi kakuhle kwe-voiding okungekuko okwe-neurogenic?

Ugqirha angaxilonga ukungasebenzi kakuhle kwe-voiding ngaphandle kwe-neurogenic ngokubuza ngembali yakho yezonyango aze enze uvavanyo lomzimba. Angenza novavanyo lwe-pelvic kubafazi okanye uvavanyo lwe-digital rectal kumadoda.

Ukongeza, ugqirha wakho angakucela ukuba ugcine "idayari yesinyi." Kuyo, uya kubhala phantsi:

• Usela amanzi angakanani ngosuku?
• Uchama nini?
• Uchitha umchamo ongakanani ngexesha?
• Umchamo uvuza nini kwaye njani ngengozi?

Ngolu lwazi, ugqirha angenza nezinye iimvavanyo ezininzi ukuqinisekisa ukuxilongwa.

Zeziphi iimvavanyo ezenziwayo?

Ugqirha angenza olunye okanye ngaphezulu kwezi vavanyo:

• Uvavanyo lwe-Prostate-specific antigen (PSA): Olu luvavanyo lwegazi. Lukhangela amanqanaba aphezulu e-PSA. Ukuba amanqanaba e-PSA aphezulu, kunokubakho ingxaki kwi-prostate gland.
• Uhlalutyo lomchamo: Oku kunokunceda ekuqinisekiseni ukuba une-urinary tract infection (UTI).
• I-ultrasound scan: Oku kujonga ukuba ingakanani na imichamo eseleyo kwisinyi sakho emva kokuba uchamile . Kungajonga nokuba imeko ichaphazele izintso zakho na.
• Uvavanyo lwe-Urodynamic: Olu vavanyo lulinganisa ukuba ingakanani imichamo enokubanjwa sisinyi sakho kunye nokuba izihlunu zesinyi sakho, i-urethra, kunye nomgangatho we-pelvic zisebenza kakuhle kangakanani.
• I-Cystoscopy: Kolu vavanyo, ugqirha ufaka isixhobo eside, esincinci (esinekhamera eqhotyoshelweyo) kwi-urethra yakho ukujonga iingxaki kwi-urethra yakho nakwi-bladder.

Kubantwana abancinci, olu vavanyo alunazo iingxaki ezininzi. Ugqirha angakucela ukuba ugcine idayari yomchamo, kwaye unokucebisa kuphela uvavanyo lwegazi, uvavanyo lomchamo, i-ultrasound, kunye novavanyo oluthile lwe-urodynamic.

Inyangwa njani le nto? (Inyangwa njani?)

Unyango lwale meko (Ukungasebenzi kakuhle kwe-neurogenic voiding dysfunction) luyahluka ngokuxhomekeke kwisizathu. Unyango lungabandakanya:

1. Uqeqesho lwesinyi

Ungaziqeqesha izihlunu zesinyi sakho ukuba zibambe umchamo ixesha elide. Oku kuthetha ukuba kufuneka uye kwindlu yangasese ngamaxesha aqhelekileyo imini yonke, nokuba awuziva ngathi kufuneka uye . Oku kunokunceda ekuthinteleni isinyi sakho ukuba singaphuphumi. Ingcali yezonyango egxile kwiingxaki zomgangatho we-pelvic inokukunceda ngale nto.

2. Ukuzilolonga kwemisipha yomgangatho wePelvic (Unyango lomgangatho wePelvic)

Ingcali yezonyango eqeqeshwe ngokukodwa ingakufundisa indlela yokuphumza izihlunu zakho zomgangatho we-pelvic ukuze ukwazi ukuchama ngokulula. Banokubeka "ii-biofeedback sensors" kwilungu lakho lobufazi okanye i-rectum ukuqinisekisa ukuba uzilolonga kakuhle izihlunu.

Baza kukufundisa nokuzilolonga ngeKegel ukuqinisa izihlunu zakho zomgangatho we-pelvic. Izihlunu zomgangatho we-pelvic ezomeleleyo zinceda ukuthintela ukungakwazi ukuzibamba komchamo kunye nokukhuthaza ukungakwazi ukuzibamba.

3. Amayeza

Kukho amayeza anokunceda ukuphucula iingxaki zomchamo. Imizekelo:

• Ii-Alpha-blockers, umzekelo i-tamsulosin (iFlomax®).
• Ii-antispasmodics zomchamo, ezifana ne-oxybutynin (Ditropan®) kunye ne-tolterodine (Detrol®).

4. Ityhefu yeBotulinum

Ugqirha wakho angakufaka i-botulinum toxin (Botox®) kwisinyi sakho. Oku kukhulula izihlunu zesinyi kwaye kunciphisa ukungakwazi ukuzibamba.

5. Ukuvuselelwa kwemithambo-luvo ye-Percutaneous tibial (PTNS)

Ngamanye amaxesha, kufuneka unike imithambo-luvo yakho "ukhuthazo" oluncinci ukuze uvuselele izihlunu zesinyi sakho. Kwi-PTNS, ugqirha wakho ubeka i-electrode kufutshane nemithambo-luvo yakho ye-tibial eqatheni lakho. Emva koko, bathumela imiqondiso yombane ethambileyo kwi-electrode. Oku kuvuselela imithambo-luvo ye-tibial, ethi emva koko ihambe iye kwimithambo-luvo ye-sacral kwi-pelvis yakho. Oku kuyayekisa imiqondiso engaqhelekanga evela kwimithambo-luvo ye-sacral ukuya kwi-sphincter yomchamo, isinyi, kunye nemisipha yomgangatho we-pelvic, okukunceda ukuba uphinde ulawule isinyi.

6. Ukuvuselelwa kwemithambo-luvo yeSacral

Kule nkqubo, ugqirha wakho uza kubeka ii-electrode phantsi kwesikhumba ngaphezulu nje kweempundu zakho. Ezi electrode zithumela imiqondiso yombane ethambileyo kwi-sacral nerve ngentambo encinci (probe) engena phantsi kwesikhumba. Ezi miqondiso zivuselela izihlunu zesinyi sakho ukuba zinciphe.

7. Ukuzicoca nge-catheterization

Ungafaka i-catheter yomchamo kwisinyi sakho ngamaxesha athile uze uqokelele umchamo wakho ebhegini. Ugqirha wakho uza kukubonisa indlela yokwenza oku (ukuzilungisa ngokwakho).

8. Utyando

Ukuba ezinye iindlela zonyango azisebenzi, ugqirha wakho unokucebisa utyando lokwandisa isinyi (cystoplasty). Olu tyando lwenza isinyi sakho sibe sikhulu ukuze sikwazi ukugcina umchamo omninzi.Ndiyakwazi ukujongana nezinto ezininzi.

Ziziphi iindlela zokuqala zonyango lwe-non-neurogenic overactive bladder?

Ezi zilandelayo zihlala ziyindlela yokuqala yonyango lwesi sifo:

• Ukunciphisa ukutya neziselo eziyingozi kwisinyi (iti, ikofu, utywala, ukutya okuneziqholo okanye okune-asidi).
• Uqeqesho lwesinyi.

Ukuba olu tshintsho lokuziphatha aluncedi, oogqirha banokunika amayeza anjengala, kuxhomekeke kuhlobo lokungasebenzi kakuhle kwe-voiding okungengokwasemzimbeni:

• I-Anticholinergics
• I-Alpha-blockers
• Ii-agonists ze-Beta 3 receptor

Iphathwa njani le meko kubantwana abancinci?

Ii-Alpha-blockers kunye namayeza e-anticholinergic anokunceda ekunyangeni isinyi esisebenza kakhulu kubantwana abancinci. Abanye abantwana banokufundiswa ukwenza umthambo womgangatho we-pelvic.

Ugqirha angacebisa noqeqesho lwesinyi. Umzekelo, ukukhuthaza umntwana ukuba aye kwindlu yangasese ngamaxesha amiselweyo nokumfundisa ukuma kakuhle kwindlu yangasese.

Ndiza kuziva bhetele nini emva konyango?

Iyahluka ngokuxhomekeke kunyango. Uqeqesho lwesinyi kunye noqheliso lomgangatho we-pelvic lunokuqala ukusebenza kwiiveki okanye kwiinyanga ezimbalwa. Ukuvuselelwa kwemithambo-luvo kudla ngokuqala ukusebenza kwiiveki ezimbalwa. Amayeza kufuneka aqale ukusebenza kwiintsuku okanye kwiiveki ezimbalwa. Ugqirha wakho uza kukunika umbono olungileyo ngale nto.

Ndifanele ndimbone nini ugqirha?

Thetha nogqirha kwangoko nje ukuba uqaphela ezi ngxaki ngokuya kwindlu yangasese:

• Ukungakwazi ukuchama ixesha elide.
• Utshintsho kumchamo wakho: Umzekelo, ivumba elibi, umbala omnyama, okanye igazi kumchamo (i-hematuria).
• Intlungu xa uchama (i-dysuria).
• Iimpawu ezingapheliyo zokuqunjelwa.
• Iimpawu zosulelo: umkhuhlane, ukubanda, intloko ebuhlungu.

Xa ubona ugqirha, ungabuza le mibuzo:

• Wazi njani ukuba `ndine-(Non-neurogenic voiding dysfunction)`?
• Yintoni unobangela wemeko yam?
• Loluphi unyango olundicebisayo?
• Zithini iziphumo ebezingalindelekanga zolo nyango?
• Kuza kuthatha ixesha elingakanani ukubona iziphumo zolo nyango?
• Zeziphi iinguqu kwindlela yokuphila ozicebisayo ukunciphisa iimpawu zam?
• Zeziphi iingxaki ekufuneka ndiziqaphele?
• Ngaba kufuneka ndidibane nogqirha wezifo zomchamo?

Ngaba oku kungathintelwa?

Unokunceda ekuthinteleni le meko (ukungasebenzi kakuhle kwe-neurogenic voiding dysfunction) ngokwenza utshintsho kwindlela ophila ngayo kunye nokutya kwakho. Oku kungabandakanya:

• Ukunciphisa ukutya neziselo eziyingozi kwisinyi: Iziselo ezine-caffeine (ikofu, iti), iziqhamo ze-citrus (ezifana nee-orenji, iilayimu), ukutya okuneziqholo, kunye notywala konke oku kunokuvuselela isinyi kwaye kubangele iingxaki zokuchama .
• Ukutya ukutya okunefayibha eninzi: Ukuqhina kunokubangela okanye kuyenze mandundu le meko. Ungayifumana ifayibha ngokutya iimbotyi, iziqhamo, imifuno, kunye neenkozo ezipheleleyo (isonka esipheleleyo, i-oats, i-quinoa, irayisi emdaka, kunye nepasta esipheleleyo). Ungathatha nee-laxatives (` laxatives ') zokuqhina. Nangona kunjalo, kufuneka uthethe nogqirha wakho ngaphambi kokuba uthathe ii-laxatives okanye uzinike umntwana.
• Ukugcina ubunzima bakho busempilweni: Ukuba i-body mass index (BMI) yakho ingaphezulu kwama-25 (ukuba nobunzima obukhulu), inokubangela uxinzelelo kwisinyi sakho kwaye ibangele ukuvuza komchamo .
• Ukuyeka ukutshaya: I-Nicotine, eyona nto iphambili kwicuba, inokuvuselela izihlunu zesinyi. Abantu abatshayayo banamathuba amaninzi okuba nokukhwehlela okungapheliyo, okunokufaka uxinzelelo kwisinyi.

Yintoni endinokuyilindela ukuba ndinengxaki yokungasebenzi kakuhle kwemithambo-luvo?

Ithemba labantu abanale meko lihle. Ngonyango, uninzi lwabantu lunokulawula isinyi sabo. Utyando lokwandisa isinyi (cystoplasty) alufuneki rhoqo.

Yintoni umahluko phakathi kokungasebenzi kakuhle kwe-Non-neurogenic kunye ne-Neurogenic Voiding Dysfunction?

Ukungasebenzi kakuhle kwe-neurogenic voiding (ekwaziwa ngokuba yi-neurogenic bladder) yimeko echaphazela inkqubo yakho yemithambo-luvo. Oku kuthetha ukuba awukwazi ukulawula i-bladder yakho ngenxa yengxaki yengqondo yakho, imithambo-luvo, okanye umqolo.

Nangona kunjalo, "ukungasebenzi kakuhle kwe-voiding okungeyo-neurogenic" esithethe ngayo namhlanje yimeko eyenzeka ngaphandle kokubandakanyeka kwenkqubo yemithambo-luvo.

Eyona nto ibalulekileyo ekufuneka uyikhumbule: I-Non-Neurogen voiding dysfunction (i-NNODD) yimeko esongela ubomi enokuchaphazela abantwana kunye nabantu abadala. Inokuba yintloni kwaye ingakhululeki. Inokubangela ukuba uzive ngathi awuyi kuchama xa kufuneka. Nangona kunjalo, awufuni ukuvumela le meko ichaphazele umgangatho wobomi bakho. Ukuba wena okanye umntu omthandayo unale mpawu, thetha nogqirha. Banokukunceda ufumane unobangela kwaye unyange.

Isishwankathelo (Umyalezo Wokuya Ekhaya)

Kulungile, ngoku uyaqonda kakuhle into esithethe ngayo namhlanje, "Ukungasebenzi kakuhle kwe-Non-Neurogenic Voiding Dysfunction". Oku akukho nto ingaphezulu kwesiphene kwinkqubo yemithambo-luvo.Le yeyona nto ibalulekileyo. Ubuthathaka bemisipha yesinyi, ukuvaleka kwenkqubo yomchamo, imikhwa emibi, kunye nokuqhina kwesisu kunokubangela oku.

• Iimpawu: Ubunzima bokuchama , ukungakwazi ukuzibamba komchamo , ukukhupha isinyi ngokupheleleyo, ukuchama ngokungazi, ukuchama emini ebantwaneni, njl.
• Uxilongo: Ngovavanyo lwezonyango, idayari yomchamo, i-ultrasound, kunye novavanyo lwe-urodynamic.
• Unyango: Utshintsho kwindlela yokuphila, uqeqesho lwesinyi, umthambo womgangatho we-pelvic, amayeza, kunye nonyango oluthile.
• Kubalulekile: Ukuba uneempawu, ungabi nantloni kwaye ufune ingcebiso kagqirha. Ukuqala unyango kwangethuba kunokuthintela iingxaki.

Ukuba unemibuzo engaphezulu malunga noku, ungathandabuzi ukubuza ugqirha. Hlala usempilweni!

Ukungasebenzi kakuhle kokukhupha umchamo okungekuko okwe -neurological, ukungakwazi ukuzibamba, isinyi, usulelo lwendlela yomchamo, ukuqhina, iingxaki zomchamo kubantwana, ulawulo lomchamo, ukungakwazi ukuzibamba, isinyi esisebenza kakhulu, uqeqesho lwesinyi