Ngokuvamile, sizizwa sifisa ukuchama, bese sikulawula bese silinda size siye endlini yokugezela. Konke lokhu kwenzeka ngokusebenzisana okumangalisayo phakathi kobuchopho bethu, intambo yomgogodla, imizwa, kanye nesinye, okusebenza njengohlelo lwekhompyutha. Kodwa cabanga ukuthi bekuzokwenzekani uma singalahlekelwa ukulawula isinye ngenxa yenkinga ohlelweni lwezinzwa oluthwala le miyalezo. Yilokho esikubiza ngokwezokwelapha ngokuthi 'isinye se-Neurogenic'.
Kalula nje, siyini i-Neurogenic Bladder?
Uhlelo lwezinzwa luthumela imiyalezo, njengezibonakaliso zikagesi, kuyo yonke imizimba yethu. Lolu hlelo lwezinzwa lwakhiwe izingxenye ezintathu eziyinhloko:
- Ubuchopho
- Umhlonzo
- Imizwa
Lezi zinzwa zithumela isignali ebuchosheni bakho yokuthi isinyi sakho sigcwele. Bese kuthi, isignali evela ebuchosheni bakho ithumele umlayezo esinyini sakho ithi, "Manje sekuyisikhathi esifanele sokuchama." Uma lesi signali sitholakala, imisipha yesinyi iyafinyela bese umchamo uyakhishwa.
Esimweni esibizwa ngokuthi i-Neurogenic Bladder, lolu hlelo lokudlulisa izimpawu luyaphazamiseka ngenxa yokuphazamiseka kobuchopho, umgogodla, noma imizwa. Lokhu kungaholela ekulahlekelweni ngokuphelele kokulawula isinye. Okusho ukuthi, isinye siba matasa kakhulu noma ukusebenza kwaso kuyaphazamiseka.
Kunezinhlobo ezimbili eziyinhloko ze-Neurogenic Bladder:
Isinye esibangela i-neurogenic singahlukaniswa sibe izinhlobo ezimbili eziyinhloko, kuye ngohlobo lomonakalo wemizwa owubangelayo. Ukuqonda lokhu kungakusiza ukuthi uqonde kangcono izimpawu zakho.
| Isimo sesinye | Ukuchaza kalula... |
|---|---|
| Isinye Esisebenza Kakhulu (I-Spastic/Hyper-reflexive) Isinyi esisebenza ngokweqile | Okwenzekayo kulokhu ukuthi isinyi siba nomuzwa ojulile. Ngisho noma sigcwele kancane, imisipha yesinyi iyafinyela ngokuzumayo bese izama ukukhipha umchamo. Kufana nomuntu okhathazekile, osabela ngokushesha ngisho nasezintweni ezincane kakhulu. |
| Isinye Esingasebenzi Kahle (I-Flaccid/Hypotonic) Isinyi esingasebenzi kahle | Kulokhu, imisipha yesinye iba "yivila." Ngisho noma isinye sigcwele kakhulu, asikwazi ukufinyela ngokwanele ukuze sikhiphe. Ngakho-ke, umchamo uhlala ngaphakathi. |
Ziyini izimpawu zalesi simo?
Uphawu oluvame kakhulu lwesinyi esibangelwa yizinzwa ukungakwazi ukulawula umchamo. Kodwa-ke, izimpawu zingahluka kuye ngohlobo onalo.
| Ngohlobo lwezimpawu | |
|---|---|
| Izimpawu Zesinye Esisebenza Kakhulu | |
| Ubunzima bokuchama, umchamo ohamba kancane noma ogeleza kancane (Ukungabaza komchamo). | |
| Ukungakwazi ukuzibamba ngomchamo ukulahlekelwa umchamo ngokungenhloso. | |
| Ukudinga ukuchama izikhathi ezingaphezu kuka-8 ngosuku (Ukuchama njalo). | |
| Isidingo sokuchama ngokungazelelwe, esingabekezeleleki (Ukuphuthuma komchamo). | |
| Izimpawu Zesinye Esingasebenzi Kahle | |
| Isinyi asibi nalutho ngokuphelele ngisho nangemva kokuchama (Ukugcinwa komchamo). | |
| Ukungakwazi ukuzibamba ngokweqile ukuvuza komchamo ngokungazikhetheli ngenxa yesinyi esigcwaliswe ngokweqile. | |
| Angizizwa sengathi isinyi sakho sigcwele. | |
Kungani lokhu kwenzeka? Yiziphi izizathu?
Kunezici eziningana ezingabangela i-Neurogenic Bladder. Ezinye zizalwa nazo, kanti ezinye zingase zibangelwe yizifo noma izingozi ezenzeka kamuva ekuphileni.
Izimbangela ezingaba khona zokuzalwa:
- I-Spine bifida: Lokhu kuyinkinga yomgogodla eyenzeka ngesikhathi sokuzalwa.
- I-Cerebral palsy: Isimo esithinta ukukhula kobuchopho.
- I-Caudal regression syndrome: Ukukhula okungasebenzi kahle kwengxenye engezansi yomgogodla.
Izimbangela ezingaba khona zokuvela kamuva:
- Izimila zesimiso sezinzwa esiphakathi: Umdlavuza noma ezinye izimila ezikhula ebuchosheni noma emgogodleni.
- I-Multiple sclerosis (MS): Isifo esonakalisa imithambo yegazi.
- Isifo sikaParkinson: Isimo esithinta amangqamuzana ezinzwa ebuchosheni.
- Isifo sohlangothi: Ukuphazamiseka kokunikezwa kwegazi ebuchosheni.
- Ukulimala komgogodla: Ngenxa yokuwa, izingozi zezimoto, njll.
- Isifo Sikashukela: Isifo sikashukela esingalawulwa isikhathi eside singabangela ukulimala kwemizwa.
Imiphumela emibi engaba khona (izinkinga)
Uma isinyi esibangelwa yizinzwa singelashwa kahle, kungenzeka kakhulu ukuthi sibangele ezinye izinkinga zempilo.
- Ukulimala kwezinso: Ingcindezi esinyeni iyanda ngenxa yokugcinwa komchamo, futhi leyo ngcindezi ingathinta izinso.
- Ukutheleleka okuvamile komgudu womchamo (UTIs): Ukungasusi ngokuphelele isinye kudala indawo enhle yokukhula kwamagciwane.
- Amatshe omchamo: Amatshe angakheka esinyeni noma ezinso.
- I-Vesicoureteral reflux: Lesi yisimo esiyingozi lapho umchamo ugeleza usuka kwesinye uye ezinso.
Ngaphezu kwalezi zinkinga zomzimba, kungaba nomthelela omkhulu ngokwengqondo . Ukwesaba ukuvuza komchamo kungakwenza uzizwe wesaba ukuhlangana nabantu noma ukuya ohambweni. Lokhu kungaholela emizweni yokukhathazeka, ukucindezeleka, kanye nesizungu . Uma uhlangabezana nale mizwa, ungabi namahloni okukhuluma nodokotela wakho ngakho.
Udokotela usithola kanjani lesi sifo?
Uma uya kudokotela, uzolalela ngokucophelela izimpawu zakho. Ngemuva kwalokho, bazokuhlola. Uma kusolwa ukuthi unezinkinga zesinye ezibangelwa yizinzwa, bazoncoma ukuhlolwa okukhethekile okuhlobene nesimiso sezinzwa nesinye.
- I-Cystoscopy: Ukuhlolwa kwengaphakathi le-urethra kanye nesinye kusetshenziswa ikhamera encane, efana nethubhu.
- Ukuhlolwa kwezithombe:Ukuhlolwa okufana nokuskena kwe-CT, ukuskena kwe-MRI, kanye ne-ultrasound.
- Ukuhlolwa kwe-Urodynamic: Lokhu ukuhlolwa okukhethekile. Kulinganisa ukuthi ingakanani umchamo ongabanjwa yisinye sakho, ingcindezi engaphakathi kwesinye, isivinini sokugeleza komchamo, nokuthi isinye siphuma kahle kangakanani.
Ngemva kwalezi zivivinyo, ungathunyelwa kudokotela ochwepheshe ohlelweni lwesinyi kanye nomchamo, udokotela wezifo zomchamo .
Yiziphi izindlela zokwelapha lokhu?
Into ebalulekile ukuthi ayikho ikhambi le-Neurogenic Bladder. Kodwa-ke, ngokwelashwa okufanele, abantu abaningi bangakwazi ukulawula izimpawu zabo kahle futhi baphile impilo evamile.
Uhlelo lokwelashwa lunqunywa yimbangela yesimo sakho kanye nohlobo lwezimpawu zakho.
1. Izinguquko zendlela yokuphila
Okokuqala, udokotela uzama ukulawula lokhu ngezinto ezilula.
- Gwema ukudla neziphuzo ezicasula isinyi (ikhofi, utshwala, iziphuzo ezine-carbonated).
- Ukulawula Ukuqunjelwa: Ukuqunjelwa kungacindezela esinyeni.
- Ukuqeqeshwa kwesinyi: Ucelwa ukuba ugcine idayari yezikhathi ochama ngazo, inani ochama ngalo, nanoma yikuphi ukuchama okungahleliwe. Lokhu kuzokusiza ufunde ukuchama ngesikhathi esifanele.
- Ukuzivocavoca kwe-Kegel: Lokhu kuzivocavoca kuqinisa imisipha yephansi le-pelvic futhi kungathuthukisa ukulawula umchamo.
2. Imithi
Kunemithi eyahlukahlukene engaphumuza imisipha yesinye noma ivuselele ukufinyela. Isibonelo, udokotela wakho angase akunike imithi efana ne-Oxybutynin, i-Tolterodine, ne-Mirabegron.
3. Ukufakwa kwe-Catheterization
Le ndlela ibaluleke kakhulu uma isinye singaphumi kahle.
- Ukuzithulula: Uzofundiswa ukuthi ungakhipha kanjani konke esinyini sakho usebenzisa ipayipi elincane elihlanzekile (i-catheter) izikhathi eziningana ngosuku. Lokhu kungase kubonakale kunzima ekuqaleni, kodwa kuzoba lula kakhulu uma usujwayele.
- Ukufakwa kwe-catheter okuqhubekayo: Kwezinye izimo, i-catheter eqhubekayo ingadingeka.
4. Ezinye izindlela zokwelapha kanye nokuhlinzwa
Uma ezinye izindlela zokwelapha zingaphumeleli, udokotela wakho angase acabangele okulandelayo:
- Imijovo ye-Botox: I-Botox ifakwa emisipheni yesinye ukuze ingayifinyi ngokweqile.
- Ukuhlinzwa:Ukuhlinzwa okwandisa amandla esinyini (i-augmentation cystoplasty) noma ukuhlinzwa kokushintsha indlela yokugeleza komchamo (ukuphambuka komchamo) kungadingeka ezimweni ezingavamile kakhulu.
Udokotela wakho uzoxoxa nawe futhi anqume ukuthi yikuphi ukwelashwa okukulungele.
Umlayezo Wokuya Nawe Ekhaya
- I-Neurogenic Isinyi siwukulahlekelwa ukulawula isinyi ngenxa yokuphazamiseka kwesimiso sezinzwa. Akusona isifo, kodwa umphumela wesinye isifo.
- Uma uhlangabezana nanoma yiziphi izinguquko ekulawuleni umchamo, ukuchama njalo, noma ubunzima bokubamba umchamo wakho, ungabi namahloni futhi ubone udokotela ngokushesha okukhulu.
- Nakuba lesi simo singelapheki ngokuphelele, izimpawu zingalawulwa kahle futhi impilo evamile nesebenzayo ingaholwa.
- Kunezindlela eziningi zokwelapha. Udokotela wakho uzokusiza ukhethe ukwelashwa okukulungele.
- Naka ukucindezeleka kwengqondo okungabangelwa yilokhu. Uma kudingeka, khuluma nodokotela wakho ngakho bese ucela iseluleko.
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