Ingabe nawe unenkinga yokuchama kahle? Ake sifunde nge-Non-Neurogenic Voiding Dysfunction!

Ingabe ngezinye izikhathi uzizwa sengathi unenkinga yokuchama ? Noma uzizwa sengathi isinyi sakho asikaphumi ngokuphelele ngemuva kokuqeda ukuchama ? Mhlawumbe uvuza nomchamo ngokungalindelekile. Lokhu akuyona inkinga kuwe kuphela, kodwa nakubantu abaningi. Namuhla, sizokhuluma ngokungakwazi ukuzibamba komchamo okungabangelwa yizinkinga zezinzwa . Ngokwezokwelapha, lokhu sikubiza ngokuthi "Ukungasebenzi Kahle Kokuvotela Okungeyona I-Neurogenic".

Kuyini Ukungasebenzi Kahle Kokuvotela Okungeyona I-Neurogenic?

Kalula nje, lesi yisimo lapho ungakwazi khona ukukhipha ngokuphelele isinye sakho. Igama elithi "non-neurogenic" lapha lisho ukuthi lesi simo asibangelwa yizinkinga ngesimiso sakho sezinzwa, okungukuthi, ubuchopho bakho, umgogodla, noma imizwa. "Ukungasebenzi kahle kwemizwa" kusho ukuthi inqubo yokuchama ayenzeki kahle.

Lesi simo singavela kunoma ubani. Ngokuvamile, lokhu kungaba ngenxa yemisipha yesinye ebuthakathaka, ukuvaleka endaweni ethile ohlelweni lomchamo, noma imikhuba emibi esesiyijwayele isikhathi eside. Kodwa-ke, lesi simo sivame kakhulu ezinganeni ezincane eziqeqeshwe ukuya endlini yangasese eziphakathi kweminyaka engu-4 nengu-6 kanye nakwabesifazane abangaphezu kweminyaka engu-40. Cabanga nje, cishe ingane eyodwa kwezinhlanu eziphakathi kweminyaka engu-4 nengu-6 kufanele ichame emini ngenxa yalokhu `(ukungasebenzi kahle kokuphuma kwegazi okungeyona i-neurogenic)`. Futhi, abesifazane abangaphezu kuka-6% abangaphezu kweminyaka engu-40 banalesi simo.

Ziyini izimpawu zalesi simo? (Izimpawu Zokungasebenzi Kahle Kokuvoca Okungeyona I-Neurogenic Voiding)

Bheka ukuthi unazo yini lezi zici:

• Ingabe kunzima ukuqala ukuchama ? Noma kufanele uzikhandle uma uchama ?
• Ingabe umgudu womchamo unciphile kakhulu? Noma umgudu womchamo uqala, ume isikhashana, bese uqala futhi?
• Ingabe kufanele uqinise imisipha yesisu sakho uma uchama ? Noma kufanele ubambe isisu sakho esingezansi ngezandla zombili?
• Uzizwa sengathi isinyi sakho asikaphumi ngisho noma usuqedile ukuchama ?
• Ingabe unesifo sokuqunjelwa ? (Lokhu kuvame ukuhlobene)
• Ingabe uchama kakhulu kunokujwayelekile (uchama njalo) noma ngaphansi?
• Ingabe uvuza umchamo ngengozi (ukungakwazi ukuzibamba komchamo)?
• Ingabe uzizwa ngokuzumayo isidingo esiphuthumayo sokuchama (ukukhuthaza ukungakwazi ukuzibamba)?
• Ukuchama izikhathi ezingaphezu kwesisodwa ebusuku ngenkathi uleleIngabe kufanele uvuke ukuze ukwenze (i-nocturia)?

Izici ezikhethekile izingane ezincane ezingaba nazo:

Uma izingane ezincane zinalesi simo, zingase zibonise izinto ezifana nalezi:

• Ukumanzisa izingubo zakho emini (ngisho nangemva kokuqeqeshwa ukuya endlini yangasese).
• Kunezinto ezahlukahlukene ezingenziwa ukuze kugcinwe umchamo . Isibonelo:
• Imilenze yami iphambene.
• Ukuhlala phansi ngenkathi uhleli.
• Babambe imilenze yabo ndawonye, ​​kungaba ngezandla noma ngezithende zabo.

Uma ubona ingane yakho yenza lezi zinto, kufanele ukhathazeke kancane.

Yini ebangela lokhu? (Izimbangela Zokungasebenzi Kahle Kokuvoca Okungeyona I-Neurogenic Voiding)

Kunezizathu eziningana eziyinhloko zalesi simo:

• Ubuthakathaka bemisipha yesinye.
• Kukhona ukuvaleka endaweni ethile ohlelweni lwakho lomchamo.
• Isinyi esisebenza ngokweqile (isinyi esisebenza ngokweqile).
• Isinye asisebenzi kahle, okusho ukuthi akukho muzwa wokudinga ukuchama ("isinye esingasebenzi kahle").
• Ukuqunjelwa (lesi yisizathu esibaluleke kakhulu).
• Ukutheleleka Kwendlela Yomchamo (UTIs).
• Ngisho noma udinga ukuchama , awukunaki bese ulinda kuze kube yilapho isinyi sakho sigcwele ngaphambi kokuba uchame kamuva.
• Kwabesilisa, kuyindlala ye-prostate ekhulisiwe (i-Benign Prostatic Hyperplasia - BPH).
• Umdlavuza we-prostate.

Ezinganeni ezincane, lokhu kungabangelwa yisimo esibizwa ngokuthi "i-dysfunctional elimination syndrome," lapho imisipha nemizwa esinyeni kungasebenzi kahle.

Yiziphi izinkinga ezingaba khona ngenxa yalesi simo?

Uma isinyi sakho singaphumi ngokuphelele, amagciwane asemchameni osele angabangela izifo. Isibonelo, izifo zomgudu womchamo (UTIs). Unamathuba amaningi okuthola amatshe ezinso noma amatshe esinyini. Ngezinye izikhathi, uma le nkinga iba yimbi kakhulu, ingabangela ngisho nokulimala kwezinso.

Into ebaluleke kakhulu ukuthi ukuba nenkinga ethile ngokuchama kungakuthinta nawe ngokwengqondo. Abantu abaningi bazizwa benamahloni futhi bekhathazekile ngoba abakwazi ukulawula umchamo wabo. Ungase ucabange nokuthi, "Ingabe ngingumthwalo kwabanye?" Uma kufanele uyeke imisebenzi yakho yansuku zonke ngalezi zimpawu ngaso sonke isikhathi. Uma uhlala kude nomphakathi ngenxa yalokhu, ungase ubhekane nezimo ezingathi sína njengokukhathazeka nokucindezeleka.

Odokotela bakuthola kanjani ukungasebenzi kahle kokuphuma kwegazi okungeyona i-neurogenic?

Udokotela angakwazi ukuthola ukungasebenzi kahle kokuphuma kwegazi okungeyona i-neurogenic ngokubuza ngomlando wakho wezokwelapha nokwenza ukuhlolwa ngokomzimba. Angase futhi enze ukuhlolwa kwe-pelvic kwabesifazane noma ukuhlolwa kwe-digital rectal kwabesilisa.

Ngaphezu kwalokho, udokotela wakho angakucela ukuthi ugcine "idayari yesinye." Kuyo, uzobhala phansi:

• Uphuza amanzi angakanani ngosuku?
• Uchama nini?
• Ukhipha umchamo ongakanani ngesikhathi?
• Umchamo uvuza nini futhi kanjani ngokungahlosile?

Ngalolu lwazi, udokotela angenza nezinye izivivinyo eziningana ukuqinisekisa ukuxilongwa.

Yiziphi izivivinyo ezenziwayo?

Udokotela angenza okukodwa noma ngaphezulu kwalokhu kuhlolwa:

• Ukuhlolwa kwe-Prostate-specific antigen (PSA): Lokhu ukuhlolwa kwegazi. Kubheka amazinga e-PSA aphezulu. Uma amazinga e-PSA ephezulu, kungase kube nenkinga nge-prostate gland.
• Ukuhlolwa komchamo: Lokhu kungasiza ekunqumeni ukuthi unesifo somgudu womchamo (UTI).
• I-Ultrasound scan: Lokhu kuhlola ukuthi kusele umchamo ongakanani esinyeni sakho ngemva kokuchama . Kungahlola nokuthi isimo sithinte izinso zakho.
• Ukuhlolwa kwe-Urodynamic: Lokhu kuhlolwa kulinganisa ukuthi ingakanani umchamo ingakwazi ukuwubamba isinye sakho nokuthi imisipha yesinye sakho, i-urethra, kanye nephansi le-pelvic isebenza kahle kangakanani ndawonye.
• I-Cystoscopy: Kulolu vivinyo, udokotela ufaka ithuluzi elide, elincane (elifakwe ikhamera) nge-urethra yakho ukuze ahlole izinkinga kwi-urethra yakho kanye nesinye.

Ezinganeni ezincane, lezi zivivinyo zivame ukungaphazamisi kakhulu. Udokotela angase akucele ukuthi ugcine idayari yomchamo, futhi angancoma kuphela ukuhlolwa kwegazi, ukuhlolwa komchamo, i-ultrasound, kanye nokuhlolwa kwe-urodynamic.

Kuphathwa kanjani lokhu? (Kuphathwa kanjani?)

Ukwelashwa kwalesi simo (Ukungasebenzi kahle kokuphuma kwegazi okungeyona i-neurogenic) kuyahlukahluka kuye ngembangela. Ukwelashwa kungafaka:

1. Ukuqeqeshwa kwesinye

Ungaqeqesha imisipha yesinye sakho ukuthi ibambe umchamo isikhathi eside. Lokhu kusho ukuthi udinga ukuya endlini yangasese ngezikhathi ezijwayelekile phakathi nosuku, noma ngabe awuzizwa sengathi udinga ukuya . Lokhu kungasiza ekuvimbeleni isinye sakho ukuthi singagcwali. Udokotela wezokwelapha ngokomzimba ochwepheshe bezinkinga zephansi le-pelvic angakusiza ngalokhu.

2. Ukuzivocavoca kwemisipha yaphansi kwe-pelvic (Ukwelashwa kwaphansi kwe-pelvic)

Uchwepheshe wezokwelapha ngokomzimba oqeqeshwe ngokukhethekile angakufundisa indlela yokukhulula imisipha yakho yaphansi kwe-pelvic ukuze ukwazi ukuchama kalula. Angase futhi abeke "izinzwa ze-biofeedback" esithweni sakho sangasese noma e-rectum ukuqinisekisa ukuthi uvivinya imisipha efanele.

Bazokufundisa nokuzivocavoca kwe-Kegel ukuqinisa imisipha yakho yaphansi kwe-pelvic. Imisipha eqinile yaphansi kwe-pelvic isiza ukuvimbela ukungakwazi ukuzibamba komchamo kanye nokukhuthaza ukungakwazi ukuzibamba.

3. Imithi

Kunemithi engasiza ekuthuthukiseni izinkinga zomchamo. Izibonelo:

• Ama-Alpha-blockers, isibonelo i-tamsulosin (i-Flomax®).
• Ama-antispasmodics omchamo, njenge-oxybutynin (Ditropan®) kanye ne-tolterodine (Detrol®).

4. Ubuthi be-Botulinum

Udokotela wakho angase afake ubuthi be-botulinum (Botox®) esinyeni sakho. Lokhu kukhulula imisipha yesinye futhi kunciphise ukungakwazi ukuzibamba.

5. Ukukhuthazwa kwemizwa ye-percutaneous tibial (PTNS)

Ngezinye izikhathi, udinga ukunikeza imizwa yakho "umfutho" omncane ukuze uvuselele imisipha yesinye sakho. Ku-PTNS, udokotela wakho ubeka i-electrode eduze kwe-tibial nerve yakho eqakaleni lakho. Bese, bathumela izimpawu zikagesi ezithambile kakhulu ku-electrode. Lokhu kuvuselela i-tibial nerve, bese ihamba iye emithanjeni ye-sacral ethangeni lakho. Lokhu kumisa izimpawu ezingavamile ezivela emithanjeni ye-sacral ziye emisipheni yomchamo, isinye, kanye nemisipha yephansi le-pelvic, okukusiza ukuthi uphinde uthole ukulawula isinye.

6. Ukuvuselelwa kwemizwa ye-Sacral

Kule nqubo, udokotela wakho uzobeka ama-electrode ngaphansi kwesikhumba ngaphezu nje kwezinqe zakho. Lawa ma-electrode athumela izimpawu zikagesi ezithambile emthanjeni we-sacral ngentambo encane (i-probe) engena ngaphansi kwesikhumba. Lezi zimpawu zivuselela imisipha yesinye sakho ukuba ifinyele.

7. Ukuzihlikihla nge-catheter

Ungafaka i-catheter yomchamo esinyini sakho ngezikhathi ezithile bese uqoqa umchamo wakho esikhwameni. Udokotela wakho uzokukhombisa ukuthi ungakwenza kanjani lokhu (ukuzithutha).

8. Ukuhlinzwa

Uma ezinye izindlela zokwelapha zingasebenzi, udokotela wakho angase akuncome ukuhlinzwa kokukhulisa isinyi (cystoplasty). Lokhu kuhlinzwa kwenza isinyi sakho sibe sikhulu ukuze sikwazi ukugcina umchamo omningi.Ngingakwazi ukubhekana nezinto eziningi.

Yiziphi izindlela zokuqala zokwelapha isinyi esingasebenzi ngokweqile esingabangelwa yi-neurogenic?

Lokhu okulandelayo ngokuvamile kuyindlela yokuqala yokwelapha lesi simo:

• Ukunciphisa ukudla neziphuzo eziyingozi esinyeni (itiye, ikhofi, utshwala, ukudla okubabayo noma okune-asidi).
• Ukuqeqeshwa kwesinye.

Uma lezi zinguquko zokuziphatha zingasizi, odokotela bangase banikeze imithi efana nale, kuye ngohlobo lokungasebenzi kahle kokuphuma kwegazi okungeyona i-neurogenic:

• Imithi yokulwa ne-cholinergic
• Ama-blocker e-Alpha
• Ama-agonist e-Beta 3 receptor

Lesi simo siphathwa kanjani ezinganeni ezincane?

Ama-alpha-blocker kanye nemithi yokulwa ne-cholinergic kungasiza ekwelapheni isinyi esisebenza ngokweqile ezinganeni ezincane. Ezinye izingane zingafundiswa nokwenza izivivinyo zaphansi kwe-pelvic.

Udokotela angase futhi ancome ukuqeqeshwa kwesinyi. Isibonelo, ukukhuthaza ingane ukuba iye endlini yangasese ngezikhathi ezibekiwe nokuyifundisa ukuma kahle endlini yangasese.

Ngizozizwa ngingcono ngokushesha kangakanani ngemva kokwelashwa?

Kuyahlukahluka kuye ngokwelashwa. Ukuqeqeshwa kwesinyi kanye nokuzivocavoca phansi kwe-pelvic kungaqala ukusebenza emavikini ambalwa noma ezinyangeni ezimbalwa. Ukuvuselelwa kwemizwa kuvame ukuqala ukusebenza emavikini ambalwa. Imithi kufanele iqale ukusebenza ezinsukwini noma emavikini ambalwa. Udokotela wakho uzokunikeza umbono omuhle ngalokhu.

Kufanele ngimbone nini udokotela?

Khuluma nodokotela ngokushesha nje lapho uqala ukuqaphela lezi zinkinga ngokuya endlini yangasese:

• Ukungakwazi ukuchama isikhathi eside.
• Izinguquko emchameni wakho: Isibonelo, iphunga elinamandla, umbala omnyama, noma igazi emchameni (i-hematuria).
• Ubuhlungu lapho uchama (i-dysuria).
• Izimpawu eziqhubekayo zokuqunjelwa.
• Izimpawu zokutheleleka: umkhuhlane, ukubanda, ikhanda elibuhlungu.

Uma ubona udokotela, ungabuza nale mibuzo:

• Wazi kanjani ukuthi ngine-`(Non-neurogenic voiding dysfunction)`?
• Iyini imbangela yesimo sami?
• Yikuphi ukwelashwa ongincomayo?
• Yimiphi imiphumela emibi yalokho kwelashwa?
• Kuzothatha isikhathi esingakanani ukubona imiphumela yalokho kwelashwa?
• Yiziphi izinguquko zendlela yokuphila ozincomayo ukuze unciphise izimpawu zami?
• Yiziphi izinkinga okufanele ngiziqaphele?
• Ingabe kufanele ngibone udokotela wezifo zomchamo?

Ingabe lokhu kungavinjelwa?

Ungasiza ekuvimbeleni lesi simo (ukungasebenzi kahle kokuphuma kwegazi okungeyona i-neurogenic) ngokwenza izinguquko endleleni yakho yokuphila kanye nokudla. Lokhu kungafaka:

• Ukunciphisa ukudla neziphuzo eziyingozi esinyeni: Iziphuzo ezine-caffeine (ikhofi, itiye), izithelo ze-citrus (ezifana nama-orange, ama-lime), ukudla okubabayo, kanye notshwala konke kungavuselela esinyeni futhi kubangele izinkinga zokuchama .
• Ukudla ukudla okune-fiber eningi: Ukuqunjelwa kungabangela noma kubhebhethekise lesi simo. Ungathola i-fiber ngokudla ubhontshisi, izithelo, imifino, kanye nokusanhlamvu okuphelele (isinkwa esiphelele, i-oats, i-quinoa, ilayisi elinsundu, kanye ne-pasta ephelele). Ungathatha futhi imithi yokuqunjelwa (' imithi yokuqunjelwa ') yokuqunjelwa. Kodwa-ke, kufanele ukhulume nodokotela wakho ngaphambi kokuthatha imithi yokuqunjelwa noma ukuyinika ingane.
• Ukugcina isisindo sakho siphilile: Uma i-body mass index (BMI) yakho ingaphezu kuka-25 (ukuba nesisindo esikhulu), kungacindezela esinyeni sakho futhi kubangele ukuvuza komchamo .
• Ukuyeka ukubhema: I-Nicotine, isithako esiyinhloko sikagwayi, ingavuselela imisipha esinyeni. Abantu ababhemayo banamathuba amaningi okukhwehlela okungapheli, okungabeka ingcindezi kwesinyeni.

Yini engingayilindela uma nginenkinga yokungasebenzi kahle kwe-voiding okungeyona i-neurogenic?

Umbono wabantu abanalesi simo muhle. Ngokwelashwa, abantu abaningi bangakwazi ukulawula isinye sabo. Ukuhlinzwa kokukhulisa isinye (cystoplasty) akuvamile.

Uyini umehluko phakathi kokungasebenzi kahle kwe-Non-neurogenic kanye ne-Neurogenic Voiding?

Ukungasebenzi kahle kwe-neurogenic voiding (okwaziwa nangokuthi i-neurogenic bladder) yisimo esithinta uhlelo lwakho lwezinzwa. Lokhu kusho ukuthi awukwazi ukulawula isinye sakho ngenxa yenkinga yobuchopho bakho, imizwa, noma umgogodla.

Kodwa-ke, "ukungasebenzi kahle kokuphuma kwegazi okungeyona i-neurogenic" esikhulume ngakho namuhla kuyisimo esenzeka ngaphandle kokubandakanyeka kwesimiso sezinzwa.

Into ebaluleke kakhulu okufanele uyikhumbule: Ukungasebenzi kahle kokuchama okungeyona i-Neurogenic (i-NNODD) yisimo esisongela impilo esingathinta kokubili izingane kanye nabantu abadala. Kungaba namahloni futhi kungakhululeki. Kungabangela nokuthi uzizwe sengathi ngeke uchame uma kudingeka. Kodwa-ke, awufuni ukuvumela lesi simo sithinte ikhwalithi yempilo yakho. Uma wena noma othandekayo wakho enalezi zimpawu, khuluma nodokotela. Bangakusiza ukuthola imbangela futhi bayelaphe.

Isifinyezo (Umyalezo Wokuya Nawe Ekhaya)

Kulungile, manje usuqonda kahle lokho esikhulume ngakho namuhla, "Ukungasebenzi Kahle Kokuvoca Okungeyona I-Neurogenic Voiding". Lokhu akulutho ngaphandle kokungasebenzi kahle kwesimiso sezinzwa.Into ebaluleke kakhulu ukusho. Izinto ezifana nemisipha yesinye ebuthakathaka, ukuvaleka komgudu womchamo, imikhuba emibi, kanye nokuqunjelwa kungabangela lokhu.

• Izimpawu: Ubunzima bokuchama , ukungakwazi ukuzibamba ngomchamo , ukungaphumi kahle kwesinye isinyi, ukuchama ngokungazi, ukuchama emini ezinganeni, njll.
• Ukuxilongwa: Ngokuhlolwa kwezokwelapha, idayari yomchamo, i-ultrasound, kanye nokuhlolwa kwe-urodynamic.
• Ukwelashwa: Ukushintsha indlela yokuphila, ukuqeqeshwa kwesinye, ukuvivinya umzimba phansi kwe-pelvic, imithi, kanye nezinye izindlela zokwelapha ezithile.
• Okubalulekile: Uma unezimpawu, ungabi namahloni futhi ufune iseluleko sezokwelapha. Ukuqala ukwelashwa kusenesikhathi kungavimbela izinkinga.

Uma uneminye imibuzo mayelana nalokhu, ungangabazi ukubuza udokotela. Hlala uphilile!

Ukungasebenzi kahle kokuphuma komchamo okungeyona i - neurological, ukungakwazi ukuzibamba umchamo, isinye, izifo zomgudu womchamo, ukuqunjelwa, izinkinga zomchamo zezingane, ukulawula umchamo, ukungakwazi ukuzibamba umchamo, isinye esisebenza ngokweqile, ukuqeqeshwa kwesinye