Wake wazizwa sengathi umfana wakho omncane unenkinga yokuchama ? Noma uzizwa sengathi i-urethra yakhe incane kakhulu futhi iyaconsa? Nakuba abanye abazali bengase bangazinaki kakhulu lezi zinto, lokhu kungaba uphawu lwenkinga yokuzalwa ethinta abafana kuphela. Namuhla sikhuluma ngesinye sezimo ezinjalo, ama-Posterior Urethral Valves (PUV).
Ayini ngempela ama-Posterior Urethral Valves (PUV)?
Kalula nje, ama-Posterior Urethral Valves (PUV) ayisici sokuzalwa esithinta abafana kuphela. Okwenzekayo kulokhu ukuthi ingxenye eyengeziwe efana ne-membrane ikhula ngaphakathi kwepayipi elithwala umchamo (lokhu sikubiza ngokuthi i-urethra). Cabanga ngakho njengento ebhajwe ngaphakathi kwepayipi lamanzi. Ngaleyo ndlela, i-membrane ayikwazi ukugeleza kahle ngenxa yomchamo.
Kwenzekani ngenxa yalokhu? Isinye somntwana asiphumi kahle. Ngakho-ke lo mchamo oqongelelekile ugeleza emuva bese uqala ukulimaza isinye kanye nezinso . Lesi simo senzeka ngesikhathi umntwana esesesibelethweni. Ngakho-ke, ngezinye izikhathi singatholakala ngokusebenzisa ama-scan ngaphambi kokuba umntwana azalwe, noma ngemva kokuzalwa, noma ngesikhathi sobuntwana. Elinye igama lalokhu yi-`(Congenital Obstructive Posterior Urethral Membrane - COPUM)`.
Ingabe lesi yisimo esivame kakhulu?
Cha, lesi akusona isifo esithinta wonke umuntu. Kodwa lesi simo, esibizwa ngokuthi i-PUV, siyimbangela eyinhloko yokuvaleka komgudu womchamo kubafana abancane.
Ziyini izimpawu zalesi simo?
Lezi zimpawu zingahluka kuye ngosana. Ngezinye izikhathi, odokotela bathola lezi zimpawu kuma-scan kamama ngaphambi kokuba umntwana azalwe. Ngezinye izikhathi, lezi zimpawu zingase zivele ngemva kokuzalwa komntwana.
| Isici | Incazelo elula |
|---|---|
| Ukuphuma komchamo okubuthakathaka noma okuconsayo | Uma ingane ichama , umchamo awuphumi ngamandla, kodwa uphuma ngamanani amancane kakhulu, afana namaconsi. |
| Ukutheleleka okuvamile komgudu womchamo (UTIs) | Ngenxa yokuthi umchamo awukhishwa kahle, amabhaktheriya angakhula kalula futhi abangele izifo. |
| Ukwehlisa isisindo somntwana | Ukwanda kwesisindo kungase kuhambe kancane ngoba ingane ayitholi ukudla okunempilo okudingekayo ukuze ikhule. |
| Ubuhlungu ngesikhathi sokuchama (i-dysuria) | Uma ingane yakho ikhala noma ikhombisa ukungakhululeki ngesikhathi ichama , kungenzeka ukuthi kungenxa yobuhlungu. |
| Ubunzima bokuchama | Uma ingane kufanele icindezeleke ukuze ichame, lokho nakho kuyisibonakaliso. |
| Uketshezi oluphansi lwe-amniotic `(oligohydramnios)` | Lokhu kubonakala ngesikhathi kwenziwa ama-scan ngesikhathi umntwana esesibelethweni. |
| Ukuvuvukala kwezinso (i-hydronephrosis) | Odokotela bangakubona lokhu ngokusebenzisa ama-scan ngesikhathi sokukhulelwa. |
Kungani lokhu kwenzeka?
Imbangela eqondile yalokhu ayaziwa okwamanje, kodwa siyazi ukuthi kwenzeka ngoba lolu lwelwesi olwengeziwe lwakheka e-urethra ngesikhathi sokuqala kokukhula komntwana esibelethweni.
Into ebaluleke kakhulu ukukhumbula ukuthi lokhu akuyona into oyenzile kabi . Lokhu kumane kuyingxenye yokukhula ngokomzimba kwengane.
Yiziphi izinkinga ezingabangelwa yilokhu?
Uma lesi simo singelashwa ngesikhathi, singaholela ezinkingeni ezinkulu zempilo, njengoba izinso ziqhubeka nokulimala ngenxa yokugeleza komchamo emuva.
| Inkinga | Kusho ukuthini lokho? |
|---|---|
| Ukugeleza komchamo emuva ezinso (i-vesicoureteral reflux/VUR) | Umchamo ogcwalisa isinyi ubuyela phezulu, okungukuthi, uye ezinso. Lokhu kulimaza izinso. |
| Ukungakwazi ukukhipha ngokuphelele isinyi (ukugcinwa komchamo) | Kuhlala kukhona umchamo osele esinyeni. Lokhu kuyimbangela enkulu yokutheleleka. |
| Ukuvuvukala kwezinso | Izinso ziqala ukuvuvukala ngenxa yokucindezela komchamo. |
| Ukwehluleka kwezinso | Lesi yisimo esibi kakhulu esingase senzeke. Ngokuhamba kwesikhathi, izinso zingalimala futhi ziyeke ukusebenza. |
Odokotela bakuthola kanjani lokhu?
Udokotela uzohlola ingane futhi, uma kudingeka, ancome ezinye zalezi zivivinyo.
| Ukuhlolwa | Wenzani ngalokhu? |
|---|---|
| Ukuhlolwa kwezinso nge-ultrasound | Lokhu kuzobheka ukubonakala kwezinso zengane, isinyi, kanye nomgudu womchamo, futhi kuhlole noma yikuphi ukuphazamiseka. |
| I-Voiding Cystourethrogram (VCUG) | Lolu ukuhlolwa kwe-X-ray okukhethekile okungabonisa ngqo ukuthi isinyi sigcwalisa futhi sikhipha kanjani, nokuthi kukhona yini ukuvinjelwa kwe-urethra. |
| I-Cystoscopy | Ukuhlolwa lapho ipayipi elinekhamera encane lidluliselwa khona e-urethra bese ukuvaleka ngaphakathi kubhekwa ngqo. |
| Ukuhlolwa kokusebenza kwezinso | Ukuhlolwa kwegazi nomchamo kuhlola ukuthi izinso zengane zisebenza kahle kangakanani. |
Yiziphi izindlela zokwelapha lokhu?
Ukwelashwa okuyinhloko kwalokhu ukuhlinzwa ukuze kususwe ulwelwesi oluvimbayo. Lokhu kuvame ukwenziwa kusetshenziswa indlela ebizwa ngokuthi "i-fulguration." Lokhu kusho ukusebenzisa ukushisa okuvela kugesi ukuze kubhujiswe izicubu ezengeziwe.
Ngaphezu kwalokho, udokotela angase ancome ezinye izindlela zokwelapha kuye ngesimo sengane.
- Ukufakwa kwe-catheter kumchamo: Ipayipi lesikhashana (i-catheter) lingafakwa ukuze kukhishwe umchamo esinyeni.
- Ama-antibiotic: Uma unesifo somgudu womchamo, uzonikezwa ama-antibiotic ukuze uselaphe.
- Uma izinso zingasebenzi kahle: Uma isimo siba sibi kakhulu futhi izinso zingasebenzi kahle, kungadingeka ukuthi kukhishwe i-dialysis noma kufakwe ukufakelwa kwezinso.
- Eminye imithi: Ama-antispasmodics anganikezwa ukuze kube lula ukuchama.
Akuvamile kakhulu ukuthi ukuhlinzwa kwenziwe ingane isesesibelethweni.
Kwenzekani ngemva kokwelashwa? Uyini umbono?
Ingane ene-PUV izodinga ukubhekwa kwezokwelapha impilo yayo yonke, ngisho nangemva kokwelashwa. Ukuhlolwa kwegazi okuvamile, ukuskena, kanye nokusebenza kwezinso kufanele kuqashwe.
Ezinye izingane zingase zibe nenkinga yokungakwazi ukuzibamba umchamo lapho ziseyingane noma lapho sezikhulile. Izifundo zibonisa ukuthi cishe u-15% wezingane ezinalesi simo zisengozini yokuthola ukwehluleka kwezinso. Kodwa-ke, uhlangothi olubi ukuthi izingane ezingu-85 kwezingu-100 aziba nalesi simo esibi . Ngakho-ke, kubaluleke kakhulu ukusibona kusenesikhathi, siselaphe kahle, futhi uhlale uthintana nodokotela wakho.
Kufanele ngimbone nini udokotela?
Uma usola ukuthi ingane yakho inanoma yiziphi izimpawu esixoxe ngazo, sicela ungazilibali.Yisa ingane yakho kudokotela ngokushesha okukhulu. Uma ingelashwa, lokhu kungabangela izinkinga ezinkulu zempilo.
Yimiphi imibuzo okufanele uyibuze udokotela?
Uma uya kudokotela, kuzosiza ukubuza le mibuzo.
- Yiziphi izindlela zokwelapha lokhu?
- Kwenziwa kanjani ngempela lokhu kwelashwa?
- Yini okufanele uyilindele ngesikhathi sokululama ngemva kokwelashwa?
- Kufanele ngimnakekele kanjani umntwana phakathi naleso sikhathi?
- Kufanele sibuye nini kudokotela futhi?
Kuvamile ukuzizwa wesaba uma uthola ukuthi ingane yakho inenkinga yempilo efana nale. Kodwa into ebaluleke kakhulu ukuqonda ukuthi lokhu akulona iphutha lakho. Udokotela wakho kanye nethimba lezempilo bazokusiza kuzo zonke izinyathelo. Ngakho ungesabi. Landela imiyalelo kadokotela wakho ngqo, bese ubuza noma yimiphi imibuzo onayo.
Umlayezo Wokuya Nawe Ekhaya
- Ama-Posterior Urethral Valves (PUV) ayisifo sokuzalwa esithinta abafana kuphela futhi sivimba ukugeleza komchamo.
- Ubuthakathaka bomgudu womchamo, izifo ezivame ukwenzeka emchameni, kanye nokwehla kwesisindo enganeni kungaba yizimpawu eziyinhloko.
- Lesi simo singatholakala ngisho nangokuskena ngaphambi kokuba umntwana azalwe.
- Ukwelashwa okuyinhloko ukususa ukuvaleka kwe-urethra ngokuhlinzwa.
- Ngisho nangemva kokwelashwa, ukuqapha impilo yonke yezokwelapha kubaluleke kakhulu ukuvikela impilo yezinso zengane.
- Kubalulekile ukuqonda ukuthi lokhu akulona iphutha labazali.
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