Ingabe izinso zakho zivaliwe ukuvaleka kwe-ureter? (Ureteropelvic Junction - UPJ Obstruction) Ake sixoxe ngalokhu!

Ngezinye izikhathi ingane yethu encane izizwa sengathi inesilonda esincane esiswini sayo, noma ivame ukuthola izifo zomchamo, akunjalo? Mhlawumbe ngenxa yomkhuhlane. Esinye sezizathu zalezi zinto kungaba ukuvaleka kwendawo lapho umchamo uqala khona ezinso. Namuhla, sizoxoxa ngokuningiliziwe, kalula, ngalesi simo esibizwa ngokuthi `(Ureteropelvic Junction Obstruction)` noma `(UPJ Obstruction)`.

Kuyini lokhu 'kuvinjelwa kwe-ureteropelvic junction'?

Kalula nje, kunendawo efana ne-funnel phezulu kwezinso zakho zombili, esiyibiza ngokuthi `(Renal Pelvis)` . Umchamo ogeleza usuka ezinso uqoqana kule `(Renal Pelvis)`. Bese lo mchamo wehla ngepayipi elibizwa ngokuthi `(Ureter)` bese uqoqana esinyeni. Indawo lapho `(Renal Pelvis)` kanye `(Ureter)` kuhlangana khona ibizwa ngokuthi `(Ureteropelvic Junction - UPJ)`. Uma kukhona ukuvaleka, okungukuthi, ukuvaleka, kule ndawo yokuvaleka ngesizathu esithile, umchamo awuwehli kahle. Yilokhu esikubiza ngokuthi `(UPJ Obstruction)`.

Ngokuvamile, inso ngayinye ine-`(Ureter)` eyodwa kuphela. Izinso zethu zihlunga ukungcola kanye noketshezi oluningi oluvela egazini bese zikhiqiza umchamo. Umchamo okhiqizwa ngale ndlela uqoqana ku-`(Renal Pelvis)`, udlule ku-`(UPJ)`, bese uhamba nge-`(Ureter)` uye kwesinye. Uma kukhona i-`(UPJ Obstruction)`, lokhu kugeleza komchamo kuhamba kancane kakhulu, futhi ngezinye izikhathi kungayeka ngokuphelele. Lokhu kwandisa ingozi yokulimala kwezinso.

Esikhathini esiningi, lesi simo esibizwa ngokuthi `(UPJ Obstruction)` siyinto ekhona lapho kuzalwa (okungukuthi, `(Congenital urinary abnormality)`). Futhi ngokuvamile sithinta inso eyodwa kuphela. Amanye amagama alokhu yi-`(UP junction obstruction)`, `(Obstruction of the ureteropelvic junction)`, noma `(UPJO)` ngamafuphi.

Ingabe lokhu `(UPJ Obstruction)` kuyisimo esibucayi?

Yebo, i-UPJ Obstruction iyisimo esibucayi. Uma ingelashwa kahle, ingaholela nasekuhlulekeni kwezinso . Yingakho kubalulekile ukuqaphela futhi uthathe izinyathelo ezidingekayo. Akukho okufanele ukhathazeke ngakho, kodwa kufanele uqaphele.

Sivame kangakanani lesi simo?

Ngokwezibalo, cishe ingane eyodwa kwezingu-1,500 ezizalwayo inalesi simo (i-UPJ Obstruction). Lokhu kusho ukuthi, nakuba kungavamile kakhulu, kungenzeka kunoma ubani.

Yiziphi izimpawu ze-`(Ureteropelvic Junction Obstruction)`?

Kunezimpawu eziningana ezivamile ezingabonakala kulesi simo. Kodwa-ke, ngezinye izikhathi, ikakhulukazi ezinganeni ezincane, kungase kungabi khona zimpawu zangaphandle.

• Umuzwa ofana neqhubu esiswini, ikakhulukazi ohlangothini lwesisu. Lokhu kubangelwa ukuvuvukala kwezinso ngenxa yokuvaleka komchamo. Kuzwakala njengebhaluni lamanzi.
• Ukutheleleka okuvamile komgudu womchamo (UTIs) kanye nomkhuhlane. Uma ingane encane ivame ukuthola ama-UTI, lokhu kuyinto okufanele icatshangelwe.
• Ubuhlungu besifuba. Lobu ubuhlungu obuzwakala ngemuva kwezinso. Ngezinye izikhathi lobu buhlungu buyafika buphele.
• Amatshe ezinso. Amatshe ezinso avame ukwakheka uma umchamo uvaliwe.
• Igazi emchameni (`(Hematuria)`) .
• Isicanucanu nokuhlanza.
• Ukubambezeleka kokukhula noma ukwehla kwesisindo enganeni . Ngezinye izikhathi lezi zimo zingabonakala.

Iyini imbangela eyinhloko ye-UPJ Obstruction?

Sengikushilo kakade ukuthi izimo eziningi zokuvaleka kwe-UPJ zizalwa nazo . Lokhu kusho ukuthi uma ingane isesibelethweni, izingxenye zesimiso somchamo, ikakhulukazi i-ureter noma izinso, azakheki kahle. Ngezinye izikhathi, lokhu kuvaleka kungabangelwa nokucindezelwa komthambo wegazi odlula ku-UPJ. Lezi ngokuvamile ziyizenzakalo ezingahleliwe. Kodwa-ke, uma othile emndenini wakho enalesi simo, ungase ube sengozini encane yokuba naso.

Akuvamile kakhulu ukuthi abantu abadala babe ne-"UPJ Obstruction". Kodwa-ke, kungenzeka kubantu abadala ngenxa yezizathu ezilandelayo:

• Ngenxa yamatshe ezinso .
• Ngenxa yokutheleleka emgudwini womchamo ongaphezulu (`Upper UTIs`) .
• Ngemva kokuhlinzwa kuleyo ndawo.
• Ngenxa yokuvuvukala (`(Ukuvuvukala)`) engxenyeni engenhla yesistimu yomchamo .

Ubani othinteka kakhulu yilesi simo?

Ngokusho kwedatha yamanje, amadoda anamathuba okuphindeka kabili okuthola i-UPJ Obstruction kunabesifazane. Ucwaningo luthole nokuthi lesi simo cishe siphindwe kabili amathuba okwenzeka ezinso zesobunxele kunezinso zesokudla.

Yiziphi izinkinga ezingaba khona ze-UPJ Obstruction?

Uma lesi simo (i-UPJ Obstruction) singelashwa kahle, kungavela izinkinga ezahlukahlukene.

• Ukutheleleka okuphindaphindiwe komgudu womchamo (UTIs) . Ngezinye izikhathi, izicubu ezinamafutha ezizungeze izinso zingavuvukala (ukugoba kwe-perinephric).
• Ubuhlungu obungapheli bungase buvele endaweni ethintekile .
• Kungase kwakheke amanye amatshe ezinso (``amatshe ezinso esibili``) .

Into ebaluleke kakhulu ukuthi uma ingelashwa isikhathi eside, lokhu `(UPJ Obstruction)` kungalimaza izinso futhi ekugcineni kuholele ekuhlulekeni kwezinso . Yingakho kubalulekile ukuxilonga nokwelapha kusenesikhathi.

Ungasithola kanjani isimo `(UPJ Obstruction)`?

Ezimweni eziningi,Odokotela bangayixilonga i-UPJ Obstruction ngesikhathi sokuhlolwa kwe-ultrasound ngesikhathi umntwana esesesibelethweni. Lokhu kungenxa yokuthi ukuvaleka komchamo kubeka ingcindezi ngemuva kwezinso, okubangela ukuthi zivuvuke ngaphezu kokuvamile. Lokhu kubizwa ngokuthi i-hydronephrosis . Lokhu kungabonakala ngokucacile ku-ultrasound.

Ngisho nangemva kokuzalwa komntwana, odokotela bangase bacele ukuhlolwa okuhlukahlukene ukuze babone ukuthi izinso zikhiqiza futhi zikhipha umchamo kahle kangakanani. Lokhu kufaka phakathi:

• Ukuhlolwa kwegazi nomchamo (`(Ukuhlolwa kwegazi nokuhlaziywa komchamo)`). Ukuhlolwa okufana ne -`(Blood Urea Nitrogen - BUN)` kanye ne -`(Creatinine Clearance)` kungabonisa ukuthi izinso zihlunga kahle kangakanani igazi.
• Ukuhlolwa okubizwa ngokuthi i-"Intravenous Pyelogram - IVP" kuhilela ukufaka idayi ekhethekile emthanjeni osengalweni yakho bese uthatha izithombe ze-"X-ray". Idayi ingabonakala njengoba ihamba ezinso, ``Renal Pelvis'', kanye ``Ureter'' ukuze kutholakale ukuthi kukhona yini ukuvaleka.
• Ukuskena Kwezinso. Kulolu vivinyo, inani elincane lezinto ezinemisebe lifakwa emthanjeni bese kusetshenziswa ikhamera ekhethekile ukuze iwubuke udlula ezinso. Lokhu kunganikeza umbono omuhle wokuthi izinso zisebenza kahle kangakanani kanye nobukhulu bokuvinjelwa.
• I-Ultrasound, i-CT scan, kanye ne-MRI. Lezi zivivinyo zokuthwebula izithombe zingabona ngokucacile ukwakheka kwezinso, ama-ureter, kanye nesinye, kanye nanoma yikuphi ukuvinjelwa ezinso.

Iphathwa kanjani i-`(UPJ Obstruction)`?

Lokhu kuncike kakhulu esimweni. Uma ingane yakho ine-UPJ Obstruction, ngezinye izikhathi ingaba ngcono ngokwayo ezinyangeni zokuqala ezingu-18 zokuphila. Phakathi nalesi sikhathi, udokotela wengane yakho uzokwenza ukuhlolwa kwe-ultrasound njalo kanye nezinye izivivinyo ukuqinisekisa ukuthi ukuvaleka kwayo akubangeli monakalo.

Kodwa-ke, uma ingane isangakwazi ukuchama ngemva kwezinyanga ezingu-18, okusho ukuthi ukuvaleka kusekhona, cishe kuzodingeka ukuthi ihlinzwe okubizwa ngokuthi ``Open Pyeloplasty'' . Kulokhu, udokotela wezifo zomchamo wezingane wenza ukusika okukhulu, asuse ingxenye evalekile, bese exhumanisa kabusha ``Ureter'' nezinso, okwenza kube nomgodi obanzi kancane. ``Open Pyeloplasty'' imvamisa ithatha amahora ambalwa, futhi inezinga lempumelelo elingaba ngu-95%.

Kwezinye izimo, udokotela ohlinzayo angenza lokhu kuhlinzwa esebenzisa indlela ebizwa ngokuthi `(Minimally invasive pyeloplasty)`, okuyindlela yerobhothi (`(surgical robot)`) . Ngemuva kwalokho, kwenziwa ukusikwa okuncane bese `(Laparoscope)` nezinye izinto zokuhlinzwa zisebenza ngerobhothi. Impumelelo yale ndlela ifana neye `(Open Pyeloplasty).` Kodwa-ke, lokhu kudinga ikhono lobuchwepheshe elengeziwe ohlangothini lodokotela ohlinzayo. Kuncike futhi eminyakeni nobukhulu bengane.

Enye indlela inqubo ebizwa ngokuthi "i-Endopyelotomy".Kulokhu, udokotela ohlinzayo udlulisa ithuluzi elibizwa ngokuthi ``Endoscope`` (ithubhu elincane elinekhamera) nge-urethra (``Urethra``), eduze kwe-``Ureter``, bese ebheka ukuvaleka. Bese kuthi, kudluliswe ucingo ngomsele ku-``Endoscope```, kunqunywe ukuvaleka ngalo, bese kufakwa ``drain```, okungukuthi, ithubhu, lapho. Le ``drain``` ishiywa endaweni yayo amasonto amaningana ize iphole. Ku-``Endopyelotomy```, akudingeki ukusikwa, futhi kulula kunezinye izindlela ezimbili zokuhlinzwa. Kodwa-ke, izinga lempumelelo liphansi kancane. Ngezinye izikhathi lokhu kungadingeka kwenziwe izikhathi ezingaphezu kwesisodwa.

Ngizozizwa ngingcono ngokushesha kangakanani ngemva kokwelashwa?

Kuncike ekwelashweni okutholile nge-UPJ Obstruction yakho. Iningi labantu liyalulama zingakapheli amasonto amabili kuya kwamane. Kodwa-ke, umzimba wakho uhlukile, ngakho isikhathi sakho sokululama singahluka. Udokotela wakho uzokunikeza umbono omuhle kakhulu ngalokhu.

Ingabe ukuvinjelwa kwe-UPJ kungavinjelwa?

Abacwaningi bezokwelapha abakatholi ukuxhumana phakathi kokudla nokudla okunempilo ngesikhathi sokukhulelwa kanye nokukhula kwe-UPJ Obstruction embungwini. Lokhu kusho ukuthi akukho esingakwenza ukuvimbela i-UPJ Obstruction ukuthi ingenzeki ngesikhathi sokuzalwa.

Kodwa-ke, kubantu abadala abangazalwanga ne-UPJ Obstruction, ukugwema izinto ezilandelayo kungasiza ekunciphiseni le ngozi:

• Ukuvimbela ukwakheka kwamatshe ezinso .
• Ukuvikela izifo zomgudu womchamo (UTIs) .
• Ukugwema ukulimala kwezinso zakho .

Iyini inhloso yalesi simo `(UPJ Obstruction)`?

Uma kutholakale kusenesikhathi futhi kwelashwa kahle, umbono we-UPJ Obstruction muhle kakhulu. Iningi lezingane alibi nezinkinga zesikhathi eside. Futhi, uma kutholakale ngaphambi kokuzalwa, ngezinye izikhathi kungaphela ngaphandle kokwelashwa.

Kodwa-ke, uma utholakala une-UPJ Obstruction kamuva ekuphileni, usengozini enkulu kancane yokulimala kwezinso. Ezimweni ezimbi kakhulu, uma ingelashwa, i-UPJ Obstruction ingaholela ekuhlulekeni kwezinso ngisho nokufa. Yingakho ukuxilongwa kusenesikhathi kanye nokwelashwa kubaluleke kangaka.

Kufanele ubonane nini nodokotela?

Uma wena noma ingane yakho ninezinye zalezi zimpawu, xhumana nodokotela ngokushesha:

• Uma kukhona igazi emchameni (`(Hematuria)`) .
• Uma ibamba esandleni sakho njengesimila esiswini sakho.
• Uma uzwa ubuhlungu esiswini esingaphezulu noma emhlane (`(Ubuhlungu be-flank)`) .
• Uma unomkhuhlane.
• Uma ukukhula kwengane kuphazamisekile (`(Ukukhula kuyantengantenga / ukwehluleka ukukhula)`) .

Kunini lapho kudingeka uye e-Emergency Treatment Unit (ETU) ?

Uma ungakwazi ukuchama, iya ekamelweni lezimo eziphuthumayo eliseduze ngokushesha.Lokhu akuyona into yokulibazisa.

Yimiphi imibuzo okufanele uyibuze udokotela?

Ungabuza udokotela imibuzo efana nale:

• Uyixilonga kanjani le nkinga `(Ukuvimbela I-Ureteropelvic Junction)`?
• Ucabanga ukuthi i-UPJ Obstruction yengane yami izoba ngcono ngaphandle kokwelashwa?
• Yiziphi izindlela zokwelapha?
• Uma kudingeka ukuhlinzwa, iyiphi indlela oyincomayo?
• Iyini amathuba okuthi i-UPJ Obstruction iphinde ivele?

Uyini umehluko phakathi kwe-`(Ureterovesical Junction Obstruction)` kanye ne-`(Ureterovesical Junction - UVJ) Obstruction`?

Kalula nje, kokubili ukuvinjelwa kwe-Ureteropelvic Junction (UPJ) kanye ne-Ureterovesical Junction (UVJ) kwenzeka emaphethelweni e-urethra yakho (ureter). I-UVJ yilapho i-ureter yakho ixhuma khona nesinye sakho. Ukuvinjelwa kwe-UVJ kwenzeka lapho. Kodwa ukuvinjelwa kwe-UPJ kwenzeka ku-Renal Pelvis, lapho i-ureter ixhuma khona nezinso zakho.

Ngakho-ke, yimuphi umyalezo okufanele siwuthathe siwuyise ekhaya kukho konke lokhu?

Kuvamile ukuzizwa wesaba uma uzwa ukuthi ingane yakho ingase ibe nale nkinga, kungakhathaliseki ukuthi kusesikhathini sokuhlolwa ngesikhathi ingane yakho isesesibelethweni noma ngemva kokuzalwa. Ungase uzizwe sengathi uzisola, uzibuza, 'Ingabe ngenze into engalungile? Ingabe kukhona engangingakwenza ukuvimbela lokhu ukuthi kungenzeki?' Kodwa empeleni, lesi simo esibizwa ngokuthi `(Ureteropelvic Junction Obstruction)` siyinto eyenzeka ngezinye izikhathi. Ngisho nodokotela abakwazi ukusho ukuthi yini ebangela lokho.

Into ebaluleke kakhulu ukuthi abantu abaningi bangalulama kulesi simo `(UPJ Obstruction)`. Ngakho-ke, ungesabi ukubona udokotela ukhulume naye. Bayaqonda yonke imibuzo nokwesaba okucabangayo. Bazokusiza nganoma iyiphi indlela abangakusiza ngayo futhi baphendule yonke imibuzo yakho. Ukuxilongwa kusenesikhathi kanye nokwelashwa okufanele yizinto ezibaluleke kakhulu lapha.

Izinso , Umgudu Womchamo, Ukuvalwa kwe-UPJ, Udokotela Wezingane, Uhlelo Lomchamo, Ukuhlinzwa, Ukuvalwa Kwe-Ureteropelvic Junction