Yintoni i-neurogenic bladder kunye neentlobo eziphambili

Umxholo

• Iimpawu eziphambili
• 1. Isinyi esibi kakhulu
• 2. Isinye esingasebenziyo
• Izizathu ezinokubangela
• Indlela yokuqinisekisa ukuxilongwa
• Unyango lwenziwa njani
• Isinyi se-neurogenic sinonyango?

I-neurogenic bladder kukungakwazi ukulawula isenzo sokuchama ngenxa yokungasebenzi kakuhle kwisinyi okanye kwi-urinary sphincter, enokubangela izizathu ezininzi, ukusukela kutshintsho kwimithambo-luvo, ethintela izihlunu zommandla ukuba zisebenze ngokufanelekileyo, kunye iimeko ezicaphukisa ummandla, ezinje ngotshintsho lwehomoni, ukudumba kwesinyi okanye usulelo, umzekelo.

I-neurogenic bladder inokuthi okanye inganyangeki, echazwa emva kovavanyo lwe-urologist, egqiba oonobangela bayo kwaye ichaze ukuba loluluhlobo:

• Ukunyaniseka: xa izihlunu zingakwazi ukwenza isivumelwano ngexesha elifanelekileyo;
• Ukungasebenzi: xa kukho ukusikwa okuxhaphakileyo kwezihlunu kunye nokuphulukana nomchamo ngokungafunekiyo.

Ngokusekwe kuhlobo lwesinyi, ugqirha uya kuba nakho ukuchaza phakathi kwonyango, okubandakanya ukusetyenziswa kwamayeza, anje nge-oxybutynin, tolterodine okanye ukusetyenziswa kwetyhefu ye-botulinum, umzekelo, ukongeza kunyango lomzimba, ukusetyenziswa kwesinyi uphando okanye uqhaqho.

Iimpawu eziphambili

Kwisinyi se-neurogenic, kukho utshintsho kwimithambo-luvo elawula izihlunu ezijikeleze isinyi okanye i-urinary sphincter, engakwaziyo ukuphumla okanye ukwenza isivumelwano ngexesha elifanelekileyo.

Ke, umntu onolu tshintsho ulahlekelwa bubuchule bokuchama ngendlela ehambelanayo, ngokwentando yakhe. Kuxhomekeka kuhlobo lotshintsho, isinyi se-neurogenic sinokuba:

1. Isinyi esibi kakhulu

Ikwabizwa ngokuba yi-spastic bladder okanye i-nervous bladder, njenge-bladder contract engazibandakanyi, oko ke kubangela ukulahleka komchamo ngokungalindelekanga nangamaxesha angafanelekanga.

• Iimpawu: ukungakwazi ukubamba umchamo, khuthaza ukuba uchame rhoqo kwaye ubuncinci, iintlungu okanye ukutshisa kwingingqi yesinyi, ukuphulukana nolawulo lokukwazi ukuchama.

Isinyi esibaxekileyo sixhaphake kakhulu kwabasetyhini kwaye sinokuvuselelwa kukutshintsha kwehomoni ekuyekeni ukuya exesheni, okanye ngesibeleko esandisiweyo ngexesha lokukhulelwa. Fumana ezinye iinkcukacha malunga nendlela yokuchonga isinyi esingaphezulu kokusebenza.

2. Isinye esingasebenziyo

Kukwaziwa njenge bladidi yesinye, njengoko isinyi singakwazi ukwenza isivumelwano ngokuzithandela, okanye i-sphincter ayikwazi ukuphumla, ebangela ukugcinwa komchamo, ngaphandle kwesakhono sokuwususa ngokufanelekileyo.

• Iimpawuukuziva ngathi isinyi asikhange sikhuphe konke emva kokuchama, ukuvuza emva kokuchama okanye ukulahleka komchamo ngokungafunekiyo. Oku kwandisa amathuba osulelo lomchamo kunye nokusebenza kwezintso okungalunganga, ke ngoko unyango kufuneka luqaliswe ngokukhawuleza.

Izizathu ezinokubangela

Unobangela wesinyi se-neurogenic unokuba:

• Isinye ukucaphuka, usulelo lomchamo okanye utshintsho kwihomoni, njengasexesheni;
• Utshintsho lwemfuzo, njengakwi-myelomeningocele;
• Izifo eziguqukayo zemithambo-luvo ezinje nge-neurocysticercosis okanye i-neuroschistosomiasis;
• Ukunyanzeliswa kweentsholongwane kwingingqi ye-lumbar nge-disc ye-herniated;
• Ingozi eyonakalisa umqolo, ibangela i-paraplegia okanye i-quadriplegia;
• Izifo zemithambo-luvo ezinokudumba njenge-multiple sclerosis okanye iParkinson's;
• Ukukhubazeka kwemithambo-luvo emva kokubetha;
• Ukutshintsha kwemithambo-luvo ngenxa yeswekile;
• Ukuphulukana nobunzima be-bladder, obangelwa kukudumba, usulelo okanye utshintsho lwe-neurological ngokubanzi.

Emadodeni, iprostate eyandisiweyo inokulinganisa uninzi lweempawu zesinyi se-neurogenic, ekubeni sesona sizathu sibalulekileyo sokuguqula ukusebenza kwemisipha yomchamo.

Indlela yokuqinisekisa ukuxilongwa

Ukuchonga isinyi se-neurogenic, ugqirha womchamo uya kuvavanya imbali yeklinikhi yomntu, echaza iimpawu, kunye novavanyo lomzimba, ukongeza ekufuneni iimvavanyo ezinokuthi ziqwalasele ukusebenza komchamo, njenge-ultrasound, umahluko we-radiografi, urethrocystography kunye novavanyo lwe-urodynamic , Ukuvavanya ukusikwa kwezihlunu zomchamo ngexesha lokuchama.

Unyango lwenziwa njani

Unyango lwe-neurogenic bladder luyinkimbinkimbi kwaye lunokubandakanya:

• Ukusetyenziswa kwamayeza I-parasympathetic agonists, ezinje nge-bethanechol chloride, i-antimuscarinics, enje nge-oxybutynin (Retemic) okanye i-tolterodine, kunye nezinye iiarhente ezisebenza kwii-neurotransmitters, ezinjenge-glutamate, serotonin, norepinephrine, dopamine kunye ne-gamma-aminobutyric acid (GABA), esetyenziswa ngokwe Ityala ngalinye;
• Ityhefu yebotulinum (botox), enokusetyenziselwa ukunciphisa ukungangqinelani kwemisipha ethile;
• Ukuvota okungapheliyo, leyo kukudlula kwetyhubhu yesinyi, enokusetyenziswa ngamguli ngamaxesha athile (izihlandlo ezi-4 ukuya kwezi-6 ngemini) kwaye isuswe emva kokukhupha isinyi;
• Ugqirha, ezinokuba kukuphucula ukusebenza kwesinyi okanye ukuguqula umchamo ukuba uvuleke ngaphandle (i-ostomy) eyakhiwe eludongeni lwesisu;
• Umzimba wonyango, kunye nokuzilolonga ukomeleza umgangatho we-pelvic. Jonga ukuba lwenziwa njani unyango lomzimba ngokungahambelani nomchamo.

Uhlobo lonyango luya kuxhomekeka kwisizathu sesi sifo, sijolise kwisisombululo. Nangona kunjalo, xa oku kungenakwenzeka, ugqirha unokucebisa indibaniselwano yonyango ukuphucula umgangatho wobomi bomntu, ukongeza kuthintelo lwezifo eziphindaphindayo kunye nokonakala kwezintso.

Jonga kule vidiyo indlela yokwenza umthambo ukomeleza umgangatho we-pelvic kunye nokuphepha i-neurogenic bladder:

Isinyi se-neurogenic sinonyango?

Isinyi ye-neurogenic inokunyangeka xa ibangelwa zizinto ezinokubuyela umva, ezinje ngokusuleleka kumchamo okanye usulelo lobuchopho yi-neurocysticercosis, umzekelo, ukubonisa ukuphucula emva konyango.

Nangona kunjalo, kwiimeko ezininzi, i-neurogenic bladder ayinanyango, kodwa unyango lunokunceda ukuphucula ithoni yemisipha, ukunciphisa iimpawu kunye nokuphucula umgangatho wobomi bomntu. Ukulungiselela le nto, kubalulekile ukuba ulandeleke ugqirha womchamo kwaye, kwezinye iimeko, ugqirha wemithambo-luvo.