Bladder Neurogenic

ʻO ka Neurogenic bladder kahi pilikia kahi e nele ai ke kanaka i ka mana o ka maʻi bladder ma muli o ka lolo, ka iwi kuamoo, a me ke ʻano nerve.

Pono e hana pū kekahi mau mākala a me nā ʻalalā no ka huki e paʻa i ka mimi a mākaukau ʻoe e hakahaka. Hele a hoʻi nā leka nerve ma waena o ka lolo a me nā mākala e kaohi ana i ka hemo ʻana o ka ʻōpū. Inā hōʻino ʻia kēia mau aʻalolo e ka maʻi a ʻeha paha, ʻaʻole hiki i nā mākala ke hoʻopaʻa a hoʻomaha paha i ka manawa kūpono.

ʻO nā maʻi o ka ʻōnaehana waena waena ke kumu o ka neurogen bladder. Hiki i kēia mau mea ke:

• Maʻi Alzheimer
• Nā kīnā hānau o ka iwi kuamoʻo, e like me spina bifida
• ʻO nā kūpoko o ka lolo a i ʻole ka iwi kuamoʻo
• Pāpā lolo
• ʻO Encephalitis
• Ke aʻo kīnā e like me ka ʻike deficit hyperactivity maʻi (ADHD)
• Sclerosis maha (MS)
• Maʻi ʻo Parkinson
• ʻEha ʻiwi
• Hahau

ʻO ka hōʻino a i ʻole nā ​​maʻi o nā aʻalolo e hāʻawi ana i ka pūpū hiki ke kumu i kēia ʻano. Hiki i kēia mau mea ke:

• Poino ke nerve (neuropathy)
• Hoʻopilikia ke aʻalolo ma muli o ka hoʻohana lōʻihi ʻana o ka waiʻona
• Poino ke aʻa ma muli o ka maʻi kō lōʻihi
• Ka nele o ka Vitamin B12
• Poino ke aʻa mai ka syphilis
• Poino ke aʻa ma muli o ke kaha pelvis
• Hoʻopilikia ke aʻalolo mai kahi disk herniated a i ʻole stenosis canal spinal

Pili nā ʻōuli i ke kumu. Hoʻokomo pinepine lākou i nā ʻōuli o ka miki ʻole.

ʻO nā ʻōuli o ka bladder overactive:

• Loaʻa i ka mimiki pinepine i nā mea liʻiliʻi
• Hoʻopilikia i ka ninini ʻana i ka mimi āpau mai ka ʻai
• Lilo o ka mālama ʻana i ka ʻai

Hōʻike pū nā ʻōuli o ka bladder underactive i:

• Pīpī piha a hiki paha i ke kahe o ka mimi
• ʻAʻole hiki ke haʻi i ka piha o ka ʻōpū
• Nā pilikia e hoʻomaka ana i ka mimi a me ka hoʻonele ʻana i nā mimi āpau mai ka pale (urinary retention)

Hiki i nā lāʻau ke kōkua i ka mālama ʻana i kāu mau ʻōuli. E ʻōlelo paha kāu mea mālama ola:

• Nā lāʻau lapaʻau e hoʻomaha ai ka puhā (oxybutynin, tolterodine, a propantheline paha)
• Nā lāʻau lapaʻau e hana pono ai i kekahi ʻāʻī (bethanechol)
• Botulinum toxin
• Pākuʻi GABA
• Nā lāʻau antiepileptic

E kuhikuhi paha kāu mea hāʻawi iā ʻoe i kahi mea i hoʻomaʻamaʻa e kōkua i ka poʻe e hoʻokele i nā pilikia o ka maʻi ʻaʻa.

Nā mākau a i ʻole nā ​​ʻenehana āu e aʻo ai e komo pū:

• Hoʻomaʻamaʻa e hoʻoikaika i kou puʻupuʻu pelvic nā mākala (Kegel hoʻoikaika kino)
• Ke mālama nei i kahi diary o ka wā e mimi ai ʻoe, ka nui āu i mimi ai, a inā ʻoe i pū kekahi i ka mimi. Kōkua paha kēia iā ʻoe e aʻo i ka wā e ninini ai ʻoe i kou ʻōpū a i ka wā e ʻoi aku ai kou maikaʻi ma kahi o ka lua.

E aʻo e ʻike i nā ʻōuli o nā maʻi urinary (UTIs), e like me ka puhi ʻana i ka mimi ʻana, ke kuni, ka ʻehaʻeha o ke kua ma kekahi ʻaoʻao, a me ka pono pinepine e mimi. Hiki paha i nā papa Cranberry ke pale aku i nā UTI.

Pono paha kekahi poʻe e hoʻohana i ka catheter urinary. ʻO kēia kahi paipu lahilahi i hoʻokomo ʻia i loko o kāu ʻōpū. Pono ʻoe i kahi catheter e:

• I kahi i nā manawa āpau (catheter indwelling).
• I kāu pākeke 4 a 6 mau manawa i ka lā e mālama i kāu ʻōpū mai piha piha (catheterization intermittent).

I kekahi manawa pono ka ʻoki. ʻO nā ʻoki lāʻau no ka maʻi neurogenic:

• Sphincter ʻimi hoʻopunipuni
• Hoʻokomo ʻia ka uila ma kahi kokoke i nā aʻalolo o ka maʻi bladder e hoʻoulu ai i nā mākala o ka ʻai
• ʻOki kino Sling
• Hana ʻia o kahi wehe (stoma) kahi e kahe ai ka mimi i loko o kahi ʻeke kūikawā (ua kapa ʻia kēia he urinary diversion)

ʻO ka hoʻoulu uila o ka nerve tibial i ka wāwae e koi ʻia. Hoʻopili kēia i ke kau ʻana i kahi nila i ke aʻa tibial. Pili ka nila i kekahi mea uila e hoʻouna i nā hōʻailona i ke aʻalolo tibial. Hele pū nā hōʻailona i nā aʻalolo ma ka ʻaoʻao o lalo, kahi e kaohi ai i ka puhū.

Inā loaʻa iā ʻoe ka hoʻomau mimi, loaʻa nā ʻoihana no ka ʻike hou a me ke kākoʻo.

Pākuʻi ʻia paha nā pilikia o ka maʻi neurogenic:

• Hoʻopuka ka mimi paʻa mau i hiki ke hoʻohiolo i ka ʻili a alakaʻi i nā ʻeha kaomi
• Hoʻopilikia ka hakuʻala inā lilo ka piha o ka bladder i mea nui, e hoʻoulu ana i nā paipu i hiki i nā puʻupaʻa a i nā puʻupaʻa iho.
• Nā maʻi maʻi urinary

Kāhea i kāu mea hāʻawi inā ʻoe:

• ʻAʻole hiki ke hoʻonele i kāu ʻōpū
• Loaʻa nā hōʻailona o ka maʻi o ke kīloi (fever, burn when you urination, pinepine urination)
• I miki liʻiliʻi, pinepine

Overactivity ʻo Neurogenic detrusor; NDO; ʻO ke kīnā ʻole Neurogenic bladder sphincter; NBSD

• Sclerosis maha - hoʻokuʻu
• Kāohi ʻana i nā ulia puʻe

• Voiding cystourethrogram

Chapple CR, Osman NI. ʻO ka mea hoʻoiho hana ʻole. I: Partin AW, Dmochowski RR, Kavoussi LR, Peters CA, eds. Campbell-Walsh-Wein Urology. 12th ed. Piladelapia, PA: Elsevier; 2021: chap 118.

ʻO Goetz LL, Klausner AP, Cardenas DD. ʻO ke kīnā ʻole o ka bladder. I: Cifu DX, hoʻoponopono. ʻO Braddom's Physical Medicine and Rehabilitation. 5th lā. Piladelapia, PA: Elsevier; 2016: chap 20.

Panicker JN, DasGupta R, Batla A. Neurourology. I: Daroff RB, Jankovic J, Maziotta JC, Pomeroy SL, eds. ʻO Bradley's Neurology i ka hana lapaʻau. ʻEpekema 7 Piladelapia, PA: Elsevier; 2016: chap 47.