Epispadias

ʻO Epispadias kahi kīnā koʻikoʻi i loaʻa i ka wā hānau. I kēia kūlana, ʻaʻole ulu ka urethra i loko o kahi paipu piha. ʻO ka urethra ka paipu e lawe i ka mimi mai ke kino mai ka pale. Hoʻopuka ka mimi i ke kino mai kahi kūpono ʻole me nā epispadias.

ʻAʻole ʻike ʻia nā kumu o nā epispadias. Kūpono paha ia no ka mea ʻaʻole ulu pono ka iwi pubic.

Hiki i nā Epispadias ke hana me kahi hānau hānau kīnā ʻole i kapa ʻia ʻo bladder exstrophy. I kēia kīnā hānau, hāmama ka ʻōpū ma ka paia o ka ʻōpū. Hiki pū kekahi iā Epispadias me nā kīnā hānau ʻē aʻe.

Kū pinepine ke ʻano i nā keikikāne ma mua o nā kaikamahine. Hoʻomaopopo pinepine ʻia i ka wā hānau a i ʻole ma hope koke.

E loaʻa i nā kāne kahi penis, ākea ākea me ka piko ʻole. Wehe pinepine ka urethra ma luna a ʻaoʻao paha o ka peni ma kahi o ka piko. Eia nō naʻe, wehe paha ka urethra ma ka lōʻihi holoʻokoʻa o ka peni.

He clitoris a labia ʻole nā ​​wahine. ʻO ka wehe ʻana o ka urethral ma waena o ka clitoris a me ka labia, akā aia paha ia ma ka ʻōpū. Loaʻa paha iā lākou ka pilikia i ke kaohi ʻana i ka urination (urinary incontinence).

Aia nā hōʻailona me:

• ʻO ka wehe maʻamau mai ka ʻāʻī bladder i kahi ma luna aʻe o ka wehe urethra maʻamau
• Kahe hope o ka mimi i loko o ka puʻupaʻa (reflux nephropathy, hydronephrosis)
• Miki ʻole
• Nā maʻi maʻi urinary
• Iwi iwi maha

E komo pū paha nā hoʻāʻo:

• Hōʻaʻo koko
• Intravenous pyelogram (IVP), kahi kūikawā x-ray o nā puʻupaʻa, loko, a me nā ureter
• MRI a me CT scans, kaukaʻi ʻia i ke ʻano
• Pelvis x-ray
• ʻO Ultrasound o ka ʻōnaehana urinary a me nā genital

ʻO ka poʻe i ʻoi aku ma mua o kahi hihia akahai o nā epispadias e pono ke ʻoki.

Hiki ke hoʻoponopono pinepine ʻia ka liʻu o ka mimi (incontinence) i ka manawa like. Eia nō naʻe, pono paha kahi ʻoki ʻelua ma hope koke iho o ke ʻoki mua, a i ʻole kekahi manawa i ka wā e hiki mai ana.

Hiki i ke kīpoki ke kōkua i ke kanaka e kaohi i ke kahe o ka mimi. Hoʻoponopono ia i ka hiʻohiʻona o nā genital.

Hiki i kekahi poʻe me kēia ʻano ke hoʻomau i ka incontinence urinary, ʻoiai ma hope o ke kaha ʻana.

Hiki ke hōʻino ʻia ka ureter a me ka hakuʻala a me ka infertility.

Kāhea i kāu kahu mālama ola inā he nīnau kāu e pili ana i ka helehelena a i ʻole ka hana o nā genital a kāu keiki a i ʻole ka urinary tract.

Hewa ʻōiwi - epispadias

ʻO Elder JS. Nā Anomalia o ka ʻai. I: Kliegman RM, St Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. ʻO Puka Textbook of Pediatrics ʻo Nelson. 21st ed. Piladelapia, PA: Elsevier; 2020: chap 556.

Gearhart JP, Di Carlo HN. Pākuʻi exstrophy-epispadias. I: Partin AW, Dmochowski RR, Kavoussi LR, Peters CA, eds. Campbell-Walsh Urology. 12th ed. Piladelapia, PA: Elsevier; 2021: chap 31.

ʻO Stephany HA. ʻO MC. Nā maʻi Urologic. I: Zitelli, BJ, McIntire SC, Nowalk AJ, eds. ʻO Zitelli lāua ʻo Davis 'Atlas o ka Pediatric Physical Diagnosis. ʻEpekema 7 Piladelapia, PA: Elsevier; 2018: chap 15.