Hoʻoponopono extrophy bladder

ʻO ka hoʻoponopono ʻana o ka bladder extrophy kahi ʻoki e hoʻoponopono i kahi kīnā o ka hānau ʻana o ka ʻōpū. Aia ka ʻai i loko o waho. Hoʻohui ʻia me ka paia o ka ʻōpū a hōʻike ʻia. Hoʻokaʻawale ʻia nā iwi pelvic.

Hoʻopili ka hoʻoponopono bladder extrophy i ʻelua ʻoki lāʻau. ʻO ke ʻoki mua ka hoʻoponopono ʻana i ka ʻōpū. ʻO ka lua e hoʻopili i nā iwi pelvic i kekahi i kekahi.

Hoʻokaʻawale ka ʻoki mua i ka pale bladder mai ka paia o ka ʻōpū. Hoʻopaʻa ʻia ka ʻōpū. Hoʻomaikaʻi ʻia ka ʻāʻī bladder a me ka urethra. Hoʻokomo ʻia kahi paipu kūpono, hollow i kapa ʻia he catheter e hoʻokahe i ka mimi mai ka ʻai. Hoʻokomo ʻia kēia ma ka paia o ka ʻōpū. Waiho ʻia ka lua o ka catheter i ka uretra e hāpai i ka hoʻōla.

ʻO ke kaha ʻelua, ʻoki ʻana i ka iwi pelvic, hiki ke hana ʻia me ka hoʻoponopono o ka maʻi ʻaʻa. Hiki ke hoʻolohi ʻia no kekahi mau pule a mau mahina paha.

Pono ke kolu o ke kahakaha inā loaʻa kahi kīnā o ka ʻōpū a i ʻole nā ​​pilikia me nā hoʻoponopono ʻelua.

Paipai ʻia ke ʻoki no nā keiki i hānau ʻia me ka exstrophy o ka bladder. Kū pinepine pinepine kēia hemahema i nā keikikāne a pili pinepine ʻia i nā kīnā hānau ʻē aʻe.

Pono ke ʻoki kino i:

• E ʻae i ke keiki e hoʻomohala i ka mana mimi maʻamau
• Hōʻalo i nā pilikia e hiki mai ana me ka hana moekolohe
• E hoʻomaikaʻi i ke ʻano o ke kino o ke keiki (e nānā maʻamau nā genital)
• Kāohi i ka maʻi hiki ke hōʻeha i nā puʻupaʻa

I kekahi manawa, liʻiliʻi loa ka ʻōpū i ka wā hānau. I kēia hihia, e hoʻopaneʻe ʻia ke kaha a hiki i ka ulu ʻana o ka ʻōpū. Hoʻouna ʻia kēia mau keiki hānau hou i ka home ma nā antibiotic. ʻO ka pūpū, ma waho o ka ʻōpū, pono e māū.

Hiki iā ia ke hala i mau mahina no ka ulu ʻana o ka ʻōpū i ka nui kūpono. E ukali kokoke ʻia ka pēpē e kahi hui olakino. Hoʻoholo ke kime i ka manawa e pono ai ke ʻoki.

Nā pilikia o ka anesthesia a me ke kahakaha ʻana ma:

• Nā hopena i nā lāʻau
• Nā pilikia hanu
• Kahe ʻana o ke kahe, kahe koko
• Maʻi kīnā

Pākuʻi ʻia paha nā pilikia me kēia kaʻina hana:

• Nā maʻi maʻi urinary maʻi
• ʻO ka moe kolohe / erectile
• Nā pilikia ʻiʻo
• Pono no nā hana hou e hiki mai ana
• Manaʻo maikaʻi urinary (incontinence)

Hana ʻia ka hapa nui o ka hoʻoponopono extrophy bladder i ka piha ʻana o kāu keiki i kekahi mau lā wale nō, ma mua o ka haʻalele ʻana i ka haukapila. I kēia hihia, hoʻomākaukau nā limahana o ka haukapila i kāu keiki no ke kaha.

Inā ʻaʻole i hana ʻia ke ʻokiʻoki ke hānau hou kāu keiki, pono paha i kāu keiki i kēia mau hōʻike ma ka manawa o ke ʻoki kino.

• Hōʻike mimi (ka moʻomeheu mimi a me ka urinalysis) e nānā i ka mimi o kāu keiki no ka maʻi a e hoʻāʻo i nā hana o ka hakuʻala
• Nā hoʻokolohua koko (helu piha i ke koko, nā electrolytes, a me nā hoʻāʻo ʻana o nā puʻupaʻa)
• Kākau o ka puka mimi
• X-ray o ka pelvis
• Ultrasound o nā puʻupaʻa

E haʻi mau i ka mea mālama ola o kāu keiki i nā lāʻau a kāu keiki e lawe nei. E hoʻomaopopo iā lākou e pili ana i nā lāʻau a me nā mea kanu āu i kūʻai ai me ka ʻole o ka lāʻau.

He ʻumi mau lā ma mua o ke kaha ʻana, e noi ʻia paha kāu keiki e haʻalele i ka lawe ʻana i ka aspirin, ibuprofen, warfarin (Coumadin), a me nā lāʻau ʻē aʻe. Hana paʻakikī kēia mau lāʻau i ke kōpulu ʻana o ke koko. E noi i ka mea nāna e hāʻawi i kāu keiki i ka lā o ke ʻoki.

I ka lā o ke kaha:

• E noi pinepine ʻia kāu keiki mai inu a ʻai i kekahi mea no kekahi mau hola ma mua o ke kaha ʻana.
• Hāʻawi i nā lāʻau i hāʻawi ʻia e kāu mea hāʻawi aku iā ʻoe e hāʻawi me kahi wai liʻiliʻi.
• E haʻi ka mea hāʻawi i kāu keiki iā ʻoe i ka wā e hōʻea ai.

Ma hope o ke kīpoki iwi pelvic, pono kāu keiki e hoʻolei i ke kino o lalo a i ʻole ka maʻa no 4 a 6 mau pule. Kōkua kēia i ka iwi e hoʻōla.

Ma hope o ke kaha o ka ʻōpū, e loaʻa i kāu keiki kahi paipu e hoʻokahe i ka ʻai ma o ka paia ʻōpū (suprapubic catheter). E noho ana kēia no 3 a 4 mau pule.

Pono pū kāu keiki i ka mālama ʻeha, mālama i ka ʻeha, a me nā lāʻau ʻaloʻalo. E aʻo aku ka mea hoʻolako iā ʻoe e pili ana i kēia mau mea ma mua o kou haʻalele ʻana i ka haukapila.

Ma muli o ka nui o ka makaʻu no ka maʻi, pono i kāu keiki ke loaʻa kahi urinalysis a me ka moʻomeheu mimi i kēlā me kēia kipa keiki maikaʻi. I nā hōʻailona mua o kahi maʻi, hiki ke hana hou i kēia mau hoʻokolohua. Lawe kekahi mau keiki i nā lāʻau antibiotic i nā manawa āpau e pale ai i ka maʻi.

Hana pinepine ka mana mimi ma hope o ka hoʻoponopono ʻana o ka ʻāʻī o ka pale. ʻAʻole kūleʻa kēia ʻoki mau. Pono paha ke keiki e hana hou i ke kahakaha ma hope.

ʻOiai me ke kaha hou ʻana, ʻaʻohe mana o kekahi mau keiki i kā lākou mimi. Pono lākou i catheterization.

Hoʻoponopono i ka hānau hānau kīnā; Hoʻoponopono i ka pale o ka pale hope. Hoʻoponopono hou i ka ʻai; Hoʻoponopono o ka extrophy bladder

• Mālama ʻeha ʻeha - wehe

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-Wein Urology. 12th ed. Piladelapia, PA: Elsevier; 2021: chap 31.

Weiss DA, Canning DA, Borer JG, Kryger JV, Roth E, Mitchell ME. ʻO ka bladder a me ka exacophy cloacal. I: Holcomb GW, Murphy JP, St. Peter SD eds. ʻO Holcomb a me Ashcraft's Pediatric Surgery. ʻEpekema 7 Piladelapia, PA: Elsevier; 2020: chap 58.