Urinary incontinence - hoʻomaha ʻana o retropubic

Hoʻomaha ʻia ʻo Retropubic i kahi ʻoki e kōkua i ka mālama ʻana i ke koʻikoʻi incontinence. ʻO kēia ka liu mimi e hana i ka wā e ʻakaʻaka ai ʻoe, ʻūlū, uunu ai, hāpai i nā mea, a hoʻoikaika kino paha. Kōkua ke kīʻaha i kou urethra a me ka ʻāʻī bladder. ʻO ka urethra ka paipu e lawe ana i ka mimi mai ka pūpū a i waho. ʻO ka ʻāʻī bladder ka ʻāpana o ka pākā e hoʻopili i ka urethra.

Loaʻa iā ʻoe i ka anesthesia ākea a i ʻole ka anesthesia spinal ma mua o ka hoʻomaka ʻana o ke kaha.

• Me ka anesthesia laula, ke hiamoe nei ʻoe a ʻaʻohe ʻeha.
• Me ka anesthesia ʻōiwi, ua ala ʻoe akā numb mai ka pūhaka a iho a ʻaʻohe ʻeha.

Hoʻokomo ʻia kahi catheter (Tube) i loko o kāu pēpē e hoʻokahe i ka mimi mai kāu pēpē.

Aia he 2 mau ala e hana ai i ka hoʻomaha ʻana o ka retropubic: hāmama hāmama a i ʻole keoki laparoscopic. Ma kēlā a me kēia ʻaoʻao, hiki i ke kahakaha ʻana i 2 mau hola.

I ka wā hāmama:

• Hoʻokiʻoki ʻia kahi ʻoki (incision) ma ka ʻaoʻao haʻahaʻa o kou ʻōpū.
• Ma o kēia ʻoki e loaʻa ai ka pūpū. Humuhumu ke kauka (sutures) i ka ʻāʻī bladder, ʻāpana o ka paia o ka ʻōpū, a me ka urethra i nā iwi a me nā liga i kou pelvis.
• Hāpai kēia i ka bladder a me ka urethra i hiki iā lākou ke pani maikaʻi.

I ka wā o ke kāpili laparoscopic, hana ke kauka i kahi ʻoki liʻiliʻi i loko o kou ʻōpū. Hoʻokomo ʻia kahi mea like Tube e hiki ai i ke kauka ke ʻike i kāu mau ʻōpū (laparoscope) i loko o kou ʻōpū ma o kēia ʻoki. Nānā ke kauka i ka ʻāʻī bladder, ʻāpana o ka paia o ka ʻōpū, a me ka urethra i nā iwi a me nā liga i ka pelvis.

Hana ʻia kēia hana e mālama ai i ka incontinence o ke koʻikoʻi.

Ma mua o ke kūkā kamaʻilio ʻana, e hoʻāʻo ka kauka iā ʻoe e hoʻāʻo hou i ka bladder, hoʻoikaika kino Kegel, nā lāʻau, a i ʻole nā ​​koho ʻē aʻe. Inā ua hoʻāʻo ʻoe i kēia mau mea a ke loaʻa nei nā pilikia me ka hoʻokahe ʻana o ka mimi, ʻo ke ʻoki paha kāu koho maikaʻi loa.

ʻO nā pōʻino no kēlā me kēia ʻoki kino:

• Kahena
• Hoʻopaʻa ke koko i nā wāwae e hele paha i nā akemāmā
• Nā pilikia hanu
• ʻO ka maʻi i keʻokiʻoki, a wehe paha o kaʻoki
• Nā maʻi ʻē aʻe

ʻO nā pilikia no kēia ʻoki kino penei:

• ʻO ke ala maʻamau (fistula) ma waena o ka lua a me ka ʻili
• ʻO ka hōʻino i ka urethra, bladder, a i ʻole nā ​​ʻōpū
• ʻO ka huhū huhū, ke kumu o ka mimiki pinepine pinepine
• ʻOi aku ka paʻakikī o ka hoʻonele ʻana i kāu bladder, a i ʻole ka pono e hoʻohana i kahi catheter
• Worsening o ka mimi leakage

E haʻi i kāu mea mālama ola i nā lāʻau āu e lawe nei. Hoʻopili kēia i nā lāʻau, nā mea hoʻopihapiha, a i ʻole nā ​​mea kanu āu i kūʻai ai me ka ʻole o ka lāʻau.

I nā lā ma mua o ke kaha ʻana:

• E noi ʻia paha ʻoe e haʻalele i ka lawe ʻana i ka aspirin, ibuprofen (Advil, Motrin), warfarin (Coumadin), a me nā lāʻau ʻē aʻe paʻakikī i kou koko ke ʻū.
• E nīnau i nā lāʻau āu e lawe ai i ka lā o kou ʻoki ʻana.
• Inā puhi ʻoe, hoʻāʻo e kū. Hiki i kāu mea hāʻawi ke kōkua.

I ka lā o kou ʻoki kino:

• E noi ʻia ʻoe ʻaʻole e inu a ʻai paha i kekahi mea no 6 a 12 mau hola ma mua o ke kaha ʻana.
• E lawe i nā lāʻau i kauoha ʻia iā ʻoe e lawe me kahi wahi wai ʻuʻuku.
• E haʻi ʻia ʻoe i ka wā e hōʻea ai i ka haukapila. E hōʻea pono i ka manawa.

E loaʻa paha kahi catheter i kāu urethra a i ʻole i loko o kou ʻōpū ma luna o kou iwi pubic (suprapubic catheter). Hoʻohana ʻia ka catheter e hoʻokahe i ka mimi mai ka ʻai. E hoʻi paha ʻoe i ka hale me ka catheter ma kahi. A i ʻole, pono ʻoe e hana catheterization intermittent. He hana kēia e hoʻohana ai ʻoe i kahi catheter wale nō ke pono ʻoe e mimi. E aʻo ʻia ʻoe pehea e hana ai i kēia ma mua o kou haʻalele ʻana i ka haukapila.

Loaʻa paha iā ʻoe ka ʻūlū ʻino i loko o ka lua ma hope o ke kaha ʻana e kōkua ai e hōʻoki i ke kahe ʻana o ke kahe. Lawe ʻia ia i kekahi mau hola ma hope o ke kaha ʻana.

Hiki iā ʻoe ke haʻalele i ka haukapila i ka lā like me ke ʻoki. A i ʻole, noho paha ʻoe no 2 a 3 mau lā ma hope o kēia ʻoki ʻana.

E hāhai i nā ʻōkuhi e pili ana i ka mālama ʻana iā ʻoe iho ma hope o kou hoʻi ʻana i ka home. Mālama i nā wā hoʻopaʻa hope.

Hoʻoemi ka liʻiliʻi urinary no ka hapa nui o nā wahine i loaʻa i kēia ʻoki. Akā loaʻa mau paha kahi kahe. ʻO kēia paha no ka mea ʻo nā pilikia ʻē aʻe ke kumu o kou incontinence urinary. I ka hala ʻana o ka manawa, hoʻi paha kekahi a i ʻole nā ​​kulu āpau.

E wehe i ka colposuspension retropubic; Marshall-Marchetti-Krantz (MMK) hana; Laparoscopic retropubic colposuspension; Hoʻokuʻu nila; ʻO Burch colposuspension

• Hoʻomaʻamaʻa Kegel - mālama pono iā ʻoe iho
• ʻO ka catheterization ponoʻī - wahine
• Mālama pōpoki Suprapubic
• Nā mīkini mimi - he aha e nīnau aku ai i kāu kauka
• Nā huahana incontinence urinary - mālama pono iā ʻoe iho
• ʻOki kino incontinence - wahine - hoʻokuʻu
• Urinary incontinence - he aha e nīnau aku ai i kāu kauka
• Nā ʻeke hoʻokahe mimi
• Ke loaʻa ʻoe i ka incontinence urinary

ʻO Chapple CR. ʻO ke keʻoki hoʻomaha hoʻomaha Retropubic no ka hoʻomau ʻole i nā wahine. I: Wein AJ, Kavoussi LR, Partin AW, Peters CA, eds. Campbell-Walsh Urology. 11th hua. Piladelapia, PA: Elsevier; 2016: chap 82.

Dmochowski RR, Blaivas JM, Gormley EA, et al. Hōʻano hou o ke alakaʻi AUA e pili ana i ka hoʻokele hoʻokele o ka wahine urinary incontinence. J Urol. 2010; 183 (5): 1906-1914. PMID: 20303102 www.ncbi.nlm.nih.gov/pubmed/20303102.

ʻO Kirby AC, ʻo Lentz GM. ʻO ka hana o ka urinary tract haʻahaʻa a me nā maʻi: physiology o ka micturition, hoʻopau ʻole i ka hana ʻole, ka hoʻomau ʻole ʻana o ka urinary, nā maʻi maʻi urinary, a me ka maʻi maʻi bladder. I: Lobo RA, Gershenson DM, Lentz GM, Valea FA, eds. Gynecology Comprehensive. ʻEpekema 7 Piladelapia, PA: Elsevier; 2017: chap 21.