He aha nā pūnana neurogenic a me nā ʻano nui

Anter

• Nā hōʻailona nui
• 1. ʻO ka bladder overactive
• 2. Hypoactive bladder
• Nā kumu kūpono
• Pehea e hōʻoia ai i ke kuhi
• Pehea e hana ai i ka lāʻau
• Loaʻa ka lāʻau neurogenic bladder?

ʻO ka bladder neurogenike ka hiki ʻole ke kaohi i ka hana o ka urination ma muli o ke kīnā ʻole o ka puhā a me ka sphincter urinary, hiki ke loaʻa i kekahi mau kumu, mai nā loli o nā aʻa, kahi e pale ai i nā mākala o ka ʻāina e hana pono, a me nā hanana e hoʻonāukiuki i ka ʻāina, e like me ka hoʻololi ʻana o ka hormonal, ka pehu ʻana o ka puhā a i ʻole nā ​​maʻi, no ka laʻana.

ʻAʻole hiki ke hoʻōla ʻia ka bladder neurogenic, i wehewehe ʻia ma hope o ka loiloi e ka urologist, nāna e hoʻoholo i kāna mau kumu a wehewehe inā he ʻano kēia:

• Hypoactive: ke hiki ʻole i nāʻiʻo ke ʻaelike i ka manawa kūpono;
• Hyperactive: ke nui ka hopena o nā mākala a me ka lilo ʻole o ka mimi.

Ma muli o ke ʻano o ka hakahaka, e hiki i ke kauka ke wehewehe i waena o nā koho lapaʻau, i hoʻopili ʻia me ka hoʻohana ʻana i nā lāʻau, e like me ka oxybutynin, tolterodine a i ʻole ke noi ʻana o ka botulinum toxin, no ka laʻana, me ka hoʻohui ʻana i ka lāʻau hoʻoikaika kino, ka hoʻohana ʻana o ka puhā. probe a ʻoki kino paha.

Nā hōʻailona nui

I loko o ka puhaka neurogenike, aia kahi hoʻololi o nā aʻalolo e kaohi ana i nā mākala e pili ana i ka ʻōpū a i ʻole ka urinary sphincter, i hiki ʻole ke hoʻomaha a ʻaelike paha i ka manawa kūpono.

No laila, lilo ka mea me kēia hoʻololi i ka hiki ke mimi i kahi ala i hoʻohui ʻia, e like me kona makemake. Kaukaʻi ʻia i ke ʻano o ka loli, hiki i ka bladder neurogenic ke:

1. ʻO ka bladder overactive

ʻIke ʻia ia hoʻi he bladder spastic a i ʻole bladder nerve, no ka mea, ʻaelike ʻole ka pākeke, no laila ke kumu o ka nalowale ʻana o ka mimi me nā manawa kūpono ʻole.

• Nā ʻōuli: urinary incontinence, koi e mimi pinepine a i nā mea liʻiliʻi, ʻeha a puhi paha i ka wahi bladder, lilo o ka kaohi o ka hiki ke mimiki.

ʻOi aku ka maʻamau o ka bladder i nā wahine a hiki ke hoʻoulu ʻia e nā loli hormonal i ka menopause, a i ʻole ka uterus hoʻonui ʻia i ka wā hāpai. E ʻike i nā kikoʻī hou aʻe pehea e ʻike ai i ka bladder overactive.

2. Hypoactive bladder

ʻIke ʻia ia hoʻi he pākeke flaccid, ʻoiai ʻaʻole hiki i ka ʻōpala ke ʻaelike manawaleʻa, a i ʻole hiki ʻole i ka sphincter ke hoʻomaha, kahi e mālama ai i ka mimi, me ka hiki ʻole ke hoʻopau pono iā ia.

• Nā ʻōuli: ke manaʻo nei ʻaʻole i hoʻopau loa ka pākeke ma hope o ka mimiki ʻana, e kahe ana ma hope o ka mimi ʻana a i ʻole ka nalowale mimi ʻole. Hoʻonui kēia i nā manawa o ka maʻi urinary tract a me ka hōʻino ʻana o ka hakuʻala, no laila e hoʻomaka koke ʻia ka mālama ʻana.

Nā kumu kūpono

ʻO nā kumu o ka neurogenic bladder hiki i:

• Hoʻonāukiuki i ka maʻi ʻaʻai, e ka maʻi urinary a i ʻole nā ​​hoʻololi hormonal, e like me ka menopause;
• Hoʻololi genetic, e like me myelomeningocele;
• Nā maʻi neurological hiki ke hoʻohuli ʻia e like me neurocysticercosis a i ʻole neuroschistosomiasis;
• Ka hoʻopili ʻana o nā aʻalolo i ka lumbar wahi e ka herniated disc;
• ʻO ka ulia pōpilikia i ka iwi kuamoʻo, ke kumu o ka paraplegia a i ʻole ka quadriplegia;
• Nā maʻi neurological Degenerative e like me nā sclerosis a i ʻole Parkinson's;
• Ka hoʻohaunaele Neurological ma hope o ka hahau ʻana;
• Hoʻololi nā neurological peripheral ma muli o ka maʻi diabetes;
• ʻO ka lilo o ka elasticity bladder, i hoʻokumu ʻia e ka mumū, nā maʻi a i ʻole nā ​​hoʻololi neurological i ka maʻamau.

I nā kāne, hiki i ka prostate hoʻonui nui ke hoʻohālikelike i nā ʻōuli he nui o ka neurogen bladder, kahi kumu i hoʻohuli ʻia i kumu o ka hoʻololi i ka hana o nā mākala urinary.

Pehea e hōʻoia ai i ke kuhi

No ke kuhi ʻana i ka maʻi neurogenic, e loiloi ka urologist i ka mōʻaukala pilikino o ke kanaka, e hōʻike kikoʻī ana i nā ʻōuli, a me ka hoʻokolohua kino ʻana, me ka noi ʻana i nā hoʻokolohua e hiki ke nānā i ka hana o ka urinary tract, e like me ultrasound, radiography ʻokoʻa, urethrocystography a me urodynamic hoʻokolokolo. , e loiloi i ka hōʻemi o nāʻiʻo urinary i ka manawa o ka urination.

Pehea e hana ai i ka lāʻau

Kūpilikiʻi ka mālama ʻana no ka bladder neurogenic a pili pū paha:

• Hoʻohana o nā lāʻau nā agonists parasympathetic, e like me bethanechol chloride, antimuscarinics, e like me oxybutynin (Retemik) a i ʻole tolterodine, a me nā ʻākena ʻē aʻe e hana i nā neurotransmitters, e like me glutamate, serotonin, norepinephrine, dopamine a me gamma-aminobutyric acid (GABA), hoʻohana ʻia e like me kēlā me kēia hihia;
• Botulinum toxin (botox), ka mea hiki ke hoʻohana ʻia e hōʻemi i ka spasticity o kekahi mau mākala;
• Wahi koho, ʻo ia ka paukū o kahi pūpū bladder, i hiki ke hoʻohana ʻia i kēlā me kēia manawa e ka mea maʻi iā ia iho (4 a 6 mau manawa i ka lā) a hemo ʻia ma hope o ka ninini ʻana i ka ʻai.
• ʻOki kino, kahi e hiki ai ke hoʻomaikaʻi i ka hana o ka pākino a hoʻohuli paha i ka mimi i kahi puka waho (ostomy) i hana ʻia i ka paia o ka ʻōpū;
• Physiotherapy, me nā hoʻoikaika kino e hoʻoikaika i ka papahele pelvic. E ʻike pehea e hana ʻia ai ka hoʻōla kino no ka incontinence urinary.

E pili ana ke ʻano o ka mālama ʻana i ke kumu o ka maʻi, ke ʻimi nei i kāna hopena. Eia nō naʻe, inā ʻaʻole hiki kēia, hiki i ke kauka ke koi aku i kahi hui o nā lapaʻau e hoʻomaikaʻi ai i ke ola o ke kanaka, me ka pale ʻana i nā maʻi kūlohelohe a me ka hōʻino kino.

E ʻike i loko o kēia wikiō pehea e hana ai i nā hoʻoikaika kino e hoʻoikaika ai i ka papakū pelvic a pale i ka maʻi neurogenic.

Loaʻa ka lāʻau neurogenic bladder?

Hiki ke hoʻōla ʻia ka maʻi neurogenic ke kumu ʻia ia e nā kumu hoʻohuli, e like me ka maʻi urinary tract a i ʻole ka maʻi lolo e ka neurocysticercosis, e laʻa me ka hōʻike ʻana i ka hoʻomaikaʻi ma hope o ka lapaʻau.

Eia nō naʻe, i nā manawa he nui, ʻaʻohe lāʻau o ka neurogen bladder, akā hiki i ka mālama ʻana ke kōkua i ka hoʻomaikaʻi ʻana i ke kani o nā mākala, hoʻomaha i nā ʻōuli a hoʻomaikaʻi i ke ola o ke kanaka. No kēia, he mea nui e ukali me kahi urologist a, i kekahi mau manawa, kahi neurologist.