He aha te Exstrophy o te Pareihana? Tohutohu, Take, me te Maimoatanga

Ko te exstrophy o te pareihana he mate whanautanga onge e puta mai ana te pareihana o te pepe i waho o tōna tinana, kaua ki roto. Ka puta mai tenei ina kore te pakitara o te kopu o raro e kati tika i te wa o te haputanga, ka waiho te pareihana kia kitea ki waho o te puku.

Ko tenei ahuatanga e pa ana ki te 1 i roto i te 30,000 ki te 50,000 o ngā whānautanga, ka meinga he mea onge. Ahakoa e rangona ana he wehi, kua pai ake ngā tikanga pokanga hou, ā, ka taea e ngā tamariki e pangia ana e te exstrophy o te pareihana te noho ora, hauora, me te tiaki hauora tika.

He aha te exstrophy o te pareihana?

Ka puta te exstrophy o te pareihana ina whanake te pareihana o tō pēpi ki waho o tōna tinana, kaua ki roto i te upoko. Ka puta te pareihana hei mea whero, kia kitea ki te taha raro o te puku o te pēpi, ā, he rite ki te pereti iti, papatahi.

Ko tenei ahuatanga he wāhanga o te rōpū e kiia nei ko te complex exstrophy-epispadias. Kāore te pareihana anake te mea e pā ana – kāore ngā uaua o te kopu, ngā wheua o te upoko, me ngā ira tangata e hangaia ana i tō rātou huarahi noa. Ko ngā wheua o te ihu, e tutaki noa ana i mua, ka wehe tonu.

I ngā tama, ko te tuwhera o te titi (urethra) kei runga ake te nuinga, kaua ki te pito. I ngā kōhine, ka wehe pea te clitoris, ā, ka iti ake pea te tuwhera o te tara i te noa. Ko ēnei rerekētanga katoa e hono ana ki te whanaketanga o te tinana o raro i te wa o te haputanga.

He aha ngā tohu o te exstrophy o te pareihana?

Ko te tohu matua o te exstrophy o te pareihana ka kitea tika i te whānautanga – ka taea e koe te kite i te pareihana ki waho o te puku o tō pēpi. Ko tenei pareihana e kitea ana he whero, he makuku, he rite ki te roto o tō waha, no te mea he rite te momo kiko.

Ko ēnei ngā tohu matua e titiro ana ngā tākuta:

• He pareihana e kitea ana i te taha raro o te kopu e puta ana he whero, he makuku
• He waahi i waenganui i ngā wheua o te ihu e taea ai te kite
• He pito o te puku poto ake, whānui ake e noho ana i raro i te noa
• Te rere tonu o te mimi no te mea kāore te pareihana e taea te pupuri i te mimi tika
• He titi iti ake i te noa i ngā tama, ā, he pōkai te ahua
• I ngā kōhine, he clitoris wehe me te tuwhera o te tara iti
• Ngā hernia inguinal (ngā pupuhi i te rohe o te huha) e puta ake ana i ēnei pēpi

Ko te makuku tonu mai i te mimi ka pāngia te kiri i te taha o te pareihana e kitea ana. Koia te take e aro nui ana ngā tākuta ki te tiaki i te pareihana me te kiri e karapotia ana i muri i te whānautanga.

He aha ngā momo o te exstrophy o te pareihana?

Ko te exstrophy o te pareihana kei roto i ngā momo rerekē, e pā ana ki tō tamaiti i ngā huarahi iti rerekē. Ko te momo tino noa ko te exstrophy o te pareihana noa, kua whakamāramahia nei e tātou.

Ko te exstrophy o te pareihana noa e hanga ana i te 60% o ngā take katoa. I roto i tēnei momo, ka kitea te pareihana, engari ko ētahi atu whekau penei i ngā whekau ka noho tonu ki roto i te tinana. Ko te waahi i waenganui i ngā wheua o te ihu he 2-4 henimita te whānui.

Ko te momo uaua ake ko te cloacal exstrophy e pā ana ki te pareihana, ngā whekau, me te tuaiwi katoa i te wa kotahi. Ka puta mai tenei i te 1 i roto i te 200,000 o ngā whānautanga, ā, e hiahia ana ki te pokanga whānui ake. I roto i tēnei momo, he wāhanga o te whekau nui e kitea ana, ā, pea he raruraru ki te tuaiwi.

Ko te momo ngawari ko te epispadias kāore he exstrophy. I konei, ka noho te pareihana ki roto i te tinana, engari ko te tuwhera o te urethra kei te wahi he. Koinei te pānga ki ngā ira tangata, ā, he uaua pea te whakahaere i te mimi, engari he ngāwari ake te whakaora i te exstrophy o te pareihana.

He aha ngā take o te exstrophy o te pareihana?

Ka puta te exstrophy o te pareihana i ngā wiki tuatahi o te haputanga ina hangaia te tinana o tō pēpi. I waenganui i te 4 me te 10 wiki, ka mutu te whanaketanga noa o te pakitara o te kopu o raro me te pareihana.

Kāore i tino mōhiotia te take tika, engari e whakapono ana ngā tākuta he whakakotahitanga pea o ngā take ira me ngā taiao. Kāore i puta mai i tetahi mea i mahi koe, kāore rānei i mahi i te wa o te haputanga – he mea nui tēnei ki te mōhio no te mea he tokomaha ngā mātua e whakahe ana ki a rātou ano kāore he take.

Ko ēnei ngā mea e kī ana te rangahau pea ka āwhina ki tēnei ahuatanga:

• Ngā huringa ira tupurangi e pā ana ki te hanga o te pakitara o te kopu
• Ngā raruraru ki te nekehanga o ngā pūtau i te wa o te whanaketanga
• Te rere o te toto ki te rohe o te kopu e whanake ana
• Ngā take taiao pea, ahakoa kāore i kitea ngā mea motuhake

Ko te nuinga o ngā take ka puta noa iho, arā, ka puta noa iho kāore he hītori whānau. Ko te tūponotanga o te whānautanga atu i tetahi pēpi me te exstrophy o te pareihana he iti rawa, he iti iho i te 1 i roto i te 100.

Nōhea te kite i te tākuta mō te exstrophy o te pareihana?

Ko te exstrophy o te pareihana e kitea ana i te whānautanga no te mea ka kitea tonu. Ki te whānau tō pēpi me tēnei ahuatanga, ka uru atu kē tō rōpū hauora, ā, ka whakarite i te tiaki i mua atu i tō haerenga atu i te whare haumanu.

Heoi, ki te hapu koe, ā, kāore i kitea te ahuatanga i ngā whakaahua ultrasound noa, ko ēnei ngā tohu e hiahia ana ki te tiaki hauora tonu i muri i te whānautanga. I ētahi wā kāore te ahuatanga e kitea mārama ana i ngā whakaahua ultrasound i mua i te whānautanga, inā he ngawari.

Me whakapiri atu koe ki tō tākuta tamariki tonu ki te kite koe i tetahi ahua ke o te rohe ira tangata o tō pēpi hou, o te kopu o raro rānei. Whakawhirinaki ki ō tūmanako – ki te rerekē te ahua o tetahi mea i tō tumanako, he pai tonu te ui.

Mō ngā tamariki kua pokangahia te exstrophy o te pareihana, me karanga atu koe ki tō tākuta ki te kite koe i ngā tohu o te mate penei i te kirika, te whero ake i te taha o ngā waahi pokanga, te tukunga ranei. Ko ngā huringa i ngā tauira mimi, te mamae hou rānei me whakatenatena te karangatanga ki tō rōpū hauora.

He aha ngā take tūponotanga mō te exstrophy o te pareihana?

Ko te nuinga o ngā take o te exstrophy o te pareihana ka puta noa iho, engari kua kitea e ngā kairangahau etahi take pea ka piki ake te tūponotanga. He mea nui te mahara ko ēnei noa ngā hononga – ko te whai i ngā take tūponotanga kāore e tikanga ka pangia tō pēpi e tēnei ahuatanga.

Ko te ahuatanga he tino noa ake i ngā tama i ngā kōhine, e pā ana ki te 2-3 tama mō ia kōhine. Ko ngā pēpi ma te nuinga e pangia ana e te exstrophy o te pareihana i ngā pēpi o ētahi atu momo iwi, ahakoa ka puta te ahuatanga i ngā rōpū iwi me ngā iwi katoa.

Kua honoa te pakeke o te whaea (neke atu i te 35) ki te piki iti o te tūponotanga, engari kāore tēnei hononga e kaha. E kī ana ētahi rangahau pea ko ētahi tikanga whakahaputanga pea ka honoa ki te tūponotanga teitei ake o te exstrophy o te pareihana, engari kāore te mōhiohio e tino tika.

Ko te whai i te hītori whānau o te exstrophy o te pareihana ka piki ake te tūponotanga, engari he mea onge tonu. Ki te whānau koe, tō hoa rānei me tēnei ahuatanga, ko tō tūponotanga ki te whānau i tetahi tamaiti e pā ana he 1 i roto i te 70, he teitei ake i te taupori whānui, engari he iti tonu.

He aha ngā raruraru pea o te exstrophy o te pareihana?

Ahakoa he tino whakaora te exstrophy o te pareihana, ka āhei te arahi ki ngā raruraru maha ki te kore e whakahaere tika. Ko te mōhio ki ēnei tūponotanga ka āwhina i a koe ki te mahi tahi me tō rōpū hauora hei ārai, hei whakaoti rānei i a rātou i te tīmatanga.

Ko te āwangawanga tino nui ko te tiaki i te pareihana e kitea ana mai i te mate me te whara. Ka āhei te pāngia te kiko o te pareihana, te pupuhi, te mate rānei no te mea ka whakatārewatia tonu ki te hau me ngā huakita. Koia te take e tūtohutia ana e ngā tākuta te pokanga i roto i ngā rā tuatahi o te ora.

Ko ēnei ngā raruraru matua e taea te whanake:

• Ngā mate mimi maha no te hanganga o te pareihana
• Te kino o te whatukuhu no te mimi e hoki ana ki ngā whatukuhu
• Te tūponotanga o te mate pukupuku pareihana, he teitei ake i ngā tāngata me te exstrophy o te pareihana (ahakoa he mea onge tonu)
• Ngā wero whakahaputanga i ngā tāne me ngā wāhine no ngā rerekētanga ira tangata
• Ngā raruraru o te huha mai i ngā wheua o te ihu wehe e pā ana ki te hikoi
• Ngā wero hinengaro e pā ana ki te ahua o te tinana me ngā pokanga maha
• Ngā raruraru whakahaere o te whekau ki te pāngia hoki te tara

Ko te rongo pai, me te tiaki hauora tika me te whai i te aronga, ka taea te ārai, te whakaora rānei i te nuinga o ēnei raruraru. He tokomaha ngā tāngata me te exstrophy o te pareihana e haere tonu ana ki te whānau i ō rātou ake tamariki, ā, e ora ana i ngā ora noa.

Me pēhea te ārai i te exstrophy o te pareihana?

Aroha mai, kāore he huarahi e mohiotia ana hei ārai i te exstrophy o te pareihana no te mea ka puta i te wa o te whanaketanga o te haputanga. Ka puta noa iho tēnei ahuatanga i te nuinga o ngā take, ā, kāore i puta mai i tetahi mea i mahi, kāore rānei i mahi ngā mātua.

Ko te tango i te waikawa folic i mua i te haputanga me te wa o te haputanga e tūtohutia ana mō ngā wāhine katoa, no te mea ka āwhina i te ārai i ētahi mate whānautanga. Ahakoa kāore e ārai motuhake i te exstrophy o te pareihana, ka tautoko i te whanaketanga hauora whānui.

Ki te whai koe i te hītori whānau o te exstrophy o te pareihana, ka taea e te tohutohu ira i mua i te haputanga te āwhina i a koe ki te mōhio ki ō tūponotanga me ō kōwhiringa. Ka taea e te kaiwhakaako te whakamārama i ngā tūponotanga o te whānautanga i tetahi tamaiti e pā ana, ā, ka kōrero mō ngā kōwhiringa whakamātautau i mua i te whānautanga ki te hiahia koe.

Ko te tiaki hauora i mua i te whānautanga me ngā whakaahua ultrasound taipitopito ka taea te kite i te exstrophy o te pareihana i mua i te whānautanga. Ahakoa kāore tēnei e ārai i te ahuatanga, ka taea e te kite i te tīmatanga te āwhina i tō rōpū hauora ki te whakarite mō te whānautanga me te tiaki tonu, ka taea te whakapai ake i ngā hua mō tō pēpi.

Me pēhea te whakatau i te exstrophy o te pareihana?

Ko te exstrophy o te pareihana e whakatauhia ana i tetahi o ngā huarahi e rua: i mua i te whānautanga mā te ultrasound i mua i te whānautanga, i muri tonu i te whānautanga ina kitea te ahuatanga. Kei ia huarahi tōna wa me tōna tukanga.

Ka taea te whakatau i mua i te whānautanga i ngā whakaahua ultrasound noa, i muri i te 15-20 wiki o te haputanga. Pea ka kite te kaiwhakamahi ultrasound kāore te pareihana e kitea ana i tōna wahi noa i roto i te upoko, kāore rānei ka kite i te pareihana e kitea ana i te puku o te pēpi.

Heoi, kāore te kite i mua i te whānautanga e taea ana i ngā wā katoa. Ka ngaro pea te ahuatanga i ngā whakaahua ultrasound, inā he momo ngawari, he uaua rānei te ahua o te pēpi ki te kite mārama. Koia te take ka kitea noa ētahi take i te whānautanga.

I muri i te whānautanga, he tere te whakatau, he mea tirohanga. Ka tirotirohia e tō rōpū hauora tō pēpi, ā, pea ka tono i ngā whakamātautau atu penei i:

• Te ultrasound whatukuhu hei tirotiro i ngā raruraru whatukuhu e pā ana
• Ngā X-rays hei kite i te wehenga o ngā wheua o te ihu
• Ngā whakamātautau toto hei tirotiro i te mahi o te whatukuhu
• Te whakamātautau ira ki te whai tohu o te mate

Ka aromatawaihia hoki e tō rōpū hauora te nui o te ahuatanga hei whakarite i te huarahi whakaora pai. Ka āwhina tēnei aromatawai i a rātou ki te mōhio ki ngā hanganga e pā ana, me te uaua o te whakaora.

He aha te maimoatanga mō te exstrophy o te pareihana?

Ko te maimoatanga mō te exstrophy o te pareihana e hāngai ana ki te pokanga, engari ko te wā me te huarahi e hāngai ana ki te āhuatanga motuhake o tō pēpi. Ko te whāinga matua ko te neke i te pareihana ki roto i te tinana, te kati i te pakitara o te kopu, ā, te āwhina i tō tamaiti ki te mimi noa me te mana mimi.

Ko te nuinga o ngā pēpi e hiahia ana ki tō rātou pokanga tuatahi i roto i te 48-72 haora i muri i te whānautanga. Ko tēnei tukanga tīmatanga, e kiia nei ko te kati matua, e hāngai ana ki te whakanoho i te pareihana ki roto i te kopu, ā, te kati i te waahi i te pakitara o te kopu. Ka whakatata atu hoki te taote i ngā wheua o te ihu wehe.

Pea ka hiahia tō tamaiti ki ētahi atu pokanga i a ia e tipu ana. Ko te pokanga nui tuarua e puta ana i waenganui i ngā tau 2-4 hei āwhina i te whanake o te mana mimi (te kaha ki te pupuri i te mimi). Pea ka hāngai tēnei ki te hanga i tetahi pareihana hou, ki ētahi atu whakarerekētanga rānei hei āwhina i tō tamaiti ki te whakahaere i te mimi.

Ko te mahere maimoatanga e hāngai ana ki:

• Te pokanga kati matua i ngā rā tuatahi o te ora
• Te hanga hou o te pareihana i waenganui i ngā tau 2-4
• Ngā pokanga whakaora ira tangata hei whakapai ake i te ahua me te mahi
• Ngā tukanga atu pea mō te mana mimi ki te hiahiatia
• Ngā haerenga aronga tonu hei tirotiro i te mahi o te whatukuhu me te tipu

Pea ka hiahia ētahi tamariki ki te catheterization intermittent ma (CIC) hei whakamahinga katoa i tō rātou pareihana. Ko tēnei e hāngai ana ki te whakanoho i tetahi pūtau iti ki te pareihana i ngā wā maha i te rā, ā, he tokomaha ngā tamariki e ako ana ki te mahi i tēnei i a rātou e tipu haere ana.

Me pēhea te whakahaere i te tiaki kāinga i te wa o te maimoatanga exstrophy o te pareihana?

Ko te tiaki i te tamaiti me te exstrophy o te pareihana i te kāinga e hiahia ana ki tetahi arotahi motuhake, engari ka noho hei mahi noa me te mahi. Ka whakaakohia e tō rōpū hauora ngā mea katoa e hiahia ana koe ki te mōhio, ā, ka nui te tautoko i a koe.

I mua i te pokanga tuatahi, me tiaki koe i te pareihana e kitea ana mā te hipoki ki te kiriata kiriata mārama, ā, te pupuri i te makuku me te otinga saline. Ka whakaaturia e tō nēhi te tikanga tika, ā, he ngāwari ake i tō whakaaro.

I muri i ngā pokanga, ka nui te tiaki o ngā whara. Ka ako koe ki te pupuri i ngā waahi tapahi kia ma, kia maroke, te titiro ki ngā tohu o te mate, te hoatu rānei i ngā rongoā penei i te whakahaunga. Ko te nuinga o ngā tamariki e ora pai ana, ā, ka tere te whakarite ki tō rātou mahi tiaki.

Ko ēnei ngā mea e hāngai ana te tiaki kāinga ki:

• Te hoatu i ngā rongoā penei i te whakahaunga hei ārai i ngā mate mimi
• Te ako i ngā tikanga catheterization ki te hiahia tō tamaiti
• Te tirotiro i ngā tohu o te mate penei i te kirika, te tukunga ke, te mamae nui rānei
• Te pupuri i ngā hui aronga mō ngā tirotiro whara me te tirotiro i te whakapai
• Te pupuri i te hauora pai i te taha o te ira tangata me ngā rohe pokanga
• Te whakatenatena i ngā mahi noa i te wa e whai ana i ngā herenga nekehanga

Ka taea e tō tamaiti te whai wāhi ki te nuinga o ngā mahi tamariki noa. Ko te kauhoe he mea pai te nuinga i muri i te ora o ngā waahi pokanga, ā, ko te nuinga o ngā hākinakina he mea taea me ētahi whakarerekētanga. Ka ārahi koe e tō rōpū hauora ki ētahi herenga motuhake.

Me pēhea te whakarite mō tō hui tākuta?

Ko te whakarite mō ngā hui ka āwhina i a koe ki te whakamahi i tō wā me te rōpū hauora, ā, ka whakarite kia whakautua ō patai katoa. He mea nui tēnei ina whakahaere ana i tetahi ahuatanga uaua penei i te exstrophy o te pareihana.

Tuhia ō patai i mua i ia haerenga, no te mea he ngāwari te wareware i ngā āwangawanga nui ina kei te hui koe. Pupurihia he pukapuka, he rarangi waea rānei o ngā tohu, ngā huringa, ngā āwangawanga rānei kua kitea e koe mai i te haerenga whakamutunga.

Kawe mai he rarangi o ngā rongoā katoa e tangohia ana e tō tamaiti, tae atu ki ngā horopeta me te maha o ngā wā e tangohia ana e rātou. Kawe mai hoki i ngā hua whakamātautau hou, i ngā rēkōta rānei mai i ētahi atu tākuta ki te kite koe i ngā tohunga i ētahi atu wāhi.

Whakaarohia te kawe mai i tetahi mema whānau tautoko, i tetahi hoa rānei ki ngā hui, inā mō ngā haerenga whakarite pokanga. Ka taea e rātou te āwhina i a koe ki te mahara ki ngā mōhiohio, ā, te whakarato i te tautoko hinengaro i ngā kōrero mō ngā kōwhiringa maimoatanga.

Whakaritea ngā patai motuhake mō te whanaketanga o tō tamaiti, ngā pokanga kei te heke mai, ngā herenga mahi, me te tirohanga roa. Kaua e whakaroa te ui mō tetahi mea e awangawanga ana koe, ahakoa he iti pea te ahua.

He aha te tango matua mō te exstrophy o te pareihana?

Ko te exstrophy o te pareihana he ahuatanga nui, engari he tino whakaora e pā ana ki ngā pēpi mai i te whānautanga. Ahakoa e hiahia ana ki ngā pokanga maha me te tiaki hauora tonu, ko te nuinga o ngā tamariki me tēnei ahuatanga e tipu ana ki te ora ora, hauora, ā, kaha.

Ko te mea nui rawa ki te mahara ko kāore koe e noho kotahi i tēnei haerenga. Ko ngā rōpū urology tamariki he tino wheako ki te whakaora i te exstrophy o te pareihana, ā, kei reira ngā rōpū tautoko me ngā rauemi hei āwhina i ngā whānau ki te whakahaere i ngā wero.

Me te tiaki hauora tika, ko te nuinga o ngā tamariki e whanake ana i te mana mimi pai, te mahi whatukuhu noa hoki. Ka taea e rātou te whai wāhi ki ngā hākinakina, te haere ki te kura noa, te whai mahi rānei, me te whai i ō rātou moemoeka penei i tetahi atu tamaiti. Ko te matua ko te mahi tata atu ki tō rōpū hauora me te whai i te mahere maimoatanga.

Mahara ko ia haerenga o te tamaiti he mea motuhake, ā, ka whakapai tonu ngā hua i te wa e whakapai ake ana ngā tikanga pokanga. Noho whakaaro pai, ui patai, ā, whakanui i ngā wikitoria iti i te huarahi.

Ngā patai e ui pinepinetia ana mō te exstrophy o te pareihana

Ka taea e taku tamaiti me te exstrophy o te pareihana te whānau i ōna ake tamariki a mua?

Ae, he tokomaha ngā tāngata me te exstrophy o te pareihana e taea te whānau i ngā tamariki, ahakoa pea he iti ake ngā reiti whakahaputanga i te noa. Ko ngā tāne te nuinga e whai hua ake ana i ngā wāhine, engari he mea taea te haputanga mō ngā wāhine me te exstrophy o te pareihana.

Ko ngā pokanga whakaora ira tangata e āwhina ana ki te whakapai ake i te mahi me te ahua, e tautoko ana i ngā hononga tata noa. Ka kōrero tō rōpū hauora o tō tamaiti mō ngā kōwhiringa tiaki whakahaputanga ina tika te tau, ā, ka whakautu i ngā patai mō te whakarite whānau.

Me whakamahi tonu rānei taku tamaiti i ngā catheters?

Kāore pea. Ko te nuinga o ngā tamariki me te exstrophy o te pareihana ka whanake i te mana mimi kāore e hiahia ana ki ngā catheters, inā me te pokanga whakaora pareihana angitu. Heoi, he tokomaha ngā tamariki e hiahia ana ki te whakamahi i te catheterization intermittent ma.

Ki te hiahiatia te catheterization, ko te nuinga o ngā tamariki e ako ana ki te mahi i a rātou ano i te tau kura. Ka noho hei wāhanga noa o tō rātou rā, he rite ki te horoi niho, ā, kāore e ārai i a rātou ki te whai wāhi ki ngā mahi noa.

E hia ngā pokanga e hiahiatia ana e taku tamaiti?

Ko te nuinga o ngā tamariki e hiahia ana ki te 2-4 pokanga nui, engari ko te maha tika e hāngai ana ki te hanganga motuhake o tō tamaiti me te pai o te whakautu ki te maimoatanga. Ko te pokanga tuatahi e puta ana i te wā pēpi hou, ka whai ngā tukanga mana mimi i waenganui i ngā tau 2-4.

Pea ka hiahiatia ētahi atu pokanga mō te whakaora ira tangata, ki te puta mai rānei ngā raruraru. Ka kōrero tō rōpū pokanga i te wa e tūmanakohia ana, ā, ka āwhina i a koe ki te whakarite mō ia wāhanga.

Ka taea te kite i te exstrophy o te pareihana i te wa o te haputanga?

I ētahi wā, engari kāore i ngā wā katoa. Ka taea te kite i te exstrophy o te pareihana i ngā whakaahua ultrasound taipitopito i muri i te 15-20 wiki o te haputanga, engari ka ngaro pea. Ko te reiti kite e whakapai ake ana me ngā hangarau ultrasound pai ake me ngā kaimahi wheako ake.

Ahakoa kua kitea i mua i te whānautanga, kāore tēnei e whakarerekē i te huarahi maimoatanga, engari ka taea te āwhina i ngā whānau ki te whakarite hinengaro me te mahi mō ngā hiahia tiaki o tō rātou pēpi.

He aha te tirohanga roa mō ngā tamariki me te exstrophy o te pareihana?

Ko te tirohanga roa he tino pai me te maimoatanga tika. Ko te nuinga o ngā tamariki e whanake ana i te mana mimi, te mahi whatukuhu noa hoki, ā, e ora ana i ngā ora noa. Ka haere rātou ki te kura noa, te whai wāhi ki ngā hākinakina, te whai mahi rānei, ā, te whānau i ō rātou ake whānau.

Ko te whai i te aronga tonu me te rōpū urology he mea nui i te ora katoa hei tirotiro i te mahi whatukuhu me te hauora o te pareihana. Me te tiaki hauora pai, ka taea e ngā tāngata me te exstrophy o te pareihana te tumanako i te roa o te ora me te kounga o te ora.