He aha te pokanga rāwaka rāwaka? Te Whāinga, te Hātepe me ngā Hua

Ko te pokanga rāwaka rāwaka he tikanga iti nei te whakaeke e whakamahi ana i te kaha rāwaka i arotahi ki te tango, ki te whakaiti rānei i te kiko rāwaka kua whānui. Ko tēnei huarahi hou e āwhina ana i ngā tāne e pā ana ki te hyperplasia prostatic benign (BPH) - he āhuatanga kāore i te mate pukupuku e whānui ai te repe rāwaka me te aukati i te rere o te mimi. Ka arotahi te rāwaka ki te kiko nui rawa atu i te wā e tiaki ana i ngā wāhi hauora e tata ana, he maha ngā wā ka taea e koe te hoki ki te kāinga i te rā kotahi.

He aha te pokanga rāwaka rāwaka?

Ko te pokanga rāwaka rāwaka e rongoā ana i te repe rāwaka kua whānui mā te whakamahi i te kaha mārama i arotahi ki te tango, ki te whakaheke rānei i te kiko e aukati ana. Ka ārahi tō tākuta i tētahi āwhina muka-optic angiangi mā tō urethra (te ngongo e kawe ana i te mimi) kia tae atu ki te repe rāwaka me te kore e tapahi i waho.

Ka mahi te rāwaka pēnei i te taputapu tapahi me te hiri tika. Ka whakawātea i te kiko rāwaka nui rawa atu e pēhi ana i tō urethra, ka whakatuwhera tonu i te ara mō te mimi kia rere noa. I te wā kotahi, ka hiri te wera o te rāwaka i ngā oko toto, e tino whakaiti ana i te toto i te whakataurite ki te pokanga tuku iho.

He maha ngā momo pokanga rāwaka, engari he rite tonu te whāinga: te waihanga i te wāhi nui ake mō te mimi kia haere mā te wā e whakaiti ana i te mamae me te wā whakaora. Ko te nuinga o ngā tāne e kite ana i te pai ake o te mimi i roto i ngā rā, kaua i ngā wiki.

He aha te take e mahia ai te pokanga rāwaka rāwaka?

Ka āwhina te pokanga rāwaka rāwaka i ngā tāne ko te repe rāwaka kua whānui e pā ana ki ngā tohu mimi e raru ana kāore i pai ake i te rongoā. Ka tūtohu pea tō tākuta i tēnei tikanga i te wā e tino pā ana tō kounga o te ora i te mimi i te pō, te rerenga mimi ngoikore, te āhua rānei kāore e taea e koe te whakawātea katoa i tō pūpū.

Ka hiahia te tikanga nei ina karekau nga rongoa tuku iho pērā i te alpha-blockers, i te 5-alpha reductase inhibitors i te whai hua i muri i te marama. He maha nga tāne ka tae ki tēnei wāhi ka ara ake i te pō ki te mimi, ka pōhēhē ki te wharepaku, ki te raru rānei i te rerenga mimi ngoikore e roa ana te otinga.

I ētahi wā ka tūtohu te pokanga rāwerawera mō ngā raruraru nui ake. Kei roto i ēnei ko te kore e mimi (te pupuri mimi), ngā mate mimi e hoki mai ana, ngā kōhatu pūpū i puta mai i te kore e horoi, i ngā raruraru tākihi rānei i te pēhanga mimi.

He aha te tikanga mō te pokanga rāwerawera prostate?

Ko te pokanga rāwerawera prostate te tikanga 30 ki te 90 meneti, ka mahia i raro i te rongoa whānui, i te rongoa tuarā rānei. Ka whakatakoto tō tākuta i a koe i runga i tō tuara me ō waewae e paku ana te tiketike, pērā i te whakamātautau urological engari kei te moe koe.

Ka tīmata te tikanga i te whakauru marie a tō tākuta i tētahi āwhi angiangi, ngawari e kiia nei he resectoscope mā tō urethra. Kei roto i tēnei āwhi he kāmera iti me te muka rāwerawera, e āhei ana tō tākuta ki te kite i ngā mea e mahia ana i runga i te aroturuki. Kāore he tapahi o waho e hiahiatia ana i te mea ka puta katoa ngā mea mā tō whakatuwheratanga mimi tūturu.

I te wā o te rongoa rāwerawera, ka ārahi tō tākuta i te kaha rāwerawera ki te whai i te kiko prostate kua whānui. Ka whakakore te rāwerawera i te kiko tonu (i ngā tikanga pērā i te PVP, i te GreenLight rānei) ka tapahi rānei ki ngā wāhanga ka taea te tango (i ngā tikanga pērā i te HoLEP). Ko te wera mai i te rāwerawera ka hiri i ngā oko toto, ka iti te toto.

Kia tangohia te kiko e aukati ana, ka whakatakoto tō tākuta i tētahi catheter rangitahi mā tō urethra ki tō pūpū. Ka āwhina tēnei ngongo angiangi ki te whakaheke i te mimi i te wā e ora ana tō tinana i te tikanga, te tikanga ka noho i te wāhi mō te 1-3 rā i runga i tō āhuatanga.

Me pēhea te whakarite mō tō pokanga rāwerawera prostate?

Ko te whakarite mō te pokanga rāwerawera prostate e whai ana i ētahi mahi nui hei āwhina i te whakatutuki i te hua pai rawa atu. Ka arotake tō tākuta i ō rongoā katoa o nāianei, ina koa ngā rongoā whakaheke toto pēnei i te warfarin, te aspirin, te clopidogrel rānei, tērā pea me whakamutu 5-7 rā i mua i te pokanga hei whakaiti i te tūponotanga o te whakaheke toto.

Ko te tikanga me karo koe i te kai, i te inu rānei i tētahi mea mō te 8-12 hāora i mua i tō tikanga. He mea nui tēnei wā pōkai kai mō tō haumaru i te wā o te anethesia. Ka hoatu e tō rōpū hauora ngā tohutohu motuhake ki a koe mō te wā hei whakamutu i te kai me te inu i runga i te wā o tō pokanga.

I ētahi rā i mua i te pokanga, he mea whai hua ki te whakarite i tō kāinga mō te whakaora. Whakakiia ngā kākahu hāneanea, whānui, te wai nui me ngā kai hauora, me te whakarite i tētahi tangata hei taraiwa i a koe ki te kāinga me te noho ki a koe mō te 24 hāora tuatahi.

Tera pea ka tūtohu tō tākuta kia whakamutua ētahi taapiri pēnei i te huaora E, te hinu ika, ngā rongoā otaota rānei ka pā ki te whakaheke toto. Mēnā kei te tango koe i ngā rongoā mō ētahi atu āhuatanga pēnei i te mate huka, te toto tiketike rānei, ka whiwhi koe i ngā tohutohu motuhake mō ēhea hei haere tonu me ēhea hei whakamutu mō tētahi wā.

Me pēhea te pānui i ō hua pokanga rāwerawera prostate?

Ka inea te angitu i muri i te pokanga rāwerawera prostate mā te nui o te whakapai ake o ō tohu mimi me te pēhea te huri o tō kounga o te oranga. Ko te nuinga o ngā tāne ka kite i te whakapai ake nui i te kaha o te rere mimi i roto i ngā rā tuatahi, ahakoa ka puta te whakaora katoa me ngā hua pai i roto i te 4-6 wiki.

Tera pea ka whakamahi tō tākuta i ngā ine whāinga hei whai i tō ahunga whakamua. Ko te pātai International Prostate Symptom Score (IPSS), i oti pea i a koe i mua i te pokanga, ka tukurua i ngā haerenga whai muri hei whakatau i tō whakapai ake. Ko te tikanga ka heke ngā kaute mai i ngā awhe nui (20-35) ki ngā awhe ngawari (0-7) i muri i te pokanga angitu.

He huarahi kē anō te rangahau rere wai mimi hei ine i te angitu. I mua i te pokanga, ko te tere o te rere o tō wai mimi pea 8-10 mL ia hēkona, he puhoi rawa tēnei. Whai muri i te whakaora, he maha ngā tāne e eke ana ki te 15-20 mL ia hēkona, neke atu rānei, e whakaatu ana i te whakapai nui i te whakawātea i te pūpū.

E whakaatu ana ngā ine toenga i muri i te mimi i te tino whakawātea o tō pūpū. Ko te toenga i mua i te pokanga o te 100-200 mL (nui atu rānei) ka heke ki raro i te 50 mL i muri i te pokanga rāwerawera angitu, e tohu ana kei te pai ake te mahi o tō pūpū.

Me pēhea te whakanui i tō whakaora i muri i te pokanga rāwerawera prostate?

Ko te whakaora i muri i te pokanga rāwerawera prostate e arotahi ana ki te tuku i tō tinana kia ora i te wā e hoki haere ana ki ngā mahi noa. I ngā rā tuatahi, ka pāngia pea e koe te wera iti i te wā e mimi ana, ā, ka kite pea koe i te iti o te toto i roto i tō wai mimi – he wāhanga noa ēnei o te tukanga whakaora.

He mea nui te noho wai mō te whakaora. Ko te inu i te wai nui ka āwhina i te horoi i tō pūnaha me te whakaiti i te tūponotanga o te pūhui toto, te mate rānei. Me whai kia 8-10 karaihe wai ia rā, ki te kore tō tākuta e tohutohu kē, me te karo i te waipiro me te kawheine ka riri ai i ō kiko e ora ana.

Me whakanui haere te mahi tinana i roto i ngā wiki maha. E whakahihiri ana te hikoi māmā mai i te rā tuatahi, engari me karo koe i te hiki i ngā mea taumaha (nui atu i te 10 pauna), te whakakori tinana kaha, te mahi tūāhua rānei mō te 4-6 wiki. Ka āwhina ēnei here ki te ārai i te toto me te whakarite i te whakaora tika o te wāhi pokanga.

Ka taea e te nuinga o ngā tāne te hoki ki te mahi tēpu i roto i ngā rā torutoru, i te wā e hiahia ana pea te hunga e mahi ana i ngā mahi tinana ki te 2-3 wiki. Ka hoatu e tō tākuta ngā aratohu motuhake i runga i tō ahunga whakamua whakaora me ngā whakaritenga mahi.

He aha te putanga pai mō te pokanga rāwerawera prostate?

Ko te putanga pai rawa atu mai i te pokanga rāwaka rāwaka prostate he whakapai ake nui, he roa i roto i ō tohu mimi me ngā pānga iti. Ko te nuinga o ngā tāne ka kite i te whakahekenga nui o te mimi i te pō, he kaha ake te rere o te mimi, me te kaha ki te whakawātea katoa i ō rātou pūpū mimi me te kore e tōia.

He tino whakahihiri ngā reiti angitu, me te 85-90% o ngā tāne e pūrongo ana i te whakapai ake nui i ō rātou tohu. He tokomaha ka kite ka taea e rātou te moe i te pō anō, kāore anō i te whakamahere i ngā mahi huri noa i ngā wāhi wharepaku, me te whai māia mō te whakahaere i ō rātou pūpū mimi i ngā mahi o ia rā.

Kei roto hoki i te hua pai te pupuri i te mahi tūāhua. Ahakoa ka kite pea ētahi tāne i ngā huringa wā poto i roto i te whakaputa uri (pērā i te whakaputa uri whakamuri i te wā e hoki ana te wai tai ki roto i te pūpū mimi), ko te mahi tūāhua e kore e huri. Ko te nuinga o ngā tāne e pupuri ana i tō rātou kaha ki te whai hononga tata e pai ana.

Ko te roa-roa te tahi atu tohu o te pokanga rāwaka angitu. Kāore i rite ki ētahi rongoā ka ngaro pea te whai huatanga i te roanga o te wā, ko te tango tinana i te kiko e aukati ana ka whai oranga roa mō te nuinga o ngā tāne, me te whakapai ake i ngā tohu e mau ana mō ngā tau maha.

He aha ngā āhuatanga mō ngā raruraru i muri i te pokanga rāwaka prostate?

He maha ngā āhuatanga ka whakanui i tō tūponotanga ki ngā raruraru i muri i te pokanga rāwaka prostate, ahakoa he iti noa iho ngā raruraru nui. He mahi te tau, me ngā tāne neke atu i te 75 tau te pakeke he paku teitei ake te tūponotanga o te pupuri mimi, o ngā raruraru whakaora rānei, ahakoa he maha ngā tāne pakeke e pai tonu ana me te manaaki tika.

Ka pā te hauora o mua ki tō whakaora. Ka taea e te mate huka te whakaroa i te whakaora me te whakanui i te tūponotanga o te mate, i te wā e uaua ai ngā mate ngākau i te rongoā. Ka taea e ngā mate toto toto, i ngā rongoā rānei e pā ana ki te toto te whakanui i te tūponotanga o te toto i muri i te pokanga, ahakoa ka āta whakahaere tō rōpū pokanga i ēnei āhuatanga.

Ka pānga hoki te rahi me te uaua o te whakanui i tō pūkahukahu ki te tūponotanga. Ko ngā pūkahukahu tino nui (nui atu i te 80-100 karamu) ka roa pea te wā o te pokanga, ā, he nui ake te tūponotanga ka hiahiatia ētahi atu tikanga, ahakoa he angitu tonu te pokanga rāihana i ēnei wā.

Ka pānga ētahi āhuatanga o te noho ki tō whakaoranga. Ka tino pā te paowa i te whakaora me te whakanui i te tūponotanga o te mate, i te mea ka uaua te anahēhia me te whakaora i te nui o te taumaha. Ka mahi tō tākuta ki a koe ki te whakatika i ēnei āhuatanga i mua i te pokanga i te wā e taea ana.

He pai ake te pokanga rāihana, te pokanga pūkahukahu rānei?

He maha ngā painga o te pokanga rāihana i te pokanga pūkahukahu tuku iho, mō ngā tāne e hiahia ana ki te whakaiti i te wā whakaora me ngā tūponotanga pokanga. Ko te huarahi rāihana te tikanga ka iti ake te toto, ka poto ake te noho i te hōhipera, ā, ka tere ake te hoki ki ngā mahi noa i te whakataurite ki ngā tikanga tuku iho pēnei i te TURP (te tango i te pūkahukahu mā te ara mimi).

Ka tino iti te ngaronga toto i te pokanga rāihana nā te mea ka hiri te pūngao rāihana i ngā oko toto i a ia e mahi ana. Ko te tikanga he iti ake ngā tāne e hiahiatia ana he whakawhitinga toto, ā, ko te hunga e tango ana i ngā rongoā whakaheke toto ka taea pea te haere tonu i ā rātou rongoā me te mātakitaki tupato, i te mea ko te pokanga tuku iho te tikanga me whakamutu ēnei rongoā.

Ko te wā whakaora te tikanga he poto ake i ngā tikanga rāihana. Ahakoa ka hiahiatia pea e te pokanga tuku iho te 3-5 rā i te hōhipera, he maha ngā tūroro pokanga rāihana ka hoki ki te kāinga i te rā kotahi, i muri rānei i te pō kotahi. Ka tangohia hoki te katetā i mua, te tikanga i roto i te 1-2 rā, kaua i te 3-5 rā.

Heoi, ka tūtohu pea te pokanga tuku iho i ētahi wā. Ko ngā pūkahukahu tino nui, ko te hunga he nui te kiko kiko, ko ngā tūponotanga rānei e whakapaehia ana he mate pukupuku ka pai ake te whakahaere mā ngā huarahi tuku iho. Ka tūtohu tō tākuta mimi i te kōwhiringa pai rawa atu i runga i tō hanganga tinana me tō āhuatanga hauora.

He aha ngā raruraru ka puta i te pokanga rāwerawera prostate?

Ahakoa te nuinga o te wā he haumaru te pokanga rāwerawera prostate, mā te māramatanga ki ngā raruraru ka puta ka āwhina i a koe ki te whakatau whakatau mōhio, me te mōhio ki te wā ki te rapu āwhina hauora. Ko te nuinga o ngā raruraru he iti noa iho, he wā poto, engari he mea nui kia mōhio ki ngā mea ka puta.

Ngā raruraru wā poto noa, ko ngā tohumate mimi rangitahi ka ngaro i roto i ngā wiki. Ka pāngia pea e koe te wera i te wā e mimi ana, te piki o te auau, te ohorere rānei i te wā e ora ana tō tinana. Ka kite ētahi tāne i te toto i roto i tō rātou mimi mō ētahi rā, he mea noa tēnei i te mea ka heke haere.

Ngā raruraru e pā ana ki te māharahara, ahakoa he mea noa, me rapu tonu te āwhina hauora. Kei roto i ēnei:

• Te nui o te toto me ngā kōpuku nui e kore e mutu
• Te kore rawa e mimi i muri i te tangohanga o te katita
• Ngā tohu o te mate pēnei i te kirika, te wiri, te wera nui rānei
• Te mamae nui e kore e pai ake ki te rongoā kua tohua

He mea onge ngā raruraru wā roa, engari ka uru pea te whāiti o te urethra (te whāiti o te urethra), e hiahia ana pea ki te rongoā anō. Ka pāngia e ētahi tāne te ejaculation whakamuri, ka hoki te wai purapura ki roto i te pūpū i te wā o te whakatūpū, ahakoa kāore tēnei e pā ki te kaha ki te whai orgasms.

Ko te kī he whakawhitiwhiti kōrero tuwhera ki tō rōpū hauora me te pūrongo i ngā tohumate e pā ana ki te māharahara. Ka taea te whakahaere pai i te nuinga o ngā raruraru i te wā e kitea ana i te wā tuatahi.

Āhea au e kite ai i te tākuta i muri i te pokanga rāwerawera prostate?

Me whakapā atu koe ki tō tākuta tonu mēnā ka pāngia e koe te nui o te toto, e kore e taea te mimi, ka puta rānei ngā tohu o te mate i muri i tō pokanga rāwerawera prostate. Ko te nui o te toto ko te tuku i ngā kōpuku nui, te whai mimi whero kanapa e kore e mārama ki te piki o te wai, te ngoikore me te whanoke rānei.

Ko ngā tohu o te mate e hiahia ana kia arohia wawe e te tākuta, kei roto ko te kirika i runga ake i te 101°F (38.3°C), te wera nui e kino haere ana, kaua e pai ake, te mimi haunga, te wiri me te mamae o te tinana. Ko ēnei tohu ka tohu pea i te mate i roto i te ara mimi e hiahia ana ki te rongoā paturopi.

Ko te kore rawa e mimi i muri i te tangohanga o tō katita he ohorere hauora. Ahakoa he uaua ki te tīmata i te mimi he mea noa, ki te kore e taea e koe te whakaputa mimi mō te 6-8 haora ahakoa te hiahia, me whai aromatawai hauora tonu koe.

Mō te aroturuki i muri i te mahi, ka whakarite te nuinga o ngā tākuta i ngā whakaritenga i te 1-2 wiki, 6 wiki, me te 3 marama i muri i te pokanga. Mā ēnei haerenga e āhei ai tō tākuta ki te aroturuki i tō haere whakamua o te whakaora, te aromatawai i te whakapai ake o ngā tohu, me te whakatika i ngā āwangawanga e pā ana ki tō whakaora.

Ngā pātai e pā ana ki te pokanga rāweri prostate

Q.1 He pai te pokanga rāweri prostate mō ngā prostate nui rawa?

Āe, ko ētahi momo pokanga rāweri ka taea te rongoā i ngā prostate nui rawa, ahakoa he mea nui te tikanga motuhake. He tino whai hua te HoLEP (Holmium Laser Enucleation of Prostate) mō ngā prostate i runga ake i te 80-100 karamu, e whakahere ana i ngā hua pai ahakoa mō ngā repe kua nui rawa.

Mō ngā prostate nui rawa, ka roa pea te pokanga, me te hiahia kia nui ake te mātanga, engari he maha ngā tāne me ngā prostate kua nui rawa te whakatutuki i te whakamaarama tohu pai. Ka aromatawai tō urologist i tō anatomy motuhake hei whakatau mēnā he tika te pokanga rāweri, mēnā rānei he pai ake ngā huarahi tuku iho.

Q.2 Ka pā te pokanga rāweri ki te kore e taea te whakatika tūāwhiwhi?

Kāore, ko te pokanga rāweri prostate kāore i te nuinga o te wā e pā ana ki te kore e taea te whakatika tūāwhiwhi. Ko ngā tikanga rāweri i hangaia hei tiaki i ngā io e whai wāhi ana ki te mahi tūāwhiwhi, ā, ko te nuinga o ngā tāne e mau ana i tō rātou kaha tūāwhiwhi i mua i te pokanga.

Heoi anō, ka pā pea ētahi tāne i ngā huringa wā poto i roto i te mahi tūāhua i te wā o te whakaora. Ko te tikanga ka ngaro ēnei i roto i te 6-12 wiki i te hekenga o te pūpū me te whakaora o ngā kiko. Mēnā i raru koe i te tūāhua i mua i te pokanga, kāore te tikanga e whakapai ake, engari kāore hoki e kino ake.

Q.3 Ka taea e au te taraiwa i ahau ki te kāinga i muri i te pokanga rāwerawera prostate?

Kāore, kāore e taea e koe te taraiwa i a koe ki te kāinga i muri i te pokanga rāwerawera prostate nā te mea kua whiwhi koe i te rongoā whakawātea, ā, kei te wāhi pea he katita. Me whai tangata koe hei taraiwa i a koe ki te kāinga, ā, me noho tahi koe mō te 24 haora tuatahi.

Ka taea e te nuinga o ngā tāne te hoki ki te taraiwa i roto i te 2-3 rā i te wā e mutu ana te rongoā mamae, e mārama ana, ā, ka taea te noho pai. Heoi anō, me karo koe i te taraiwa i te wā e whai katita ana koe, nā te mea ka kore e pai, ā, ka whakararuraru.

Q.4 Kia pēhea te roa i mua i taku taea te whakakori tinana i muri i te pokanga rāwerawera?

Ka taea e koe te hoki ki te whakakori tinana noa i te 4-6 wiki i muri i te pokanga rāwerawera prostate. E akiakitia ana te hikoi māmā mai i te rā tuatahi, engari me karo koe i te hiki taumaha, te oma, te mahi kaha rānei mō te marama tuatahi.

Me tīmata ki ngā mahi ngawari pēnei i te hikoi, ā, me whakanui haere i te kaha i te wā e pai ana koe. Me karo i ngā mahi e whai wāhi ana ki te tō, te hiki taumaha (nui atu i te 10 pauna), te nekehanga rānei e wiri ana kia whakawātea koe e tō tākuta, te tikanga i te 4-6 wiki i muri i te pokanga.

Q.5 Me pokanga anō au ā muri ake nei?

Kāore te nuinga o ngā tāne e hiahia pokanga anō i muri i te pokanga rāwerawera prostate angitu, me ngā reiti angitu wā roa tata ki te 85-90%. Kāore te kiko i tangohia e tipu anō, nā reira ko ngā painga tonu te tikanga he pumau.

Heoi anō, ka taea e te kiko prostate e toe ana te tipu haere i roto i ngā tau maha. Ka hiahia pea ētahi tāne i te rongoā anō i te 10-15 tau i muri mai, engari he rerekē tēnei i waenga i ngā tangata takitahi. Ko te aroturuki auau me tō tākuta urologist e āwhina ana ki te arotake i tō ahunga whakamua wā roa, ā, ki te whakatika i ngā huringa wawe.