Eseme ry’Ububabare bw’Umwenge: Ibimenyetso, Impamvu, n’Ubuvuzi

Ububabare bw’umwenge ni uburwayi bwo kuvuka buke cyane aho umwenge w’uruhinja uba hanze y’umubiri aho kuba imbere. Ibi bibaho iyo uruhu rw’inda rwo hasi rudafunze neza mu gihe cy’inda, bikagira ingaruka yo kugaragara kw’umwenge hanze y’inda.

Ubu burwayi bugera kuri 1 kuri buri 30.000 kugeza kuri 50.000 by’abavutse, bikaba bike cyane. Nubwo byumvikana biteye ubwoba, ubu buryo bushya bwo kubaga bwatumye buvurwa neza, kandi abana bafite ubu bubabare bw’umwenge bashobora kubona ubuzima buzira umuze, buzima kandi bafite ubuvuzi bukwiye.

Ese ububabare bw’umwenge ni iki?

Ububabare bw’umwenge buva aho umwenge w’uruhinja uba hanze y’umubiri aho kuba imbere mu kibuno. Umwenge ugaragara nk’umubiri utukura, ugaragara ku gice cyo hasi cy’inda y’uruhinja, ukaba usa nkaho ari agasanduku gato, kagurumye.

Ubu burwayi ni bumwe mu bwo mu itsinda ryitwa exstrophy-epispadias complex. Si umwenge gusa uba wagizweho ingaruka - imikaya y’inda, amagufwa y’igice cyo hasi, n’ibitsina nabyo ntibiba byarakozwe uko bikwiye. Amagufwa y’igitsina, asanzwe ahurira imbere, aba atandukanye.

Mu bahungu, umwenge w’igitsina (urethra) uba uri hejuru aho kuba ku mpera. Mu bakobwa, clitoris ishobora kuba yacitse, kandi umwenge w’inda ushobora kuba muto ugereranyije n’uko bikwiye. Izi mpinduka zose zifitanye isano n’uko igice cyo hasi cy’umubiri gikura mu gihe cy’inda.

Ibimenyetso by’ububabare bw’umwenge ni ibihe?

Ikimenyetso nyamukuru cy’ububabare bw’umwenge kigaragara ubwo umwana avuka - ushobora kubona umwenge hanze y’inda y’uruhinja. Uyu mwenge ugaragara utukura kandi wonyene, usa n’imbere mu kanwa, kuko wakozwe n’ubwo buryo bw’umubiri.

Dore ibimenyetso by’ingenzi abaganga bashaka:

• Umwenge ugaragara ku gice cyo hasi cy’inda ugaragara utukura kandi wonyene
• Ubusa hagati y’amagufwa y’igitsina ushobora kumva
• Umuhogo muto, mugari, uba hasi ugereranyije n’uko bikwiye
• Kuvuza umwenge buri gihe kuko umwenge udashobora kubika umwenge neza
• Igitsina gito ugereranyije n’uko bikwiye mu bahungu, kenshi gifite ishusho y’igikumwe
• Mu bakobwa, clitoris yacitse n’umwenge w’inda muto
• Inguinal hernias (ibibyimba mu gice cy’imbere cy’umubiri) bibaho kenshi muri aba bana

Ubukonje buhoraho buturuka ku mwenge bushobora gutera uburibwe bw’uruhu hafi y’umwenge ugaragara. Niyo mpamvu abaganga bashyira imbaraga mu kurinda umwenge n’uruhu ruri hafi yawo nyuma yo kuvuka.

Ubwoko bw’ububabare bw’umwenge ni ubuhe?

Ububabare bw’umwenge bufite uburyo butandukanye, buri bwo bugira ingaruka ku mwana wawe mu buryo butandukanye gato. Ubwoko busanzwe cyane ni ubwo twita classic bladder exstrophy, twavuzeho kugeza ubu.

Classic bladder exstrophy igize hafi 60% by’ibibazo byose. Muri ubwo buryo, umwenge uba ugaragara ariko izindi ngingo nka za ntanga ziba ziri mu mubiri. Ubusa hagati y’amagufwa y’igitsina busanzwe bugera kuri cm 2-4.

Uburyo bugoranye cyane bwitwa cloacal exstrophy bugira ingaruka ku mwenge, ntanga, n’umugongo icyarimwe. Ibi bibaho kuri 1 kuri buri 200.000 by’abavutse kandi bisaba kubagwa cyane. Muri ubwo buryo, igice cy’amara manini na cyo kigaragara, kandi hashobora kubaho ibibazo ku mugongo.

Uburyo buke cyane ni epispadias idafite exstrophy. Aha, umwenge uba uri mu mubiri, ariko umwenge wa urethra uba utari aho ukwiye. Ibi bigira ingaruka ku gitsina kandi rimwe na rimwe bigatuma bigorana kugenzura umwenge, ariko biroroshye kuvura kurusha exstrophy yuzuye.

Ese impamvu y’ububabare bw’umwenge ni iyihe?

Ububabare bw’umwenge buva mu byumweru byambere cyane by’inda iyo umubiri w’uruhinja uba ukiri gukura. Hagati y’icyumweru cya 4 na 10, ikintu kidindiza iterambere risanzwe ry’uruhu rw’inda rwo hasi n’umwenge.

Impamvu nyakuri ntiyumvikana neza, ariko abaganga bemeza ko bishoboka ko ari uruvange rw’ibintu by’umurage n’ibidukikije. Ntabwo biterwa n’icyo wakoze cyangwa utakoreye mu gihe cy’inda - ibi ni ingenzi kubyumva kuko ababyeyi benshi bakunda kwibasira ubusa.

Dore ibyo ubushakashatsi bugerageza kugaragaza bishobora gutera ubu burwayi:

• Impinduka z’umurage zituma uruhu rw’inda rukura nabi
• Ibibazo byo kwimuka kw’uturemangingo mu gihe cy’iterambere
• Ihindagurika ry’amaraso ajya mu gice cy’inda kiri gukura
• Ibintu bishoboka by’ibidukikije, nubwo bitaramenyekana

Ibi bibazo byinshi bibaho ku bushake, bisobanura ko bibaho ku bushake nta mateka y’umuryango.

Ni ryari ukwiye kubona muganga kubera ububabare bw’umwenge?

Ububabare bw’umwenge busanzwe bumenyekana ubwo umwana avuka kuko bugaragarira buri wese. Niba umwana wawe avuka afite ubu burwayi, itsinda ry’abaganga rimaze kuba ririmo kandi rigenzura ubuvuzi mbere y’uko uvuka mu bitaro.

Ariko rero, niba utwite kandi isuzumwa rya ecographie ritagaragaje ubu burwayi, dore ibimenyetso bikwiye kuvurirwa vuba nyuma yo kuvuka. Rimwe na rimwe ubu burwayi ntibugaragarira neza mu bipimo byo muri ecographie, cyane cyane niba ari buke.

Ukwiye kuvugana na muganga wawe vuba niba ubona ikintu kidasanzwe ku gitsina cyangwa ku gice cyo hasi cy’inda y’uruhinja rwawe. Izera icyo wumva - niba hari ikintu kidasa n’icyo witeze, bihora ari byiza kubabaza.

Ku bana bamaze kubagwa ububabare bw’umwenge, ukwiye guhamagara muganga wawe niba ubona ibimenyetso by’indwara nka fiive, ubukonje bwinshi hafi y’aho babagwe, cyangwa ibintu bitunguranye. Impinduka mu buryo bwo kwinjira umwenge cyangwa ububabare bushya bigomba gutuma uhamagara itsinda ryawe ry’ubuvuzi.

Ibyago byo kugira ububabare bw’umwenge ni ibihe?

Ibibazo byinshi by’ububabare bw’umwenge bibaho ku bushake, ariko abashakashatsi bamenye ibintu bike bishobora kongera amahirwe gato. Ni ingenzi kwibuka ko ibi ari ibintu byahuriranye gusa - kugira ibyago ntibisobanura ko umwana wawe azagira icyo kibazo.

Ubu burwayi bukunze kugaragara mu bahungu kurusha abakobwa, bugera kuri 2-3 bahungu kuri buri mukobwa. Abana b’abazungu baramenyekanaho kugira ububabare bw’umwenge kurusha abana b’andi moko, nubwo ubu burwayi buri mu moko yose n’amoko.

Imyaka myinshi y’umubyeyi (irenga 35) yagaragaye ko ifitanye isano n’ikigereranyo gito cy’ibyago, ariko iyi mibanire ntabwo ikomeye. Ubushakashatsi bumwe bugaragaza ko ubuvuzi bumwe bw’uburumbuke bushobora kuba bufite isano n’amahirwe make yo kugira ububabare bw’umwenge, ariko ibimenyetso ntibihagije.

Kugira amateka y’umuryango w’ububabare bw’umwenge byongera ibyago, ariko biracyari bike cyane. Niba wowe cyangwa uwo mwashakanye mwavutse muri ubwo burwayi, amahirwe yo kugira umwana ufite ubu burwayi ni hafi 1 kuri 70, ari yo ari hejuru y’abaturage muri rusange ariko biracyari bike.

Ingaruka zishoboka z’ububabare bw’umwenge ni izihe?

Nubwo ububabare bw’umwenge buvurwa neza, bushobora gutera ingaruka nyinshi niba budakurikiranwa neza. Gusobanukirwa ibyo bishoboka bigufasha gukorana n’itsinda ryawe ry’abaganga kugira ngo ubikumire cyangwa ubikemure hakiri kare.

Ikibazo cya mbere ni ukurinda umwenge ugaragara kwandura no gukomereka. Umutima w’umwenge ushobora kubabara, kubyimba, cyangwa kwandura kuko uhora uhura n’umwuka n’udukoko. Niyo mpamvu abaganga bakunda kugira inama yo kubaga mu minsi mike nyuma yo kuvuka.

Dore ingaruka nyamukuru zishobora kuvuka:

• Kwandura kenshi kw’inzira z’umwenge kubera imiterere idasanzwe y’umwenge
• Gukomereka kw’impyiko kubera umwenge usubira mu mpyiko
• Ibyago bya kanseri y’umwenge, bikaba byinshi mu bantu bafite ububabare bw’umwenge (nubwo biracyari bike)
• Ibibazo byo kubyara mu bagabo n’abagore kubera ibitandukanye by’ibitsina
• Ibibazo by’amagufwa kubera amagufwa y’igitsina atandukanye bigira ingaruka ku kugenda
• Ibibazo byo mu mutwe bifitanye isano n’ishusho y’umubiri n’ubuganga bwakozwe inshuro nyinshi
• Ibibazo byo kugenzura amara niba umwenge w’inyuma nawo wagizweho ingaruka

Inkuru nziza ni uko, hamwe no kuvurwa neza no gukurikirana buri gihe, ingaruka nyinshi zishobora kwirindwa cyangwa kuvurwa neza. Abantu benshi bafite ububabare bw’umwenge bakura bagira abana kandi babona ubuzima busanzwe.

Ese ububabare bw’umwenge bushobora kwirindwa?

Ikibabaje ni uko nta buryo bwo kwirinda ububabare bw’umwenge buzwi kuko buva mu iterambere ry’inda. Ubu burwayi buva ku bushake mu bihe byinshi, kandi ntibuterwa n’icyo ababyeyi bakora cyangwa batakora.

Gutaha acide folique mbere y’inda no mu gihe cy’inda bihora bisabwa ku bagore bose, kuko bifasha kwirinda uburwayi bumwe bwo kuvuka. Nubwo bitabuza ububabare bw’umwenge, bishyigikira iterambere ryiza muri rusange.

Niba ufite amateka y’umuryango w’ububabare bw’umwenge, inama y’umurage mbere y’inda ishobora kugufasha gusobanukirwa ibyago byawe n’amahitamo yawe. Umujyanama ashobora gusobanura amahirwe yo kugira umwana ufite ubu burwayi no kuganira ku bipimo byo muri ecographie niba ubikeneye.

Kwita ku buzima bw’inda buri gihe hamwe na ecographie zirambuye rimwe na rimwe zishobora kugaragaza ububabare bw’umwenge mbere y’uko umwana avuka. Nubwo ibi bitabuza ubu burwayi, kumenya hakiri kare bituma itsinda ryawe ry’abaganga ritegura kubyara no kwita ku mwana vuba, ibyo bishobora kunoza ibyavuye mu mwana wawe.

Ese ububabare bw’umwenge bumenyekana gute?

Ububabare bw’umwenge busanzwe bumenyekana mu buryo bubiri: mbere y’uko umwana avuka binyuze mu isuzumwa rya ecographie cyangwa nyuma yo kuvuka iyo ubu burwayi bugaragarira buri wese. Buri buryo bufite igihe cyabwo n’uburyo bwakozwe.

Kumenya mbere y’uko umwana avuka rimwe na rimwe bishobora kubaho mu gihe cy’isuzumwa rya ecographie, busanzwe nyuma y’ibyumweru 15-20 by’inda. Umuhanga mu isuzumwa rya ecographie ashobora kubona ko umwenge utaragaragara aho ukwiye kuba imbere mu kibuno, cyangwa ashobora kubona umwenge ugaragara ku nda y’uruhinja.

Ariko rero, kumenya mbere y’uko umwana avuka ntibishoboka buri gihe. Ubu burwayi bushobora kudasuzumwa muri ecographie, cyane cyane niba ari buke cyangwa niba umwana ari mu mwanya utuma bigorana kubona neza. Niyo mpamvu bimwe mu bibazo bimenyekana gusa ubwo umwana avuka.

Nyuma yo kuvuka, kumenya biba byihuse kandi bigaragarira buri wese. Itsinda ryawe ry’abaganga rizasesengura umwana wawe neza kandi rishobora gutegeka ibizamini byongeyeho nka:

• Isesengura rya ecographie ry’impyiko kugira ngo harebwe ibibazo by’impyiko bifitanye isano
• X-rays kugira ngo harebwe ukutandukana kw’amagufwa y’igitsina
• Ibizamini by’amaraso kugira ngo harebwe imikorere y’impyiko
• Ibizamini by’umurage niba hari ibimenyetso by’uburwayi

Itsinda ryawe ry’abaganga rizasuzuma ubu burwayi kugira ngo ritegure uburyo bwiza bwo kuvura. Iyi gusesengura irafasha gusobanukirwa ingingo zikozweho n’uburyo kubaga bizakorwa.

Ese ubuvuzi bw’ububabare bw’umwenge ni ubuhe?

Ubuvuzi bw’ububabare bw’umwenge burimo kubagwa, ariko igihe n’uburyo biterwa n’umwanya w’umwana wawe. Intego nyamukuru ni ukwimura umwenge mu mubiri, gufunga uruhu rw’inda, no gufasha umwana wawe kugira uburyo busanzwe bwo kwinjira umwenge no kugenzura umwenge.

Abana benshi bakeneye kubagwa bwa mbere mu masaha 48-72 nyuma yo kuvuka. Iki gikorwa cya mbere, cyitwa primary closure, kigizwe no gushyira umwenge mu nda no gufunga ubusa mu ruhu rw’inda. Umuganga na we azahuza amagufwa y’igitsina yari atandukanye.

Umwana wawe ashobora kuba akeneye kubagwa byongeyeho uko akura. Kubagwa kwa kabiri bikomeye bisanzwe bibaho hagati y’imyaka 2-4 kugira ngo afashe kugenzura umwenge (ubushobozi bwo gufata umwenge). Ibi bishobora kuba bigizwe no gukora umwenge mushya cyangwa izindi mpinduka kugira ngo umwana wawe agenzure umwenge.

Uburyo bwo kuvura busanzwe bugizwe na:

• Kubagwa kwa primary closure mu minsi mike nyuma yo kuvuka
• Kubagwa umwenge hagati y’imyaka 2-4
• Kubagwa ibitsina kugira ngo bigaragara neza kandi bikore neza
• Ibindi bikorwa bishoboka kugira ngo agenzure umwenge niba bikenewe
• Gusura buri gihe kugira ngo harebwe imikorere y’impyiko n’ubukure

Bamwe mu bana bashobora kuba bakeneye clean intermittent catheterization (CIC) kugira ngo bakure umwenge neza. Ibi bigizwe no gushyira umwenge muto mu mwenge inshuro nyinshi ku munsi, kandi abana benshi bigira uko babikora uko bakura.

Uko wakwita ku mwana wawe mu rugo mu gihe cyo kuvura ububabare bw’umwenge

Kwita ku mwana ufite ububabare bw’umwenge mu rugo bisaba kwita byihariye, ariko biba bisanzwe uko umuntu abimenyera. Itsinda ryawe ry’abaganga rizokwigisha ibyo ukeneye kumenya byose, kandi uzabona ubufasha bwinshi mu nzira.

Mbere yo kubagwa bwa mbere, ugomba kurinda umwenge ugaragara ukawupfuka ukoresheje firime ya plastike isobanutse kandi ukamufata neza ukoresheje umunyu. Umuganga wawe azakwereka uburyo nyabwo, kandi biroroshye kurusha uko byumvikana.

Nyuma yo kubagwa, kwita ku kibyimba biba ingenzi. Uziga uko ugomba kubika ahari ibikomere byiza kandi byumye, ukareba ibimenyetso by’indwara, kandi ugatanga imiti nk’uko byategetswe. Abana benshi barakira neza kandi bahita bimenyera gahunda yabo yo kwita.

Dore ibyo kwita mu rugo bisanzwe bigizwe na:

• Gutanga antibiotique nk’uko byategetswe kugira ngo hirindwe kwandura kw’inzira z’umwenge
• Kwigira uburyo bwo gukoresha catheter niba umwana wawe abikeneye
• Kureba ibimenyetso by’indwara nka fiive, ibintu bitunguranye, cyangwa ububabare bwinshi
• Kwitabira gahunda yo gusuzuma ibikomere n’iterambere
• Kugira isuku nziza hafi y’igitsina n’aho babagwe
• Gushishikariza ibikorwa bisanzwe mugihe ukurikiza amabwiriza yo kugenda

Umwana wawe ashobora kwitabira ibikorwa byinshi by’abana bisanzwe. Koga bisanzwe byemerewe nyuma y’aho ibikomere bikize, kandi imikino myinshi irashoboka hamwe na bimwe mu bintu byahinduwe. Itsinda ryawe ry’abaganga rizaguha amabwiriza ku mipaka yihariye.

Uko wakwitegura gusura muganga

Kwita ku gusura muganga bigufasha gukoresha neza igihe cyawe hamwe n’itsinda ry’abaganga kandi bikabuza kubura ibibazo byawe byose. Ibi ni ingenzi cyane mugihe ugenzura uburwayi bugoranye nka exstrophy.

Andika ibibazo byawe mbere yo gusura buri gihe, kuko byoroshye kwibagirwa ibibazo by’ingenzi mugihe uri mu nama. Gabanya ibitabo cyangwa urutonde rwa terefone rw’ibimenyetso, impinduka, cyangwa ibibazo wabonye kuva ku gusura gushize.

Zana urutonde rw’imiti yose umwana wawe afata, harimo n’umwanya n’igihe ayifata. Nanone, zana ibyavuye mu bipimo biheruka cyangwa inyandiko z’abandi baganga niba wabonye abaganga b’inzobere ahandi.

Tekereza kuzana umuntu wo mu muryango cyangwa inshuti igufasha, cyane cyane ku gusura kw’igenzura ry’ubuganga. Bashobora kugufasha kwibuka amakuru no gutanga ubufasha bwo mu mutwe mugihe muganira ku buryo bwo kuvura.

Tegura ibibazo byihariye ku iterambere ry’umwana wawe, ubuvuzi bw’ejo hazaza, amabwiriza yo kugenda, n’imiterere y’ejo hazaza. Ntugatinye kubabaza icyo ari cyo cyose gikubabaza, uko cyaba kimeze kose.

Icyingenzi cyo kuzirikana ku bubabare bw’umwenge

Ububabare bw’umwenge ni uburwayi bukomeye ariko buvurwa neza bugira ingaruka ku bana kuva bavutse. Nubwo bisaba kubagwa inshuro nyinshi no kwitabwaho n’abaganga buri gihe, abana benshi bafite ubu burwayi bakura bagira ubuzima buzira umuze, buzima kandi bakora ibikorwa.

Ikintu cy’ingenzi cyo kwibuka ni uko nturi wenyine muri uru rugendo. Amashyirahamwe y’abaganga b’inzobere mu kuvura ububabare bw’umwenge, kandi hari amatsinda y’ubufasha n’ibikoresho biriho gufasha imiryango guhangana n’ibibazo.

Hamwe no kuvurwa neza, abana benshi bagera ku kugenzura umwenge neza n’imikorere isanzwe y’impyiko. Bashobora kwitabira imikino, kujya mu ishuri risanzwe, no gukurikirana inzozi zabo nk’abandi bana bose. Ikintu nyamukuru ni ugukorana bya hafi n’itsinda ryawe ry’abaganga no gukurikiza gahunda yo kuvura.

Wibuke ko urugendo rwa buri mwana ari rwose, kandi ibyavuye bikomeza gutera imbere uko uburyo bwo kubaga butera imbere. Komereza kwiringira, ubaze ibibazo, kandi hizihiza intsinzi nto mu nzira.

Ibibazo byakunda kubazwa ku bubabare bw’umwenge

Ese umwana wanjye ufite ububabare bw’umwenge ashobora kugira abana be?

Yego, abantu benshi bafite ububabare bw’umwenge bashobora kugira abana, nubwo umubare w’ababyara ushobora kuba muto ugereranyije n’uko bikwiye. Abagabo basanzwe bagira ibyavuye byiza kurusha abagore, ariko gutwita bishoboka ku bagore bafite ububabare bw’umwenge.

Kubagwa ibitsina bigufasha kunoza imikorere n’ishusho, ibyo bikaba bishyigikira imibanire isanzwe. Itsinda ry’abaganga b’umwana wawe rizaganira ku buryo bwo kubika ubushobozi bwo kubyara igihe bikwiye kandi rizagusubiza ibibazo ku gutegura umuryango.

Ese umwana wanjye azakenera gukoresha catheter iteka?

Oya ntabwo ari ngombwa. Abana benshi bafite ububabare bw’umwenge bahita bagenzura umwenge batakenera catheter, cyane cyane hamwe no kubagwa neza umwenge. Ariko rero, bamwe mu bana bakeneye gukoresha clean intermittent catheterization.

Niba catheter ikenewe, abana benshi bigira uko bayikoresha ubwabo igihe bageze mu ishuri. Biba ari igikorwa gisanzwe cy’umunsi wabo, kimwe no gukaraba amenyo, kandi ntibibabuza kwitabira ibikorwa bisanzwe.

Ese umwana wanjye azakenera kubagwa inshuro zingana iki?

Abana benshi bakeneye kubagwa inshuro 2-4, ariko umubare nyakuri uterwa n’imiterere y’umubiri w’umwana wawe n’uko asubiza neza ubuvuzi. Kubagwa bwa mbere bibaho igihe umwana avuka, bikurikirwa no kubagwa kugira ngo agenzure umwenge hagati y’imyaka 2-4.

Kubagwa byongeyeho bishobora kuba bikenewe kugira ngo ibitsina bigaragara neza cyangwa niba hari ingaruka zivuka. Itsinda ryawe ry’abaganga rizaganira ku gihe cyitezwe kandi rizagufasha kwitegura buri cyiciro.

Ese ububabare bw’umwenge bushobora kumenyekana mu gihe cy’inda?

Rimwe na rimwe, ariko si buri gihe. Ububabare bw’umwenge bushobora kugaragara muri ecographie nyuma y’ibyumweru 15-20 by’inda, ariko kenshi biba bitamenyekanye. Igipimo cyo kumenya kiri gutera imbere hamwe n’ikoranabuhanga ryiza rya ecographie n’abahanga benshi.

Nubwo bimenyekanye mbere y’uko umwana avuka, ntibihindura uburyo bwo kuvura, ariko bituma imiryango yitegura mu buryo bw’umutima no mu buryo bw’imibereho ku bintu umwana wawe akeneye.

Ese imiterere y’ejo hazaza y’abana bafite ububabare bw’umwenge ni iyihe?

Imiterere y’ejo hazaza ni myiza cyane hamwe no kuvurwa neza. Abana benshi bagera ku kugenzura umwenge, bagira imikorere isanzwe y’impyiko, kandi bagira ubuzima busanzwe. Bajya mu ishuri risanzwe, bitabira imikino, bakurikirana imirimo, kandi bagira imiryango yabo.

Kwitabwaho n’itsinda ry’abaganga buri gihe ni ingenzi mu buzima bwose kugira ngo harebwe imikorere y’impyiko n’ubuzima bw’umwenge. Hamwe no kuvurwa neza, abantu bafite ububabare bw’umwenge bashobora kwitega ubuzima bw’imyaka myinshi n’ubuzima bwiza.