Umukaya Ukora Cyane

Umuvuduko ukabije w'umuyoboro w'inkari, uzwi kandi nka OAB, utera irari ry'umubiri ryo gukora inkari ryihuse bishobora kuba bigoye kuyigenzura. Bishobora kuba ngombwa gukora inkari kenshi cyane mu gihe cy'umunsi no mu ijoro. Bishobora kandi kubaho gutakaza inkari bitateganijwe, bizwi nka incontinence yo kwihuta.

Abantu bafite umuvuduko ukabije w'umuyoboro w'inkari bashobora kumva batujejwe. Ibyo bishobora gutuma birinda abandi cyangwa bagabanya akazi kabo n'ubuzima bwabo bw'imibereho. Inkuru nziza ni uko ishobora kuvurwa.

Guhindura imyitwarire yoroshye bishobora gucunga ibimenyetso by'umuvuduko ukabije w'umuyoboro w'inkari. Ibi bishobora kuba birimo guhindura imirire, gukora inkari kuri gahunda runaka no gukoresha imikaya y'igice cyo hasi cy'umubiri kugira ngo igenzure umuyoboro w'inkari. Hari kandi ubundi buryo bwo kuvura bwo kugerageza.

Niba ufite ikibazo cy'umuyoboro w'inkari ukora cyane, ushobora: Kumva umujinya wo kwinjira mu musarani udashobora gukoraho. Gutakaza inkari utabishaka nyuma yo kumva umujinya wo kwinjira mu musarani, bikitwa kugira ikibazo cyo gutakaza inkari kubera umujinya. Kwinjira mu musarani kenshi. Ibi bishobora gusobanura inshuro umunani cyangwa zirenze mu masaha 24. Kwikanguka inshuro zirenze ebyiri mu ijoro kugira ngo winjire mu musarani, bikitwa nocturia. Nubwo ushobora kugera ku musarani ku gihe iyo wumva umujinya wo kwinjira mu musarani, kwinjira mu musarani kenshi ku manywa na nijoro bishobora guhungabanya ubuzima bwawe. Nubwo ari ikintu gisanzwe mu bantu bakuze, ikibazo cy'umuyoboro w'inkari ukora cyane si ikintu gisanzwe mu gukura. Bishobora kuba bitoroshye kuvuga ibibazo byawe. Ariko niba ibibazo bikubabaza cyangwa bikahungabanya ubuzima bwawe, vugana n'umuganga wawe. Hari ubuvuzi bushobora kugufasha.

Nubwo ari imenye cyane mu bantu bakuze, ikibazo cy'umutsiko ukabije ntabwo ari ikintu gisanzwe kiba mu mikurire y'imyaka. Bishobora kuba bigoye kuvuga ibimenyetso byawe. Ariko niba ibyo bimenyetso bikubabaza cyangwa bikubuza gukora imibereho yawe, vugana n'umuganga wawe. Hari ubuvuzi bushobora kugufasha.

Impyiko zikora umushishi, ukajya mu kibuno. Iyo umuntu akuriye, umushishi uciye mu kibuno unyuze mu muyoboro witwa umuyoboro w'inkari (u-REE-thruh). Imihombo iri mu muyoboro w'inkari, yitwa sphincter, ifungura kugira ngo umushishi ubone uko uciye mu mubiri.

Mu bantu bagenewe igitsina gore bavuka, umwenge w'umuyoboro w'inkari uba uri hejuru gato y'umwenge w'inda. Mu bantu bagenewe igitsina gabo bavuka, umwenge w'umuyoboro w'inkari uba uri ku mpera y'igitsina.

Uko kibuno kigenda kirushaho kuzura, ibimenyetso by'imitsi byoherezwa mu bwonko bitera icyifuzo cyo gukurira. Iyo umuntu akuriye, ibyo bimenyetso by'imitsi bituma imitsi y'igice cyo hasi cy'umubiri n'imitsi y'umuyoboro w'inkari, yitwa imitsi ya sphincter y'inkari, yiyongera. Imitsi y'ikibuno irakara, kandi bikaba byitwa kugabanya, bikarukira umushishi hanze.

Ikibuno gikora cyane bibaho iyo imitsi y'ikibuno itangira gukara ubwayo nubwo umushishi uri mu kibuno ari muke. Ibi bita kugabanya bidakozwe n'ubushake. Bituma umuntu yumva akeneye gukurira cyane.

Ubundi buryo bushobora kuba igice cy'ikibuno gikora cyane, harimo:

• Uburwayi bugira ingaruka ku kibuno, nko kubyimba cyangwa amabuye mu kibuno.
• Uburwayi bugira ingaruka ku bwonko no ku mugongo, nko gucika kw'imitsi no kugira sclerosis nyinshi.
• Diabete.
• Ibintu bibangamira umushishi uciye mu kibuno, nko gutuma prostate ikura, gucibwamo cyangwa kuba warakoze igikorwa cyo kuvura ubutabazi bwo kugenzura inkari, bita incontinence.
• Impinduka z'imisemburo mu gihe cy'ihindagurika ry'imisemburo.
• Indwara z'inzira z'inkari, zishobora gutera ibimenyetso nk'iby'ikibuno gikora cyane.

Ibimenyetso by'ikibuno gikora cyane bishobora kandi guhuzwa na:

• Kugabanuka kw'ubushobozi bwo gutekereza bitewe n'imyaka. Ibi bishobora gutuma kibuno kigorana gukoresha ibimenyetso kibona mu bwonko.
• Kunywa ikawa cyangwa inzoga nyinshi.
• Imiti ituma umubiri ukora umushishi mwinshi cyangwa ikenera kunyobwa hamwe n'amazi menshi.
• Kudakora vuba ngo ujye mu bwiherero.
• Kudakurira neza. Ibi bituma habaho umwanya muke mu kibuno kugira ngo habeho umushishi mwinshi.

Rimwe na rimwe impamvu y'ikibuno gikora cyane ntibazwi.

Gukura kubije ibyago byo kugira umuyoboro w'umwanya udasanzwe. Kuba umugore nabyo birabyongera. Ibintu nk'umwijima waguye na diyabete nabyo bishobora kongera ibyago.

Abantu benshi bafite ubushobozi bwo gutekereza bugabanuka, nka barwaye ibicurane cyangwa abarwaye indwara ya Alzheimer, barwara umuyoboro w'umwanya udasanzwe. Ni ukubera ko badashobora kubona ibimenyetso byo gukenera kwinjira. Kunywa amazi ku giciro, guha umwanya no kubashishikariza kwinjira, imyenda isukura, na gahunda y'amara bishobora gufasha gucunga iyi ndwara.

Bamwe mu bantu bafite umuyoboro w'umwanya udasanzwe bagira ibibazo byo kugenzura umwijima. Vuga n'umuganga wawe niba ufite ikibazo cyo kugenzura umwijima wawe.

Ubwoko ubwo aribwo bwose bwa incontinence bushobora kugira ingaruka ku mibereho. Niba ibimenyetso bya overactive bladder bikubuza amahoro, ushobora kandi kugira: Ubwoba. Kugira ikibazo cy'amarangamutima cyangwa kwiheba. Ibibazo by'imibonano mpuzabitsina. Kugira ibibazo byo kurara no kubura ibitotsi. Abantu bavutse bafite igitsina gore bafite overactive bladder bashobora kandi kugira indwara yitwa mixed incontinence. Ifite ibimenyetso byombi bya urgency incontinence na stress incontinence. Stress incontinence ni ukutakaza umushitsi mu buryo butunguranye bitewe n'imigirire cyangwa imyitozo ikora igitutu kuri urinaire. Ingero ni ukukorora, kugira ibicurane, guseka cyangwa gukora imyitozo.

Ibi bikurikira ni imyifatire myiza yo kubaho bishobora kugabanya ibyago byo kurwara indwara y'umuyoboro w'inkari ikabije:

• Kora imyitozo yo gukomeza imikaya y'igice cyo hasi cy'umubiri. Iyi myitozo yitwa imyitozo ya Kegel.
• Gukora imyitozo ngororamubiri buri munsi.
• Kwirinda ikawa n'inzoga.
• Kugira ibiro bikwiye.
• Kwita ku ndwara zidakira, nka diyabete, zishobora kongera ibimenyetso by'indwara y'umuyoboro w'inkari ikabije.
• Kureka kunywa itabi.

Niba ufite irari ryo kwinjira mu musaha ritamenyerewe, umuganga wawe azasuzumira niba hari ubwandu cyangwa amaraso mu nshinge zawe. Umuhanga wawe mu buzima kandi ashobora kugenzura niba umara neza uruhago rwawe rwose iyo unyoye.

Isuzuma ryawe rizakubiyemo ibi bikurikira:

• Amateka y'ubuzima.
• Ibizamini by'imitsi y'ubwonko kugira ngo barebe ibibazo by'imikurire cyangwa ibibazo by'imikorere.
• Ibizamini by'umubiri, bishobora kuba birimo ikizamini cy'urushyi n'ikizamini cy'igice cy'inda mu bagore.
• Igipimo cy'inshinge kugira ngo harebwe ubwandu, ibimenyetso by'amaraso cyangwa ibindi bibazo.

Umuhanga wawe mu buzima ashobora kugutegurira ibizamini kugira ngo arebe uko uruhago rwawe rukora neza niba rushobora kwikuramo neza, bizwi nka urodynamic tests. Akenshi ibi bizamini bikorwa n'inzobere. Ariko, bishobora kudasabwa kugira ngo hakorwe ubuvuzi cyangwa gutangira kuvurwa.

Ibizamini bya Urodynamic birimo:

• Kupima uruhago rushigaje mu ruhago. Iki kizamini ni ingenzi niba ushobora kutarangiza uruhago rwawe rwose iyo unyoye. Uruhago rushigaje mu ruhago, bizwi nka postvoid residual urine, bishobora gutera ibimenyetso nk'ibyo mu ruhago rukora cyane.

  Kugira ngo hapimaze uruhago rushigaje nyuma yo kunywa, umuhanga wawe mu buzima ashobora gushaka ko ukorerwa iskaneri y'amajwi y'uruhago rwawe. Iskaneri y'amajwi yahindura ibimenyetso by'amajwi mu ishusho. Ishusho igaragaza uko uruhago rwawe rwagumye nyuma yo kunywa.

  Rimwe na rimwe, umuyoboro muto, witwa catheter, unyura mu nzira y'umushishi ugana mu ruhago rwawe kugira ngo ukureho uruhago rushigaje. Hanyuma uruhago rushobora gupimwa.

• Kupima umuvuduko w'uruhago. Kugira ngo hapimaze uko unywa cyane kandi uko byihuse, ushobora gusabwa kunywa mu gikorwa cyitwa uroflowmeter. Uroflowmeter ifata kandi ipimira uruhago. Hanyuma ikoresha amakuru kugira ngo ikore imbonerahamwe y'impinduka mu muvuduko wawe.

Kupima uruhago rushigaje mu ruhago. Iki kizamini ni ingenzi niba ushobora kutarangiza uruhago rwawe rwose iyo unyoye. Uruhago rushigaje mu ruhago, bizwi nka postvoid residual urine, bishobora gutera ibimenyetso nk'ibyo mu ruhago rukora cyane.

Kugira ngo hapimaze uruhago rushigaje nyuma yo kunywa, umuhanga wawe mu buzima ashobora gushaka ko ukorerwa iskaneri y'amajwi y'uruhago rwawe. Iskaneri y'amajwi yahindura ibimenyetso by'amajwi mu ishusho. Ishusho igaragaza uko uruhago rwawe rwagumye nyuma yo kunywa.

Rimwe na rimwe, umuyoboro muto, witwa catheter, unyura mu nzira y'umushishi ugana mu ruhago rwawe kugira ngo ukureho uruhago rushigaje. Hanyuma uruhago rushobora gupimwa.

Ubu buryo bushobora kwerekana uko uruhago rwawe rwuzuye iyo utangiye gukenera kunywa. Kandi bushobora kwerekana niba uruhago rwawe rwakomera igihe rutari rukwiye.

Umukozi wawe wita ku buzima asuzuma ibisubizo by'ibizamini byawe nawe akagutegurira gahunda yo kuvurwa.

Uburyo bwo kuvura butandukanye bushobora kuba bwiza mu kugabanya ibimenyetso by'umukaya ukabije.

Imisuli y'igice cyo hasi cy'igice cy'inda itera inkunga imyanya y'imbere mu gice cy'inda. Iyo myanya irimo umukaya, uruhago n'urwondo. Imikino ya Kegel ifasha gukomeza imisuli y'igice cyo hasi cy'igice cy'inda.

Imisuli y'igice cyo hasi cy'igice cy'inda cy'abagabo itera inkunga uruhago n'umwijima kandi igira uruhare mu gikorwa cy'imibonano mpuzabitsina. Imikino ya Kegel ifasha gukomeza iyo misuli.

Ubuvuzi bw'imyitwarire ni bwo bwa mbere mu gufasha gucunga umukaya ukabije. Akenshi bikora kandi nta ngaruka mbi bigira. Ubuvuzi bw'imyitwarire bushobora kuba:

• Biofeedback. Muri biofeedback, igice cy'amashanyarazi gishyirwa ku ruhu hejuru y'umukaya gihujwe n'insinga ihujwe n'ishusho. Ibi biguha uburyo bwo kumenya igihe imisuli y'umukaya ikorana. Ibi bishobora kugufasha kumenya uko byumvikana iyo imisuli ikomeye kugira ngo ubashe kuyigenzura.

• Kumenyereza uruhago. Kumenyereza uruhago bisobanura kujya mu bwiherero mu bihe byagenwe. Koresha ibitabo by'uruhago kugira ngo urebe ukuntu ujya kenshi. Hanyuma ongeraho iminota 15 buri gihe hagati y'ingendo zo kujya mu bwiherero. Kora umusambara n'ubwo utumva ukeneye. Ibi bishobora kumenyereza uruhago rwawe gufata inkari nyinshi mbere y'uko wumva ukeneye gukora umusambara.

• Uruhare rukwiye. Niba uri umubyibuhe, kugabanya ibiro bishobora kugabanya ibimenyetso. Kugabanya ibiro bishobora gufasha niba ufite kandi ikibazo cyo gutakaza inkari kubera umunaniro.

• Koresha kateteri rimwe na rimwe. Niba utashobora gusuka uruhago rwawe neza, gukoresha imiyoboro yitwa kateteri rimwe na rimwe kugira ngo usuke uruhago rwawe rwose bifasha uruhago rwawe gukora ibyo rudashobora gukora ubwaryo. Baza umuganga wawe niba ubu buryo bukubereye.

• Imikino yo gukomeza imisuli y'igice cyo hasi cy'igice cy'inda. Imikino ya Kegel ikomeza imisuli y'igice cyo hasi cy'igice cy'inda na sphincter y'inkari. Imisuli ikomeye ishobora kugufasha kubuza uruhago gukorana ubwaryo.

Umuvuzi wawe cyangwa umuganga w'imibiri ashobora kugufasha kwiga gukora imikino ya Kegel. Imikino ya Kegel isa n'indi mikino. Uko ikora neza biterwa no kuyikora buri gihe. Bishobora gufata ibyumweru bitandatu mbere y'uko itangira gukora.

Imikino yo gukomeza imisuli y'igice cyo hasi cy'igice cy'inda. Imikino ya Kegel ikomeza imisuli y'igice cyo hasi cy'igice cy'inda na sphincter y'inkari. Imisuli ikomeye ishobora kugufasha kubuza uruhago gukorana ubwaryo.

Umuvuzi wawe cyangwa umuganga w'imibiri ashobora kugufasha kwiga gukora imikino ya Kegel. Imikino ya Kegel isa n'indi mikino. Uko ikora neza biterwa no kuyikora buri gihe. Bishobora gufata ibyumweru bitandatu mbere y'uko itangira gukora.

Nyuma y'ihindagurika ry'imihango, kuvura kwa estrogen mu gitsina bishobora gufasha gukomeza imisuli n'imiterere mu gice cy'inkari no mu gitsina. Estrogen mu gitsina iboneka mu mavuta, mu maherere, mu bibindi cyangwa mu mpeta. Bishobora kunoza ibimenyetso by'umukaya ukabije.

Imiti isubiza umukaya ishobora gufasha kugabanya ibimenyetso by'umukaya ukabije no kugabanya ibintu byo gutakaza inkari kubera ubushake. Iyo miti irimo:

• Fesoterodine (Toviaz).
• Mirabegron (Myrbetriq).
• Oxybutynin, ishobora gufatwa nk'igitonyanga (Ditropan XL) cyangwa ikoreshwa nk'igipande cy'uruhu (Oxytrol) cyangwa gel (Gelnique).
• Solifenacin (Vesicare).
• Tolterodine (Detrol).
• Trospium.

Ingaruka mbi zisanzwe za byinshi muri iyo miti harimo amaso yumye n'akanwa gase. Ariko kunywa amazi kubera inyota bishobora gutuma ibimenyetso by'umukaya ukabije birushaho kuba bibi. Kugira impatwe ni indi ngaruka mbi ishobora gutuma ibimenyetso by'umukaya birushaho kuba bibi. Ubwoko bw'imiti ishobora gukoreshwa igihe kirekire, harimo igipande cy'uruhu cyangwa gel, bishobora gutera ingaruka mbi nke.

Umuvuzi wawe ashobora kugusaba kunywa amazi make cyangwa kunywa ibinyobwa by'isukari bike cyangwa kuruma iminyanya idafite isukari kugira ngo ugabanye akanwa gase. Ushobora gukoresha amavuta yo mu maso kugira ngo amaso yawe akomeze kuba asukuye.

Imiti iboneka nta rupapuro rw'abaganga, nka mouthwashes zikozwe kugira ngo zigabanye akanwa gase, zishobora gufasha mu gihe kirekire cy'akanwa gase. Kurya indyo yuzuye ibinyampeke cyangwa gukoresha imiti igabanya impatwe bishobora gufasha gukumira impatwe.

OnabotulinumtoxinA (ON-ah-boch-yoo-lih-num-tox-in-A), izwi kandi nka Botox, ni poroteyine iva mu bakoko batera indwara ya botulism. Inyuguti nke zinjizwa mu miterere y'umukaya zishobora gusubiza imisuli no kongera umubare w'inkari uruhago rushobora gufata.

Ubushakashatsi bwerekana ko Botox ishobora gufasha gutakaza inkari kubera ubushake bukabije. Ingaruka akenshi zikemara amezi atandatu cyangwa arenga. Iyo ingaruka zibaye nta cyo zikimaze, ukeneye indi nshinge.

Ingaruka mbi ziterwa n'izo nshinge harimo indwara z'inzira z'inkari no gufata inkari. Niba utekereza ku buvuzi bwa Botox, ugomba kwemera gushyira kateteri wenyine niba utangiye gufata inkari.

Mu gihe cyo gukangurira imiyoboro ya sacral, igikoresho gishyirwa mu mubiri gishyiraho impinduka z'amashanyarazi ku miyoboro igenzura ibikorwa by'umukaya. Ibi bita imiyoboro ya sacral. Icyo gikorwa gishyirwa munsi y'uruhu mu mugongo wo hasi, hafi aho umufuka wo inyuma uri ku ipantaro. Muri iyi shusho, igikoresho kigaragara kitarimo kugira ngo habeho kubona neza icyo gikorwa.

Impinduka nke z'amashanyarazi ku miyoboro y'umukaya zishobora kunoza ibimenyetso by'umukaya ukabije.

Uburyo bumwe bukoresha insinga yoroheje ishyirwa hafi y'imiyoboro ya sacral aho ica hafi y'umutwe wawe. Imiyoboro ya sacral itwara ibimenyetso ku ruhago rwawe.

Ubu buryo buke butera ingaruka mbi akenshi bukorwa n'igeragezwa ry'insinga ishyirwa munsi y'uruhu mu mugongo wawe wo hasi. Umuvuzi wawe hanyuma akoresha igikoresho gifatanye mu ntoki gihujwe n'insinga kugira ngo wohereze impinduka z'amashanyarazi ku ruhago rwawe. Ibi ni kimwe n'icyo pacemaker ikora ku mutima.

Niba igeragezwa rifashije ibimenyetso byawe, umuyoboro w'amashanyarazi ukoreshwa n'ibatteri ushyirwaho n'ubuganga. Icyo gikorwa kiguma mu mubiri wawe kugira ngo gifashe kugenzura imiyoboro.

Ubu buryo bukoresha umugozi mworoheje ushyirwa mu ruhu hafi y'akaguru. Wohereza impinduka z'amashanyarazi kuva ku muyoboro wo mu kirenge, witwa umuyoboro wa tibial, ku mugongo. Aha huhuza n'imiyoboro igenzura uruhago.

Ubuvuzi bwa PTNS butangwa rimwe mu cyumweru ibyumweru 12 kugira ngo buvure ibimenyetso by'umukaya ukabije. Nyuma y'ibyo, ubuvuzi buri byumweru 3 kugeza kuri 4 bufasha kugumisha ibimenyetso byagenzurwa.

Uburyo burimo:

• Ubuganga bwo kongera ubushobozi bw'uruhago. Ubu buryo bukoresha ibice by'umwijima gusimbuza igice cy'umukaya. Abantu bakora ubu buganga bashobora kuba bakeneye gukoresha kateteri rimwe na rimwe ubuzima bwabo bwose kugira ngo basuke uruhago rwabo.

• Gukuraho uruhago. Ubu buryo bukoreshwa nk'uburyo bwa nyuma. Bisobanura gukuraho uruhago no gukora uruhago rwo gusimbuza, bita neobladder. Cyangwa bishobora kuba bisobanura gukora umwobo mu mubiri, witwa stoma, kugira ngo bashyiremo umufuka ku ruhu kugira ngo bakusanyirize inkari.

Kubaho ufite igihombo cya vesike (overactive bladder) bishobora kuba bigoye. Amashyirahamwe yita ku burezi bw'abaguzi n'ubuvugizi nk'Ishyirahamwe ry'Igihugu ryita ku kubura ubushobozi bwo kwihagarika (National Association for Continence) arashobora kukugeza ku mabuye y'amakuru n'ibindi bisobanuro kuri internet. Aya mashyirahamwe arahuza n'abandi bantu bafite igihombo cya vesike n'ikibazo cyo kutamenya kwihagarika. Amashyirahamwe atanga uburyo bwo kuvugana ibyo uhangayikishijwe n'uburyo bushya bwo kubikemura. Kwigisha umuryango wawe n'inshuti zawe ku gihombo cya vesike n'uko kibagiraho ingaruka bishobora kugufasha kubaka umuryango wawe w'abaguha ubufasha no kugabanya ipfunwe. Iyo utangiye kubivuga, ushobora gutangazwa no kumenya ko iyi ndwara ikunze kugaragara.