Ururimi rw’inkari rusubira inyuma (Vesicoureteral Reflux) ni iki? Ibimenyetso, Intandaro, n’Uko Bavura

Ururimi rw’inkari rusubira inyuma (Vesicoureteral reflux) ruba iyo inkari zisubira inyuma mu gifu zivuye mu myanya ihuza impyiko n’igifu. Tekereza nk’umuhanda umwe gusa utwara imodoka, ariko imodoka zigatangira kugenda mu cyerekezo kitari cyo. Iyi ndwara iboneka cyane mu bana bato, nubwo ishobora kwibasira abantu b’imyaka yose.

Iyi ndwara ibaho kubera ko urugingo rumeze nk’umusego aho umuyoboro w’inkari uhura n’igifu rudakora neza. Mu mubiri muzima w’inkari, inkari ziva mu mpyiko zimanuka mu miyoboro yitwa ureters zijya mu gifu, hanyuma zigasohoka mu mubiri. Iyo ufite ururimi rw’inkari rusubira inyuma, zimwe muri izo nkari zisubira hejuru zerekeza mu mpyiko aho kuguma mu gifu.

Ibimenyetso by’ururimi rw’inkari rusubira inyuma ni ibihe?

Abantu benshi bafite ururimi rw’inkari rusubira inyuma nta bimenyetso bagira, cyane cyane iyo iyi ndwara ari ntoya. Iyo ibimenyetso bigaragaye, bikunze kuba bifitanye isano n’indwara z’inzira z’inkari, ziba kenshi iyo inkari zisubira inyuma.

Dore ibimenyetso bikunze kugaragara bishobora kugaragaza ururimi rw’inkari rusubira inyuma, cyane cyane mu bana:

• Indwara z’inzira z’inkari kenshi zifatanye n’umuriro
• Kubabara cyangwa gutwika mu gihe cyo kwinjira
• Guhora ukeneye kujya kwinjira cyangwa kujya kenshi
• Kuvuza mu bana bamaze kumenya kujya ku musarani
• Inkari zifite ibara ry’ifu cyangwa zifite impumuro ikomeye
• Kubabara mu nda cyangwa ku ruhande
• Impatwe cyangwa kugorana mu guhita

Mu bana bato cyane, ushobora kubona ko badakozwa neza, badashobora kunywa neza, cyangwa bagira umuriro utari ufite impamvu. Aba bana bato ntibashobora kukubwira icyabagoye, bityo umuriro usubira kenshi utagira impamvu ikigaragara ukunze gutuma abaganga basuzumira ibibazo by’inkari.

Bamwe mu bana bafite reflux ikomeye bashobora kugira umuvuduko w'amaraso ukabije cyangwa bagaragaza ibimenyetso byo kudakura neza. Ibi bimenyetso bisanzwe bigaragara iyo iyi ndwara imaze igihe kirekire kandi itangiye kugira ingaruka ku mikorere y'impyiko.

Ubwoko bwa vesicoureteral reflux ni bwoki?

Abaganga basobanura vesicoureteral reflux mu byiciro bitanu, hashingiwe ku rugero umwanya ugaruka inyuma ndetse n'ingaruka ugira ku mikorere y'impyiko. Igiciro cya 1 ni cyo cyoroheje, mu gihe igiciro cya 5 ari cyo gikomeye.

Mu reflux y'igiciro cya 1, umwanya ugaruka gusa mu gice cy'umuyoboro w'umwanya. Igiciro cya 2 bisobanura ko umwanya ugera ku mpyiko ariko ntugire ingaruka zo kubyimbagira. Igiciro cya 3 gikubiyemo kubyimbagira gato kw'uburyo bwo gukusanya umwanya w'impyiko.

Reflux y'igiciro cya 4 itera kubyimbagira mu rugero rwo hagati ndetse no kubura imiterere isanzwe y'impyiko. Igiciro cya 5 ni cyo gikomeye, gifite kubyimbagira bikabije ndetse n'impinduka zikomeye ku miterere y'impyiko. Ibiciro byo hejuru bigira ibyago byinshi byo kwangiza impyiko kandi bisaba ubuvuzi bukomeye.

Hari kandi ubwoko bubiri bushingiye ku gihe iyi ndwara igaragara. Vesicoureteral reflux y'ibanze ibaho kuva ku ivuka kubera umuyoboro w'umwanya mugufu cyangwa ibibazo by'uburyo umuyoboro w'umwanya uhurira n'umufuka w'umwanya. Reflux y'inyongera igaragara nyuma kubera inzitizi, indwara cyangwa izindi ndwara zigira ingaruka ku mikorere isanzwe y'umwanya.

Ni iki giterwa na vesicoureteral reflux?

Urugero rwinshi rwa vesicoureteral reflux rubaho kubera uburyo uburyo bw'umwanya bw'umwana butera imbere mbere y'ivuka. Uburyo bwo gufunga aho umuyoboro w'umwanya uhura n'umufuka w'umwanya bushobora kudakorwa neza, bigatuma umwanya usubira inyuma.

Muri reflux y'ibanze, umuyoboro w'umwanya winjira mu mufuka w'umwanya ku buryo budasanzwe cyangwa umwanya uca mu rufunzo rw'umufuka w'umwanya ari muto cyane. Ibi bivuze ko uburyo bwo gufunga busanzwe budafunga neza iyo umufuka w'umwanya wuzuye umwanya. Uko abana bakura, imiyoboro yabo y'umwanya ikura ndetse n'uburyo buhinduka, niyo mpamvu imyinshi ikemuka ubwayo.

Umusubiriro w’umwanya wa kabiri ugaragara iyo ikintu cyabujije cyangwa kidindije umuyoboro usanzwe w’inkari. Dore imvano nyamukuru ishobora gutera ubu bwoko:

• Uburwayi bw’umwijima cyangwa imitsi y’umwijima ikora cyane
• Impatwe ikunda kubaho ishyira igitutu ku mwijima
• Umuwijima wa neurogenic ukomoka ku bibazo by’umugongo
• Uburwayi bw’imiterere nko kugira imiyoboro y’inkari ibiri
• Indwara zikomeye z’inzira y’inkari ziterwa n’ububare
• Amabuye y’impyiko cyangwa ibindi bibangamira
• Igisubizo cyakozwe mbere ku nzira y’inkari

Rimwe na rimwe, reflux iba mu miryango, bigaragaza ko irashobora kuba ifite uruhare. Niba umwana umwe afite vesicoureteral reflux, abavandimwe bafite amahirwe agera kuri 25-30% yo kuyifata na bo. Ubu buhunganirane bw’umuryango ni yo mpamvu abaganga bakunda kugira inama yo gusuzuma abavandimwe b’abana barwaye.

Gake, imiti imwe cyangwa uburyo bwo kuvura bushobora gutera reflux by’agateganyo. Inkuru nziza ni uko ibi bibazo bisanzwe bikira iyo icyateye ikibazo gikemuwe.

Ni ryari ukwiye kubona muganga kubera vesicoureteral reflux?

Wagomba kuvugana na muganga wawe niba umwana wawe afite indwara zikomeza kugaruka z’inzira y’inkari, cyane cyane niba zifite umuriro. Nubwo ari indwara imwe gusa y’inzira y’inkari ku mwana uri munsi y’imyaka 2 ikeneye isuzuma, kuko iyi myaka ifite ibyago byinshi byo kwibasira impyiko.

Hamagara umuvuzi wawe niba ubona ibimenyetso by’indwara y’inzira y’inkari bitakira neza cyangwa bikomeza kugaruka. Ibi bishobora kuba harimo umuriro, ububabare mu gihe cyo kwinjira, kwinjira kenshi, cyangwa inkari zifite impumuro ikomeye.

Shaka ubufasha bw’abaganga vuba niba umwana wawe arwaye umuriro mwinshi ufite ububabare mu mugongo cyangwa ku ruhande, kuko bishobora kugaragaza ubwandu bw’impyiko. Ibindi bimenyetso byihutirwa birimo ububabare bukabije mu nda, kuruka ufite umuriro, cyangwa ibimenyetso byo gucika amazi nko kugabanuka kwinjira cyangwa guhora uhangayitse cyane ku bana bato.

Ku bana bakuru n’abakuze, mushake muganga mu gihe mufite ibibazo by’indwara zikubita inda (UTIs) kenshi, amaraso mu mpisi, cyangwa ububabare bw’umugongo budashira. Nubwo gusubira inyuma kw’umusemburo (vesicoureteral reflux) bidakunze kugaragara mu bakuru, bishobora kubaho kandi bisaba isuzuma rikwiye.

Ni ibihe bintu byongera ibyago byo kugira reflux ya vesicoureteral?

Ibintu byinshi bishobora kongera amahirwe yo kugira reflux ya vesicoureteral, nubwo kugira ibyo bintu ntibisobanura ko uzayirwara. Kubyumva bifasha imiryango kumenya igihe ikwiye kwitondera ibimenyetso.

Imyaka ni yo ntandaro ikomeye y’ibyago, iyi ndwara ikaba igaragara cyane mu bana bato n’abana bakiri bato. Abakobwa barayirwara kenshi kurusha abahungu, keretse mu mwaka wa mbere w’ubuzima aho abahungu baba bafite umubare munini gato. Imiterere y’umubiri w’umukobwa, ufite umuyoboro w’inkari (urethra) mugufi, ishobora gutera indwara zikubita inda kenshi zishobora kwerekana reflux iri inyuma.

Amateka y’umuryango agira uruhare runini mu byago. Niba umubyeyi yaragize reflux ya vesicoureteral akiri umwana, abana be bafite amahirwe agera kuri 25% yo kuyirwara na bo. Abavandimwe b’abana barwaye nabo bafite ibyago byiyongereye, ariyo mpamvu abaganga bakunze kugira inama yo gusuzuma abagize umuryango.

Indwara zimwe na zimwe zishobora kongera ibyago:

• Spina bifida cyangwa izindi mpinduka z’umugongo
• Izindi mpinduka z’impyiko cyangwa izindi mpinduka z’inkari
• Impatwe ikaze cyangwa ibibazo by’amara
• Kudakora neza kw’umufuka w’inkari cyangwa ibibazo byo kunyara
• Imisumari y’inyuma y’umuyoboro w’inkari mu bahungu
• Umuvuduko w’inda (Prune belly syndrome)

Imikorere mibi nk’ukunyara gake cyangwa gufata inkari igihe kirekire bishobora kurushaho kubihaza reflux iriho. Bamwe mu bana bategereza igihe kirekire kugira ngo bajye mu bwiherero cyangwa badasuka neza imifuka yabo y’inkari bashobora kugira ibibazo byinshi bya reflux.

Ubwoko bw’umuntu n’aho akomoka bigira uruhare ku kaga, iyi ndwara ikaba igaragara cyane mu bana b’abazungu kandi itagaragara cyane mu bana b’Abanyamerika b’Abirabura. Impamvu z’ibi bitandukanye ntibirasobanuka neza, ariko bishobora kuba bifitanye isano n’imiterere y’impyiko ifitanye isano n’imikorere y’inzira y’umuyoboro w’inkari.

Ibibazo bishobora kuvuka bitewe na Vesicoureteral Reflux?

Ikibazo gikomeye kuri Vesicoureteral Reflux ni uko gishobora gutera ibibazo ku mpimbano z’impyiko mu gihe kirekire, cyane cyane iyo indwara z’inzira y’umuyoboro w’inkari zikomeje kugaruka. Iyo umushishiri w’ubwandu ugarutse mu mpimbano z’impyiko, ushobora gutera indwara zikomeretsa imikaya y’impyiko.

Gukomeretsa kw’impyiko, bizwi kandi nka reflux nephropathy, ni ikibazo gikomeye. Iki gukomeretsa bishobora kugira ingaruka ku buryo impyiko zawe zitonora imyanda kandi zigumana umuvuduko w’amaraso ukwiye. Mu bihe bikomeye, bishobora gutera indwara z’impyiko zidakira, nubwo ibi bidahagaragara cyane iyo ufashe ubuvuzi bukwiye.

Dore ibibazo bikomeye bishobora kuvuka iyo Vesicoureteral Reflux idakurikiranwa cyangwa ikomeye:

• Indwara z’inzira y’umuyoboro w’inkari zikomeje kugaruka
• Gukomeretsa kw’impyiko n’ibikomere bidakira
• Umuvuduko w’amaraso ukabije (hypertension)
• Imyanda mu mashashi
• Indwara z’impyiko zidakira
• Gucika intege kw’impyiko mu bihe bike, bikomeye
• Ibibazo by’ubukure mu bana bafite ibibazo bikomeye by’impyiko

Inkuru nziza ni uko, hakurikijwe ubugenzuzi n’ubuvuzi bukwiye, abana benshi bafite Vesicoureteral Reflux birinda ibibazo bikomeye. Ibibazo bito bikunda gukira ubwabyo uko abana bakura, ndetse n’ibibazo bito bishobora kuvurwa neza hakoreshejwe ubuvuzi.

Gutwita bishobora gutera ibibazo byihariye ku bagore bagize Vesicoureteral Reflux bakiri abana. Nubwo abagore benshi bafite amateka ya reflux bagira gutwita bisanzwe, abafite ibikomere ku mpimbano z’impyiko bashobora gukenera gukurikiranwa hafi kugira ngo barebe umuvuduko w’amaraso cyangwa impinduka mu mikorere y’impyiko.

Gake, gusubira inyuma gukomeye mu mpyiko zombi (bikubita impyiko zombi) bishobora gutera iyangirika rikomeye ry’impyiko risaba kuvurwa hakoreshejwe imashini cyangwa gutera impyiko. Ariko, urwego rwo gukomera nk’urwo si rwo rusanzwe iyo abana babonye ubuvuzi bukwiye n’ubugenzuzi.

Uko kwirinda gusubira inyuma kwa vesicoureteral

Kubera ko gusubira inyuma kwa vesicoureteral kunini kubaho kuva ku ivuka bitewe n’uburyo urwungano rw’inkari rukura, nta buryo bwo kwirinda ubwo bwoko bw’ibanze bw’iyi ndwara. Ariko, ushobora gufata ingamba zo kugabanya ibyago byo gukomera no gusubira inyuma kwa kabiri.

Ingamba y’ingenzi yo kwirinda ni ukwirinda indwara z’inzira y’inkari, zishobora kurushaho kuba mbi gusubira inyuma bisanzwe cyangwa rimwe na rimwe zigatera gusubira inyuma kwa kabiri. Imiterere myiza yo kujya mu bwiherero igira uruhare rukomeye mu kubungabunga ubuzima bw’urwungano rw’inkari.

Dore intambwe zifatika zishobora gufasha kwirinda ingaruka mbi:

• Teza imbere gusuka uruhinja buri gihe, neza
• Komeza kunywa amazi ahagije buri munsi
• Vura impatwe vuba kandi neza
• Kora isuku nziza y’ibitsina
• Hanagura uhereye imbere ujya inyuma umaze gukoresha ubwiherero
• Kunywa amazi vuba umaze gukora imibonano mpuzabitsina (ku bangavu n’abakuze)
• Irinde koga mu mazi yuzuyemo amavuta n’amasabune akomeye mu gice cy’ibitsina

Ku miryango ifite amateka yo gusubira inyuma kwa vesicoureteral, gusuzuma abana bato hakiri kare bishobora gufasha kumenya iyi ndwara mbere y’uko ingaruka mbi zigaragara. Nubwo utazi kwirinda gusubira inyuma ubwayo, kuyibona hakiri kare bituma habaho ubugenzuzi n’ubuvuzi byiza.

Kwigisha abana imyifatire myiza yo kwita ku mpyiko kuva bakiri bato ni ingenzi cyane. Ibi birimo kutafata igihe kinini cyane uruhinja, gufata umwanya wo gusuka uruhinja rwose, no kugira impatwe zihoraho kugira ngo wirinda impatwe.

Niba umwana wawe yasanze afite reflux ya vesicoureteral, gukurikiza gahunda y’ubuvuzi yatanzwe na muganga ni bwo buryo bwiza bwo kwirinda ingaruka mbi z’igihe kirekire. Ibi bishobora kuba harimo gufata antibiotike zikumira, kujya mu bugenzuzi buhoraho, no gukurikirana ibimenyetso by’indwara y’inzira z’umusemburo.

Reflux ya vesicoureteral imenyekanwa gute?

Kumenya reflux ya vesicoureteral bisanzwe bitangira iyo umwana afite indwara zikunze kugaruka z’inzira z’umusemburo cyangwa iyo abaganga basanze ibimenyetso mu bipimo bisanzwe. Umuganga wawe azatangira akuze amateka y’ubuzima n’isuzuma ngaruka mbere.

Isuzuma nyamukuru rikoreshwa mu kumenya reflux ya vesicoureteral ni uko bita voiding cystourethrogram (VCUG). Muri iki kizamini, umuyoboro muto winjizwa mu kibuno binyuze mu gitsina, kandi amabara y’amabara akoreshwa mu kuzuza kibuno. Amafoto ya X-rays afatwa mu gihe umwana wawe ari kwinnya kugira ngo arebe niba inkari zisubira inyuma mu myeyo.

Nubwo VCUG ishobora kuba idashimishije, muri rusange irahumurizwa kandi itanga ishusho isobanutse ya reflux. Iki kizamini kandi kigaragaza urwego rwa reflux, ibyo bifasha muganga wawe kumenya uburyo bwiza bwo kuvura.

Ibizamini by’inyongera muganga wawe ashobora kugusaba birimo:

• Ubushakashatsi bw’impyiko kugira ngo urebe ibibazo by’imiterere
• Ubushakashatsi bwa nukeri (DMSA) kugira ngo urebe ibikomere by’impyiko
• Umuco w’inkari kugira ngo urebe niba hari ubwandu bukomeye
• Ibizamini by’amaraso kugira ngo urebe imikorere y’impyiko
• Ubushakashatsi bwa ultrasound bukoresheje amabara mu mubiri mu bihe bimwe na bimwe

Ku bana bato n’abana bato cyane, abaganga bashobora gukoresha ikizamini cy’ubuvuzi bwa nukeri cyitwa nuclear cystogram aho gukoresha VCUG. Iki kizamini gikoresha umwanya muto w’ibintu bya radioactive aho gukoresha X-rays kandi bishobora kuba bidashimishije ku bana bato cyane.

Niba umwana wawe yagize indwara nyinshi z’inzira z’umusemburo, muganga wawe ashobora kugusaba gupima nubwo ibindi bimenyetso bitagaragara. Kumenya hakiri kare ni ingenzi kuko bituma habaho gukurikirana no kuvura mbere y’uko imyeyo yangirika.

Rimwe na rimwe, reflux iboneka mu buryo butunguranye mu bipimo byakozwe ku mpamvu zindi. Ibi bikunda kubaho cyane iyo abana bakoze iskaneri y’amajwi ku mpamvu zindi, maze abaganga bagasanga impinduka mu mpyiko zishobora kuba ari reflux.

Ubuvuzi bwa vesicoureteral reflux ni bwoki?

Ubuvuzi bwa vesicoureteral reflux bushingiye ku bintu bitandukanye, birimo urwego rwa reflux, imyaka y’umwana, ukuntu indwara z’inzira y’umusemburo ziba kenshi, niba hari ibimenyetso byangirika ry’impyiko. Ibyinshi mu bihe byoroheje ntibikenera ubuvuzi bukomeye uretse gukurikiranwa neza.

Ku rwego rwo hasi rwa reflux (urwego rwa 1-2), abaganga bakunda kugira inama yo ‘ gutegereza no kureba’ bakurikirana hafi. Abana benshi barakura bafite reflux yoroheje uko imiyoboro yabo y’umusemburo ikura iragenda irushaho kuba miremire kandi uburyo bwo gufunga bugakira mu buryo bw’umwimerere. Muri icyo gihe, gukumira indwara z’inzira y’umusemburo biba aribyo byibandwaho.

Gukumira hakoreshejwe antibiyotike bikunze gukoreshwa ku bana bafite indwara z’inzira y’umusemburo zisubira cyangwa reflux ikomeye. Umwana wawe afata umunsi ku munsi inyongera nto y’antibiyotike kugira ngo birinde ko bagiteri bikura mu nzira y’umusemburo. Antibiyotike zisanzwe zikoreshwa harimo trimethoprim-sulfamethoxazole cyangwa nitrofurantoin.

Dore uburyo nyamukuru bw’ubuvuzi muganga wawe ashobora kugutegurira:

• Gukurikirana hafi n’isuzuma buri gihe
• Antibiyotike nke buri munsi mu rwego rwo gukumira
• Uburyo bwo guterera bukoresha ibikoresho bike
• Kubaga (gusubiza imiyoboro y’umusemburo)
• Kubaga hakoreshejwe uburyo bwa laparoscopic bufashwa na robot

Ku rwego rwo hagati kugeza ku rwego rukomeye rwa reflux rudakira cyangwa rigateza ubwandu busubira kenshi, ubuvuzi bwo kubaga bushobora kuba bukenewe. Uburyo buke cyane bwo kubaga ni ukuterera ibintu byuzuza hafi aho umuyoboro w’umusemburo winjira mu gifu. Ibi bituma uburyo bwo gufunga bugira imbaraga kandi bikorwa nk’ubuvuzi bwo hanze.

Kubaga, bizwi nka ureteral reimplantation, bisobanura gusubiza umuyoboro w’inkari (ureter) mu mwanya ukwiriye kugira ngo winjire mu kibuno cy’inkari (vessie) ku buryo bwiza, unyuze mu kigega kirekire cy’inkira mu rukuta rw’icyo kibuno. Ubu buvuzi bugira umusaruro mwinshi cyane, ariko bisaba ko umwana arara mu bitaro kandi akagira igihe cyo gukira.

Ubuvuzi bukoresheje robot bugira umusaruro mwiza kimwe n’ubuvuzi busanzwe, ariko hakoreshejwe ibikomere bito kandi bishobora gutuma umwana akira vuba. Umuganga wanyu azabaganira ku buryo bwiza bushingiye ku mimerere y’umwana wanyu.

Icyemezo cyo kuvura hakoreshejwe ubuvuzi biterwa n’ibintu bitandukanye, birimo kwandura nubwo hari imiti igikumira, kwangirika kw’impyiko, ibyifuzo by’umuryango, n’ubushobozi bw’umwana bwo kwihanganira imiti igikumira indwara igihe kirekire.

Uko wakwita ku vesicoureteral reflux muri mu rugo?

Kwita ku vesicoureteral reflux muri mu rugo bigamije gukumira indwara z’inzira z’inkari no gufasha ubuzima bw’inkari bw’umwana wanyu muri rusange. Imikorere myiza ya buri munsi ishobora kugira uruhare runini mu kugabanya ingaruka mbi no gufasha umwana wanyu kumva aruhutse.

Imikorere yo kujya mu bwiherero ni ingenzi cyane ku bana bafite vesicoureteral reflux. Shishikariza umwana wawe gukora imyeyo kenshi mu gihe cy’umunsi aho gutegereza igihe kirekire. Menya ko afata umwanya uhagije wo gusuka uruhinja rwe neza, kuko kwihuta bishobora gutuma hasigara uruhinja rwongerera ibyago byo kwandura.

Dore ingamba z’ingenzi zo kwita ku mwana mu rugo:

• Komeza umunaniro w’amazi uhagije buri munsi, cyane cyane amazi
• Tegura igihe cyo kujya mu bwiherero buri masaha 2-3
• Kwita ku kibazo cy’impiswi vuba hakoreshejwe indyo n’amazi
• Kwita ku isuku y’ibitsina
• Kwitondera ibimenyetso by’indwara z’inzira z’inkari
• Guha umwana imiti igikumira indwara nk’uko umuganga yabitegetse
• Kwandika ibimenyetso by’indwara niba umuganga yabisabye

Amazi afasha cyane mu gukuraho udukoko mu mikaya. Shishikariza umwana wawe kunywa amazi ahagije umunsi wose, ariko wirinda kuyanywa menshi cyane mbere yo kuryama niba ahangayikishijwe no kwinnya nijoro.

Impatwe ishobora kurushaho kuba mbi kubera ko ishyira igitutu ku kibuno kandi ikagira ingaruka ku buryo busanzwe bwo kwinnya. Shyira imboga n’imbuto zifite amafibe menshi mu mirire y’umwana wawe kandi ube wizeye ko anywa amazi ahagije. Niba impatwe ikomeza, vugana na muganga wawe ku bijyanye n’uburyo bwiza bwo kuyivura.

Kora isuzuma ku bimenyetso bya mbere by’indwara y’inkingi, nka fiviri, ububabare mu gihe cyo kwinnya, kwinnya kenshi, cyangwa impinduka ku ibara cyangwa impumuro y’inkari. Kumenya indwara hakiri kare bituma ivurwa vuba kandi bishobora kuyikumira kugera ku mpyiko.

Niba umwana wawe ari gufata imiti igabanya ubukana bw’indwara, muhe igihe kimwe buri munsi kandi yuzuze igihe cyose cyateganyijwe, nubwo umwana wawe yumva ameze neza. Ntuzigere ucikwa doze cyangwa uhagarika imiti udahamagaye muganga wawe mbere.

Wategura gute uruzinduko kwa muganga?

Gutegura uruzinduko kwa muganga bifasha guhamya ko ubonye ibyiza byose by’uruzinduko rwawe kandi utibagiwe ibibazo cyangwa amakuru akomeye. Tangira wandike ibimenyetso byose wabonye n’igihe byabaye.

Komereza ku kwandika ibyerekeye imikorere y’umwana wawe mu bwiherero, harimo kenshi akunnya, ububabare cyangwa ibyago, n’ibimenyetso by’indwara zishoboka. Andika igihe cyose yagize fiviri, nubwo byasa nkaho bitari bifitanye isano n’ibimenyetso byo kwinnya icyo gihe.

Zana ibi bintu by’ingenzi mu ruzinduko rwawe:

• Urutonde rw’imiti n’ibindi byongewemo ubu
• Inyandiko y’ibimenyetso biheruka n’igihe byabaye
• Ibisubizo by’ibizamini byabanje n’amateka y’ubuzima
• Amakuru y’ubwisungane bw’ubuzima n’irangamuntu
• Urutonde rw’ibibazo ushaka kubaza
• Amakuru y’aho ushobora kuvugana n’abandi baganga bavura umwana wawe

Andika ibibazo byawe mbere y’igihe kugira ngo utabyibagirwa mu gihe cy’isura. Ibibazo bisanzwe bishobora kuba birimo kubaza ibyerekeye ibikorwa bigomba kwirindwa, igihe cyo guhamagara iyo hari ibimenyetso biteye impungenge, cyangwa igihe kuvurwa bishobora kumara.

Niba umwana wawe amaze gukura, mujyane mu gutegura isura. Musobanurire ibizaba mu buryo bumwumvikana bitewe n’imyaka ye kandi umukangurire kubabaza ibibazo bye bwite. Ibi bituma yumva aruhutse kandi akitabira ubuvuzi bwe.

Teganya kuzana umuntu wo mu muryango cyangwa inshuti wizeye kugira ngo aguhe ubufasha kwibuka amakuru yavuzwe mu gihe cy’isura. Kugenda kwa muganga bishobora gutera ubwoba, cyane cyane iyo uvuga ku bijyanye n’uburyo bwo kuvura cyangwa ibisubizo by’ibizamini.

Tegura kuvugana amateka y’ubuzima bw’umuryango wawe, cyane cyane ibibazo by’impumyi, ibibazo by’inzira y’umuyoboro w’inkari, cyangwa reflux vesicoureteral mu bavandimwe cyangwa ababyeyi. Aya makuru afasha muganga wawe gusuzuma ibintu byongera ibyago no gutegura ubuvuzi bukwiye.

Ni iki gikuru wakuramo ku bijyanye na reflux vesicoureteral?

Reflux vesicoureteral ni uburwayi bushobora kuvurwa kandi busanzwe bukira ubwabwo uko abana bakura. Nubwo bisaba gukurikiranwa rimwe na rimwe no kuvurwa, abana benshi bafite reflux bakura neza, bagira ubuzima bwiza nta ngaruka z’igihe kirekire.

Ikintu cy’ingenzi cyo kwibuka ni uko kubimenya hakiri kare no kwitabwaho kwa muganga bikwiye bishobora gukumira ibibazo bikomeye. Hamwe no gutumanaho neza n’itsinda ry’abaganga bawe no kwita ku buzima bw’umwana wawe bw’inkari, ushobora gufasha kugera ku musaruro mwiza.

Imyinshi mu bintu byoroheje bya reflux bikira ubwabyo igihe abana bageze mu kigero cy’ishuri. Nubwo kuvurwa ari ngombwa, uburyo bwo kuvura n’ubuvuzi muri iki gihe bukoreshwa cyane kandi ntabwo bugoye nk’ibyo mu bihe byashize.

Komera kandi ujye wibuka ko nturi wenyine mu guhangana n’iki kibazo. Ikipe y’abaganga bawe iri aho kugira ngo igufashe wowe n’umwana wawe intambwe ku yindi, kandi ufite ubuvuzi bukwiye, reflux ya vesicoureteral ntibigomba kugabanya ibikorwa by’umwana wawe cyangwa ubuzima bwe bw’ejo hazaza.

Ibibazo bikunze kubaho ku bijyanye na reflux ya vesicoureteral

Ese umwana wanjye azakura areka reflux ya vesicoureteral?

Abana benshi barakura bakareka reflux ya vesicoureteral iciriritse cyangwa iciye hagati uko bakura. Uko umwana wawe akura, imiyoboro ye ya urinaire iragenda irushaho kuba miremire kandi umwiru aho ihurira n’umwijima uragenda utera imbere, bigatuma habaho uburyo bwo gufunga neza. Ubushakashatsi bwerekana ko abana bagera kuri 80% bafite reflux y’ikiciro cya 1-2 bazabona impinduka nziza mu myaka 5. Reflux y’ibiciro byo hejuru ntabwo ishobora gukira yonyine, ariko impinduka ikomeye irashobora kubaho. Muganga wawe azakurikirana amajyambere y’umwana wawe akoresheje isuzuma n’ibizamini bisanzwe kugira ngo arebe uko reflux ihinduka uko iminsi igenda.

Ese umwana wanjye ashobora gukora ibikorwa bisanzwe n’imikino?

Abana bafite reflux ya vesicoureteral bashobora kwitabira ibikorwa byose bisanzwe by’abana, harimo imikino no koga. Iki kibazo ubwo bwacyo ntigira ingaruka ku mikorere y’umubiri, kandi kuguma ukora siporo ni ingenzi ku buzima rusange. Ariko rero, ni ingenzi cyane kuguma wisukura neza mu gihe ukina siporo kandi ukangurira umwana wawe kujya mu bwiherero buri gihe. Niba umwana wawe ari gufata antibiotique zo kwirinda, komeza umuhe imiti nk’uko yagutegetswe n’umuganga, ndetse no mu gihe afite gahunda nyinshi. Ganira na muganga wawe niba ufite impungenge ku bikorwa runaka, ariko abana benshi ntibakenera kugira ibyo babuzwa mu bikorwa byabo bya buri munsi.

Ese reflux ya vesicoureteral itera umwana wanjye ububabare?

Ukwisubira inyuma kwa vesicoureteral ubwayo ntibisanzwe biterwa n’ububabare. Abana benshi bafite reflux bumva bameze neza buri munsi kandi bashobora kutamenya ko bafite icyo kibazo. Ububabare busanzwe buza gusa iyo habaye ubwandu bw’inzira y’umusemburo, bushobora gutera ububabare mu gihe cyo kwinjira, ububabare mu nda, cyangwa ububabare mu mugongo. Bamwe mu bana bashobora kumva batuje gato igihe umwijima wabo wuzuye cyane, ariko ibi ntibituruka kuri reflux. Niba umwana wawe agaragaza ububabare buhoraho, cyane cyane afite umuriro, hamagara muganga wawe vuba kuko bishobora kugaragaza ubwandu bukenewe kuvurwa.

Ese umwana wanjye akeneye gusubira kwa muganga kenshi gute?

Gahunda yo gusubira kwa muganga itandukanye bitewe n’ikiciro cya reflux n’imimerere y’umwana wawe. Abana bafite reflux yoroheje bashobora gukenera kujya gukorerwa isuzuma buri mezi 6-12, mu gihe abana bafite ibyiciro byo hejuru cyangwa ubwandu bwinshi bashobora gukenera gukurikiranwa kenshi. Isukura rusange irimo ibizamini by’inkari kugira ngo harebwe ubwandu, ultrasound kugira ngo hagenzurwe uko impyiko zikura n’ubuzima bwazo, hamwe no gukora ibizamini by’amashusho buri gihe kugira ngo harebwe niba reflux iri gutera imbere. Muganga wawe azategura gahunda ihuye n’ibyo umwana wawe akeneye. Hagati y’ibitaro, hamagara umuvuzi wawe niba ubona ibimenyetso by’ubwandu bw’inzira y’umusemburo cyangwa ibindi bimenyetso bishishikaje.

Ese abandi bana banjye bashobora kugira reflux ya vesicoureteral na bo?

Hari ibyago byiyongereye ko abavandimwe b’umwana ufite vesicoureteral reflux na bo bashobora kuba bafite iyo ndwara. Ubushakashatsi bugaragaza ko abavandimwe b’abahungu n’abakobwa bafite amahirwe agera kuri 25-30% yo kugira reflux, ibi bikaba birenga cyane ibyo abantu basanzwe bafite. Niyo mpamvu abaganga benshi bagira inama yo gusuzuma abavandimwe, cyane cyane niba bakiri bato cyangwa barwaye indwara z’inzira y’umusemburo. Iyo isuzumabushobozi isanzwe irimo ultrasound, ndetse n’ibindi bipimo niba hagaragaye ikibazo. Ariko rero, kuba umwana umwe afite reflux ntibisobanura ko abana bawe bose bazayigira, kandi abavandimwe benshi basanga bafite ubuzima bwiza. Muganire n’umuganga wawe ku bijyanye n’isuzumabushobozi hakurikijwe uko umuryango wanyu uhagaze.