Ibladder Eguquguqukayo

Ukukhwehlela okukhulu kwesisu, okubizwa nangokuthi i-OAB, kubangela ukunxanela okungazelelwe kokungqongqoza okungase kube nzima ukulawula. Kungase kube khona isidingo sokuphasa umchamo izikhathi eziningi emini nasebusuku. Kungase kube khona nokulahleka komchamo okungahlosiwe, okubizwa ngokuthi ukungcola okuphazamisekile.

Abantu abane-overactive bladder bangase bazizwe benesithukutheki. Lokho kungabangela ukuba bagweme abanye noma ukulinganisela impilo yabo yomsebenzi nomphakathi. Izindaba ezinhle ukuthi zingaphathwa.

Ukushintsha okulula kokuziphatha kungase kuphathe izimpawu ze-overactive bladder. Lokhu kungase kufaka ukushintsha ekudleni, ukuya eceleni ngesikhathi esithile nokusebenzisa imisipha yepelvic floor ukulawula isisu. Kukhona nezinye izindlela zokwelapha okumelwe kuzinyathelwe.

Uma unenkinga yokungasebenzi kahle kwesisu, ungase: Uzizwe unesifiso esiqhubekayo sokuya emathunzini esinzima ukulawula. Ulahlekelwe yimfucumfucu ngaphandle kokuhlose ngemuva kokuba unesidingo esiphuthumayo sokuya emathunzini, okuthiwa yi-urgency incontinence. Uye emathunzini njalo. Lokhu kungasho izikhathi ezingu-8 noma ngaphezulu emahoreni angu-24. Uvuka izikhathi ezingaphezu kwezi-2 ebusuku ukuya emathunzini, okuthiwa yi-nocturia. Ngisho noma ungaya emathunzini ngesikhathi lapho uzizwa unesifiso sokuya emathunzini, ukuya njalo emathunzini emini nasebusuku kungaphazamisa impilo yakho. Nakuba kuvamile kubantu abadala, ukungasebenzi kahle kwesisu akuyona ingxenye evamile yokuqina. Kungase kube nzima ukukhuluma ngezimpawu zakho. Kodwa uma izimpawu zikukhathaza noma ziyakuhlukumeza, xhumana nochwepheshe wakho wezempilo. Kunezindlela zokwelapha ezingase zikusize.

Nakuba kuvamile kubantu abadala, i-overactive bladder akuyona ingxenye evamile yokuguga. Kungase kube nzima ukukhuluma ngezimpawu zakho. Kodwa uma izimpawu zikukhathaza noma ziyaphula impilo yakho, xhumana nochwepheshe wakho wezokunakekelwa kwezempilo. Kunezinqubo ezingase zikusize.

Izinkila zenza umchamo, obugeleza emathunjini. Uma ukhishwa umchamo, umchamo udlula emathunjini ngomhubhe othi i-urethra (u-REE-thruh). Imisipha e-urethra ebizwa ngokuthi i-sphincter ivula ukuze ikhiphe umchamo emzimbeni.

Kubantu ababelethwe njengabesifazane, ukuvulwa kwe-urethra kuphezulu nje kokuvulwa kwesikhumba. Kubantu ababelethwe njengabesilisa, ukuvulwa kwe-urethra kuphezulu kwekhanda le-penis.

Njengoba ama-bladder egcwele, izimpawu zezinzwa ezithunyelwa ebuchosheni zibangela isidingo sokuphuma umchamo. Uma ukhishwa umchamo, lezi zimpawu zezinzwa zenza imisipha yephelika nemisipha ye-urethra, ebizwa ngokuthi imisipha ye-urinary sphincter, iphole. Imisipha yama-bladder iqinile, ebizwa nangokuthi i-contract, isusa umchamo.

I-bladder ephakeme kakhulu kwenzeka uma imisipha yama-bladder iqala ukuqinisa ngokwayo ngisho noma inani lomchamo emathunjini liphansi. Lezi zibizwa ngokuthi ukucindezeleka okungakhethiwe. Kubangela isidingo esiphuthumayo sokuphuma umchamo.

Izimo eziningi zingaba yingxenye ye-bladder ephakeme kakhulu, kufaka phakathi:

• Izimo ezihlasela ama-bladder, njengezinhlungu noma amatshe ama-bladder.
• Izimo ezihlasela ubuchopho nomgogodla, njengokuqhaqhazela nokuqina okuningi.
• Isifo sikashukela.
• Izici eziyisithiyo ekusukeni komchamo emathunjini, njenge-prostate enkulu, ukuvimbela noma ukuba nokucutshungulwa kokwelapha ukungakwazi ukulawula ukuphuma komchamo, okuthiwa ukungakwazi ukulawula.
• Ukushintsha kwamahomoni ngesikhathi se-menopause.
• Ukutheleleka kwe-urinary tract, okungabangela izimpawu ezifana nalezo ze-bladder ephakeme kakhulu.

Izimpawu ze-bladder ephakeme kakhulu zingase zihlangene ne:

• Ukwehla kokucaca kwengqondo ngenxa yokuguga. Lokhu kwenza kube nzima kuma-bladder ukusebenzisa izimpawu eziyithola ebuchosheni.
• Ukuphakelwa kakhulu kwe-caffeine noma utshwala.
• Imithi ebangela umzimba ukwenza umchamo omningi noma okudingeka uthathe amanzi amaningi.
• Ukungakwazi ukuya esigodini ngokushesha.
• Ukungakhiphi i-bladder ngokuphelele. Lokhu kuholela ekungabi khona kwendawo eyanele emathunjini emchamo omningi.

Ukuguga kukwandisa ingozi yebladder eguquguqukayo. Kuyindlela efanayo nokuba owesifazane. Izimo ezinjengokukhula kwe-prostate kanye nesifo sikashukela zingakwandisa nezingozi. Abantu abaningi abanezinhlungu ekuqondeni, njengalabo abake baba nesifo sokuqhaqhazela noma abanesifo se-Alzheimer, bathola i-bladder eguquguqukayo. Lokhu kungenxa yokuthi abanalo ikhono lokuqaphela izimpawu zokudinga ukuya emathisini. Ukuphuza amanzi ngesikhathi esibekiwe, ukuqondisa nokuqalisa ukuya emathisini, izingubo ezimunca, nezinhlelo zezisu zingasiza ekulawuleni lesi simo. Abanye abantu abane-bladder eguquguqukayo banenkinga yokulawula izisu. Tshela udokotela wakho uma unezinkinga zokulawula izisu.

Noma yiluphi uhlobo lokuqina kungenza umthelela ekukhululekeni kokuphila. Uma izimpawu zakho zebladder ezinamandla kakhulu zikuphazamisa ekuphileni kwakho, ungase futhi ube ne: Ukukhathazeka. Usizi noma ukucindezeleka. Izinkinga zobulili. Ukuphazamiseka kokulala nezikhathi zokulala eziqediwe. Abantu ababekwe njengabesifazane ekuzalweni abanebladder enamandla kakhulu bangase futhi babe nesimo esibizwa ngokuthi i-incontinence ehlanganisiwe. Lokhu kunobuningi noxinzelelo lokuqina. Ukuqina kokucindezela ukulahlekelwa okungazelelwe kwesisu ngenxa yomzimba noma umsebenzi obekela ingcindezi ebladder. Izibonelo zikukhokhla, ukuthandaza, ukuhleka noma ukuzivocavoca.

Lezi zikhetho zokuphila impilo enempilo zinganciphisa ingozi yakho yokukhubazeka kokukhulukazi kwesisu:

• Yenza ukuzivocavoca ukuqinisa imisipha yasesinyi. La maqeqeshana abizwa ngokuthi amaKegel.
• Thola umsebenzi womzimba nsuku zonke, njalo.
• Khawulela ikhofi notywala.
• Gcina isisindo esinempilo.
• Phatha izimo eziqhubekayo, ezibizwa ngokuthi izimo ezingapheli, njengokusabela kweswekile, okungase kwengeze emazingeni okukhulukazi kwesisu.
• Yeka ukubhema.

Uma uba nezifiso ezingavamile zokuya emathunzini, udokotela wakho uyobekazelela ukutheleleka noma igazi emathunzini akho. Uchwepheshe wakho wezempilo angase futhi ahlole ukuthi uyakwazi yini ukuthambisa isibeletho sakho ngokuphelele lapho uya emathunzini.

Imihlangano yakho cishe izoba yilezi:

• Umlando wezokwelapha.
• Ukuhlolwa kwezinzwa ukubheka izinkinga zezinzwa noma izinkinga ze-reflex.
• Ukuhlolwa komzimba, okungafaka nokukhehla kwesisu kanye nokukhehla kwesisu kwabesifazane.
• Isibonelo sethunzi ukuhlola ukutheleleka, izindawo zegazi noma ezinye izinkinga.

Uchwepheshe wakho wezempilo angase aphakamise ukuhlolwa ukuze abone ukuthi isibeletho sakho sisebenza kahle kangakanani nokuthi singakwazi yini ukuthambisa ngokuphelele, okuthiwa yi-urodynamic tests. Ochwepheshe ngokuvamile benza le mihlola. Kodwa ukuhlolwa kungase kungadingeki ukwenza ukuxilongwa noma uqale ukwelashwa.

Ukuhlolwa kwe-urodynamic kufaka:

• Ukulinganisa isithunzi esisele esibelethweni. Lo mkhuba ubalulekile uma ungase ungakwazi ukuthambisa isibeletho sakho ngokuphelele lapho uya emathunzini. Ukuhlala kwethunzi esibelethweni, okuthiwa yi-postvoid residual urine, kungabangela izimpawu ezifana nalezo zesibela esisebenza kakhulu.

Ukuze ulinganise isithunzi esisele ngemuva kokuthi uhambe, uchwepheshe wakho wezempilo angase afune ukuskena kwe-ultrasound yesibeletho sakho. Ukukhehla kwe-ultrasound kuhumusha amaza omsindo abe yisithombe. Isithombe sibonisa ukuthi kukhona kangakanani isithunzi esisele esibelethweni lakho ngemuva kokuthi uhambe.

Ngezinye izikhathi, ipayipi elincane, okuthiwa yi-catheter, lidluliselwa nge-urethra bese liya esibelethweni sakho ukuze liphume isithunzi esisele. Khona-ke isithunzi singalinganiswa.

• Ukulinganisa isivinini sokugeleza kwethunzi. Ukuze ulinganise ukuthi uya emathunzini kangakanani nokuthi ngokushesha kangakanani, ungase ucelwe ukuya emathunzini kwisixhobo okuthiwa yi-uroflowmeter. I-uroflowmeter ibamba futhi ilinganise isithunzi. Khona-ke isebenzisa idatha ukudala igrafu yenguquko esivinini sakho sokugeleza.

Ukulinganisa isithunzi esisele esibelethweni. Lo mkhuba ubalulekile uma ungase ungakwazi ukuthambisa isibeletho sakho ngokuphelele lapho uya emathunzini. Ukuhlala kwethunzi esibelethweni, okuthiwa yi-postvoid residual urine, kungabangela izimpawu ezifana nalezo zesibela esisebenza kakhulu.

Ukuze ulinganise isithunzi esisele ngemuva kokuthi uhambe, uchwepheshe wakho wezempilo angase afune ukuskena kwe-ultrasound yesibeletho sakho. Ukukhehla kwe-ultrasound kuhumusha amaza omsindo abe yisithombe. Isithombe sibonisa ukuthi kukhona kangakanani isithunzi esisele esibelethweni lakho ngemuva kokuthi uhambe.

Ngezinye izikhathi, ipayipi elincane, okuthiwa yi-catheter, lidluliselwa nge-urethra bese liya esibelethweni sakho ukuze liphume isithunzi esisele. Khona-ke isithunzi singalinganiswa.

Le nqubo ingabonisa ukuthi isibeletho sakho sigcwele kangakanani lapho uqala ukudinga ukuya emathunzini. Ingabonisa futhi ukuthi isibeletho sakho siqina yini lapho singafanele siqine.

Umhlinzeki wakho wezempilo ubuyekeza imiphumela yokuhlolwa kwakho nawe bese ephakamisa uhlelo lokwelapha.

Ukuhlanganiswa kokwelashwa kungaba kuhle kakhulu ekuqedeni izimpawu zesibofu esisebenza kakhulu.\n\nImisipha yasesinyi isekela amalungu esinyi. Lawo malungu afaka isisu, isibofu kanye nekhonkolo. Ukuzivocavoca kweKegel kungasiza ekuqiniseni imisipha yasesinyi.\n\nImisipha yasesinyi yabesilisa isekela isibofu kanye nezimbongolo futhi ithonya umsebenzi wezocansi. Ukuzivocavoca kweKegel kungasiza ekuqiniseni le mi sipha.\n\nUkuphathwa kwengqondo kuyisinqumo sokuqala ekusizeni ukuphatha isibofu esisebenza kakhulu. Zivame ukusebenza futhi azinacebo ezibuhlungu. Ukuphathwa kwengqondo kungafaka:\n\n- Biofeedback. Ngesikhathi se-biofeedback, iphetshi le-elekthrikhi elibekwe ebusweni lwesi khumba phezu kwesibofu sakho lixhunyiwe engxenyeni yentambo exhunyiwe esikrinini. Lokhu kukuvumela ukubona lapho imisipha yesibofu sakho iqinisile. Lokhu kungakusiza ukwazi ukuthi kuzwakala kanjani lapho imisipha iqina ukuze ufunde ukuyilawula.\n- Ukuqeqeshwa kwesibofu. Ukuqeqeshwa kwesibofu kuhilela ukuya esigodini ngezikhathi ezimisiwe. Sebenzisa idayari yesibofu ukubona ukuthi uya kangaki. Bese ungeza imizuzu engu-15 ngesikhathi phakathi kwezinkambo zokuya eceleni. Khishwa ngisho noma ungazizwa ufuna. Lokhu kungaqeqesha isibofu sakho ukuba sibeke amanzi amaningi ngaphambi kokuba uzizwe ufuna ukuya eceleni.\n- Isisindo esinempilo. Uma unesisindo esingaphezulu, ukulahlekelwa isisindo kunganciphisa izimpawu. Ukulahlekelwa isisindo kungasiza uma futhi une-incontinence ye-stress urinary.\n- Ukuhlanza okungapheli kwe-catheterization. Uma ungakwazi ukuhlanza isibofu sakho kahle, ukusebenzisa i-tube ebizwa nge-catheter ngezikhathi ezithile ukuhlanza isibofu sakho ngokuphelele kusiza isibofu sakho ukwenza lokho okungakwazi ukukwenza ngokwalo. Buza ochwepheshe bakho bezempilo uma le ndlela ifanele wena.\n- Ukuzivocavoca kwemisipha yasesinyi. Ukuzivocavoca kweKegel kuqinisa imisipha yakho yasesinyi kanye ne-urinary sphincter. Imisipha eqinile ingakusiza ukuvimbela isibofu ukuba singaqini ngokwalo.\n\nOchwepheshe bakho bezempilo noma umhlengikazi wezemidlalo bangakusiza ukufunda ukwenza ukuzivocavoca kweKegel. Ukuzivocavoca kweKegel kufana nezinye izinhlobo zokuzivivinya. Indlela okusebenza ngayo kahle kuya ngokukwenza njalo. Kungathatha amasonto ayisithupha ngaphambi kokuba kuqale ukusebenza.\n\nUkuzivocavoca kwemisipha yasesinyi. Ukuzivocavoca kweKegel kuqinisa imisipha yakho yasesinyi kanye ne-urinary sphincter. Imisipha eqinile ingakusiza ukuvimbela isibofu ukuba singaqini ngokwalo.\n\nOchwepheshe bakho bezempilo noma umhlengikazi wezemidlalo bangakusiza ukufunda ukwenza ukuzivocavoca kweKegel. Ukuzivocavoca kweKegel kufana nezinye izinhlobo zokuzivivinya. Indlela okusebenza ngayo kahle kuya ngokukwenza njalo. Kungathatha amasonto ayisithupha ngaphambi kokuba kuqale ukusebenza.\n\nNgemva kwe-menopause, ukwelashwa kwe-estrogen ye-vaginal kungasiza ekuqiniseni imisipha namalungu esigabeni se-urethra kanye nesigaba se-vaginal. I-estrogen ye-vaginal ifika ngamafutha, ama-suppositories, amathebulethi noma ama-rings. Ingathuthukisa izimpawu zesibofu esisebenza kakhulu.\n\nAmakhambi aqinisa isibofu angasiza ekuqedeni izimpawu zesibofu esisebenza kakhulu futhi anciphisa izehlakalo ze-urge incontinence. Lezi zidakamizwa zifaka:\n\n- Fesoterodine (Toviaz).\n- Mirabegron (Myrbetriq).\n- Oxybutynin, engathathwa njengephilisi (Ditropan XL) noma isebenziswe njengephetshi lesikhumba (Oxytrol) noma ijeli (Gelnique).\n- Solifenacin (Vesicare).\n- Tolterodine (Detrol).\n- Trospium.\n\nImiphumela emibi evamile yalezi zidakamizwa zifaka amehlo omile nomlomo omile. Kepha ukuphuza amanzi okunxanela kungenza izimpawu zesibofu esisebenza kakhulu zibe zimbi. Ukuvimbela kuyinye ingxenye ephumela embi engenza izimpawu zesibofu zibe zimbi. Izinhlobo ezide ze-release yalezi zidakamizwa, kufaka phakathi iphetshi lesikhumba noma ijeli, zingabangela imiphumela emibi embalwa.\n\nOchwepheshe bakho bezempilo bangase baphakamise ukuthi uphuze amanzi amancane noma umemezele i-candy engenasonka noma uhlume i-gum engenasonka ukuqeda umlomo omile. Ungase usebenzise ama-eyedrops ukugcina amehlo akho emanzi.\n\nAmakhambi atholakala ngaphandle kwesikripthi, njengamathuluzi omzimba aklanywe ukuqeda umlomo omile, angasiza ekwelapheni komlomo omile isikhathi eside. Ukudla ukudla okunamafutha amaningi noma ukusebenzisa abalungisi be-stool kungasiza ukuvimbela ukuvimbela.\n\nOnabotulinumtoxinA (ON-ah-boch-yoo-lih-num-tox-in-A), okuthiwa yiBotox, luyisiproteni oluvela kubhaktheriya obangela ukugula kwe-botulism. Izilinganiso ezincane ezidutshulwe ezingqondweni zesibofu zingakhulula imisipha futhi zande inani lamanzi esibofu esingawagcina.\n\nOkutadisha kubonisa ukuthi iBotox ingasiza ekuqedeni i-urge incontinence eqinile. Imiphumela ivame ukugcina izinyanga eziyisithupha noma ngaphezulu. Uma imiphumela iphela, udinga enye i-shot.\n\nImiphumela emibi yalezi zithombe ifaka ukutheleleka kwe-urinary tract kanye nokuhlala amanzi. Uma ucabanga ngokwelashwa kweBotox, kufanele uzimisele ukufaka i-catheter ngokwakho uma uqala ukuhlala amanzi.\n\nNgesikhathi sokuvuselelwa kwemisipha yesacral, idivayisi efakwe ngokusebenza ihlinzeka ngezimpikiswano ze-elekthrikhi emithanjeni elawula umsebenzi wesibofu. Lezi zibizwa ngokuthi imithambo yesacral. Iyunithi ifakwe phansi kwesikhumba emuva ophansi, cishe lapho iphokethi yangemuva ikhona kumabhulukwe. Kulesi sithombe, idivayisi iboniswe ngaphandle kwendawo ukuze ivumele umbono omuhle weyunithi.\n\nI-pulses ye-elekthrikhi ephansi emithanjeni yesibofu ingathuthukisa izimpawu zesibofu esisebenza kakhulu.\n\Nenye inqubo isebenzisa intambo ecwebezelayo ebekwe eduze kwemisipha yesacral lapho idlula eduze komsila wakho. Imithambo yesacral ithwala izibonakaliso esibofwini sakho.\n\Le nqubo encane yokungena ngaphakathi ivame ukwenziwa ngokuzama kwenqwaba ebekwe phansi kwesikhumba emuva ophansi. Ochwepheshe bakho bezempilo bazobe besebenzisa idivayisi yesandla exhunyiwe entanjeni ukuthumela izimpikiswano ze-elekthrikhi esibofwini sakho. Lokhu kufana nalokho i-pacemaker elikwenzela inhliziyo.\n\nUma ukuzama kusiza izimpawu zakho, i-pulse generator ebambe amandla ibhethri ifakwa ngokusebenza. Idivayisi ihlala emzimbeni wakho ukuze isize ukulawula imithambo.\n\Le nqubo isebenzisa i-needle ecwebezelayo ebekwe ngaphesheya kwesikhumba eduze kwe-ankle. Ithumela ukuvuselelwa kwe-elekthrikhi kusuka emithanjeni yomlenze, ebizwa ngokuthi i-tibial nerve, eya esigxotsheni. Lapho ixhuma nemithambo elawula isibofu.\n\Ukuphathwa kwe-PTNS kunikezwa kanye ngesonto izinyanga eziyi-12 ukuqeda izimpawu zesibofu esisebenza kakhulu. Ngemva kwalokho, ukwelashwa njalo ngemva kwamasonto angu-3 kuya kwangu-4 kusiza ukugcina izimpawu zilawulwa.\n\nIzinqubo zifaka:\n\n- Ukuhlinzwa ukuze kukhuliswe ukuthi isibofu singagcina kangakanani. Le nqubo isebenzisa izingxenye zezimbongolo ukuze ithathe indawo yengxenye yesibofu. Abantu abenza le nqubo bangase badinge ukusebenzisa i-catheter ngezinye izikhathi ukuphila kwabo konke ukuhlanza isibofu sabo.\n- Ukususa isibofu. Le nqubo isebenza njengendlela yokugcina. Kuhilela ukususa isibofu nokwenza isibofu ngokusebenza ukuze sithathe indawo yaso, okuthiwa yi-neobladder. Noma kungase kuhilele ukwenza isikhala emzimbeni, okuthiwa yi-stoma, ukunamathisela isikhwama esikhumbeni ukuqoqa amanzi.

Ukuphila nokuqina kwebladder kungaba nzima. Izinhlaka zokufundisa abathengi kanye nezinhlangano zokusekela ezifana ne-National Association for Continence zingakunikeza izinsiza nemininingwane e-inthanethi. Lezi zinhlangano zikuxhumanisa nabanye abantu abane-overactive bladder kanye nokungalawuleki kokungcola. Izinhlaka zokusekela zinika ithuba lokukhuluma ngezinkathazo zakho nokufunda izindlela ezintsha zokubhekana nazo. Ukufundisa umndeni wakho nabangane bakho nge-overactive bladder nokuthi ikuthinta kanjani kungakusiza ukwakha inethiwekhi yakho yokusekela nokunciphisa imizwa yokuhlanya. Uma uqala ukukhuluma ngakho, ungamangala ukwazi ukuthi leli simo livamile kangakanani.