Ukuphindaphinda kwe-Vesicoureteral yini? Izimpawu, Izimbangela, & Ukwelashwa

Ukuphindaphinda kwe-vesicoureteral kwenzeka lapho umchamo ugeleza emuva ecishe emathunjini akhoxa amanxeba akho ezinso ecishe esibindini sakho. Cabanga ngakho njengendlela enye kuphela lapho ukuhamba kwemoto kuqala ukuhamba ngendlela engafanele. Lesi simo sivame kakhulu kubantwana abasebancane nabakhulu, nakuba singathinta abantu banoma iyiphi iminyaka.

Lesi simo senzeka ngoba indlela efana nevalvu lapho i-ureter yakho ihlangana khona nesibindini sakho ayisebenzi kahle. Ohlelweni oluphilile lwezinso, umchamo ugeleza ezinso zakho phansi ngemizila ebizwa ngokuthi yi-ureters ecishe esibindini sakho, bese uya ngaphandle komzimba wakho. Uma une-vesicoureteral reflux, ingxenye yalo mchamo ibuyela phezulu ecishe ezinso zakho esikhundleni sokuhlala esibindini sakho.

Ziyini izimpawu zokubuyela emuva kwe-vesicoureteral?

Abantu abaningi abane-vesicoureteral reflux abanawo noma yimiphi impawu, ikakhulukazi uma isimo silula. Uma izimpawu zivele, ngokuvamile zihambisana nokutheleleka kwezinso, okuvela njalo lapho umchamo ugeleza emuva.

Nazi izimpawu ezivamile ezingase zikhombe ukuphindaphinda kwe-vesicoureteral, ikakhulu kubantwana:

• Ukutheleleka kwezinso okuvamile ngomkhuhlane
• Ukusha noma ukuvutha lapho ukhishwa umchamo
• Isifiso esiphuthumayo sokuya emathunzini noma ukuya njalo emathunzini
• Ukuphuza amanzi kubantwana abase bekhulile
• Umnandi noma unuka kabi umchamo
• Ubuhlungu besisu noma eceleni
• I-constipation noma ubunzima bokuya emathunzini

Kubantwana abasebancane kakhulu, ungase uqaphele ukukhathazeka, ukudla okubi, noma umkhuhlane ongencazelo. Laba bantwana abanakukutshela ukuthi yini ebabangela ubunzima, ngakho-ke ukubuyela komkhuhlane ngaphandle kwesizathu esicacile kuvame ukubangela odokotela ukuthi bahlole izinkinga zezinso.

Abanye abantwana abane-reflux eqatha kakhulu bangase babe nokucindezeleka kwegazi okuphezulu noma babonise izimpawu zokukhula okungekuhle. Lezi zimpawu zivame ukuvela uma isimo sesikhathi eside futhi siqalile ukuthinta umsebenzi wezinso.

Imiphi imikhakha ye-vesicoureteral reflux?

Odokotela bahlukanisa i-vesicoureteral reflux zibe izigaba ezinhlanu ngokusekelwe ekutheni isikhunta sihamba kangakanani emuva nokuthi sithinta kangakanani isimiso sokususa isikhunta. Isigaba 1 yiyona ebuthakathaka kakhulu, kuyilapho iSigaba 5 iyona eqatha kakhulu.

Ku-reflux yesigaba 1, isikhunta sibuyela nje ingxenye yendlela e-ureter. Isigaba 2 sisho ukuthi isikhunta sifinyelela esinzweni kodwa asiyikubangela ukukhula. Isigaba 3 sihilela ukukhula okuncane kwesistimu yokuqoqa yesinso.

I-reflux yesigaba 4 ibangela ukukhula okumaphakathi nokunciphisa kwezingqikithi eziqondile zesinso. Isigaba 5 siyona ebucayi kakhulu, ngokukhula okukhulu kanye nezinguquko ezinkulu esakhiweni sesinso. Izigaba eziphezulu zithwala ingozi enkulu yokulimaza izinso futhi ngokuvamile zidinga ukwelashwa okukhulu.

Kukhona futhi izinhlobo ezimbili eziyinhloko ngokusekelwe ekutheni isimo siphakama nini. I-vesicoureteral reflux eyinhloko ikhona kusukela ekuzalweni ngenxa ye-ureter emfushane noma izinkinga zendlela i-ureter ehlangana ngayo nebladder. I-reflux yesibili ithuthukiswa kamuva ngenxa yokuvinjwa, ukutheleleka, noma ezinye izimo ezithinta ukugeleza okujwayelekile kwesikhunta.

Yini ebangela i-vesicoureteral reflux?

Izigameko eziningi ze-vesicoureteral reflux zenzeka ngenxa yendlela isimiso sokususa isikhunta somntwana esithuthuka ngayo ngaphambi kokuzalwa. Umsebenzi we-valve lapho i-ureter ihlangana khona nebladder awunakwakheka kahle, okudala indlela yokuba isikhunta sigeleze emuva.

Ku-reflux eyinhloko, i-ureter ingena ebladder nge-angle engavamile noma umgodi odlula udonga lwebladder mfushane kakhulu. Lokhu kusho ukuthi isimiso se-valve esemvelo asivali kahle lapho ibladder igcwele isikhunta. Njengoba abantwana bekhula, ama-ureters abo avame ukuba makhulu futhi i-angle ilungile, kungakho izimo eziningi ziqeda ngokwazo.

Ukubuyela emuva kwesibili kwenzeka lapho kukhona okuvimba noma okuthinta ukugeleza okujwayelekile kokwetshe. Nazi izimbangela eziyinhloko ezingabangela lolu hlobo:

• Ukusebenza okungalungile kwesisu noma imisipha yesisu esebenza kakhulu
• Ukuvalelwa njalo okucindezela isisu
• Isisu se-Neurogenic esivela ezinkingeni zomgogodla
• Ukungahambisani kwesakhiwo njengokuba ne-ureters eziningi
• Ukutheleleka okukhulu kwezinso okubangela ukukhuluphala
• Amatshe esisu noma ezinye izinto ezivala
• Ukuhlinzwa kwangaphambili ohlelweni lokukhipha amanzi

Ngezinye izikhathi ukubuyela emuva kwenzeka emindenini, okubonisa ukuthi i-genetics ingase ibe nomthelela. Uma ingane enye inokubuyela emuva kwe-vesicoureteral, abazalwane banesilinganiso esingu-25-30% sokuthola nakhona. Lobu buhlobo bomndeni yingakho odokotela bavame ukuncoma ukuhlola abafowethu nodadewabo bezingane ezikhuthazwe.

Ngokwengxenye, imithi ethile noma izinqubo zezokwelapha zingabangela ukubuyela emuva okwesikhashana. Izindaba ezinhle ukuthi lezi zimo zivame ukuthuthuka uma imbangela ephambili ilungiswe.

Nini kufanele ubona udokotela ngokubuyela emuva kwe-vesicoureteral?

Kufanele uxhumane nodokotela wakho uma ingane yakho inezifo ezivamile zokutheleleka kwezinso, ikakhulukazi uma zihambisana nokuqhuma. Ngisho nokutheleleka okukodwa kwe-UTI kwingane encane eneminyaka engaphansi kwengu-2 kudinga ukuhlolwa, njengoba leli qembu leminyaka linengozi enkulu yokuthintwa yizinkimbinkimbi zezinkimbinkimbi.

Shaya udokotela wakho uma ubona izimpawu zokutheleleka kwezinso okungathuthuki ngokwelashwa noma kuqhubeka kubuyela. Lezi zingafaka phakathi ukuqhuma, ubuhlungu ngesikhathi sokuthamba, ukuthamba njalo, noma ukwetshe olunephunga eliqine.

Funani usizo lwezokwelapha ngokushesha uma ingane yakho ithola ukuqhuma okuphezulu ngebuhlungu emhlane noma eceleni, njengoba lokhu kungabonisa ukutheleleka kwezinkimbinkimbi. Ezinye izimpawu ezicasulayo zifaka phakathi ubuhlungu obukhulu besisu, ukugabha ngokuqhuma, noma izimpawu zokulahlekelwa amanzi njengokunciphisa ukuthamba noma ukukhathazeka okukhulu kubantwana abasebancane.

Kubantwana abadala nabantu abadala, vakashela udokotela uma uhlushwa yi-UTIs ephindaphindayo, igazi emathisini, noma ubuhlungu obuhlala isikhathi eside emhlane. Nakuba ukubuyela emuva kwe-vesicoureteral kungavamile kubantu abadala, kusenokwenzeka futhi kudinga ukuhlolwa okuqondile.

Iyini imizamo yokusabela kwe-vesicoureteral reflux?

Izinto eziningi zingandisa amathuba okukhula kwe-vesicoureteral reflux, yize ukuba nalezi zinto ezingozi akusho ukuthi uzoba naleli bhubhane. Ukuqonda lezi zinto kusiza imindeni ukwazi ukuthi nini kufanele ibe iqaphile ngezimpawu.

Ubudala yiyona into enkulu engaba yingozi, isimo siqheleke kakhulu kubantwana abasebancane nabantwana abancane. Amantombazane athinteka kakhulu kunamadodana, ngaphandle konyaka wokuqala wokuphila lapho abafana benesilinganiso esiphezulu kancane. Ukwakheka komzimba wesifazane, nge-urethra emfushane, kungase kuhlanganyele ekuthelekeni okuvamile kwezinso okutholakala ukubuyela emuva.

Umlando womndeni udlala indima ebalulekile engozini. Uma umzali ebe ne-vesicoureteral reflux njengengane, abantwana babo banethuba elingaba ngu-25% lokuba nayo futhi. Abazalwane babantwana abathintekayo nabo banegozi eyenyuke kakhulu, kungakho odokotela bavame ukuncoma ukuhlola amalungu omndeni.

Izimo ezithile zezokwelapha zingandisa izinto ezingozi:

• I-Spina bifida noma ezinye izinkinga zomgogodla
• Ezinye izinkinga zokuzalwa zezinso noma izindlela zokukhishwa kwamathisini
• Ukuvimbeka kwesisu esiqhubekayo noma izinkinga zesisu
• Ukusebenza okungalungile kwesisu noma izinkinga zokukhishwa kwamathisini
• I-Posterior urethral valves kubafana
• I-Prune belly syndrome

Izinto zokuziphatha njengokungakhishwa kwamathisini njalo noma ukubamba imithambo isikhathi eside zingenza ukubuyela emuva kube sibi. Abanye abantwana abalinda isikhathi eside kakhulu ukuya esigodini noma abangayigcwalisi ngokuphelele imithambo yabo bangaba nezinkinga eziningi zokubuyela emuva.

Umuhlanga nobuzwe nawo buthinta ingozi, lapho isimo siqheleke kakhulu kubantwana baseCaucasian futhi singavamile kubantwana base-Afrika Amerika. Izizathu zalezi zimehluko aziqondakali ngokugcwele kodwa zingahlobana nezici zezofu eziqondene nokuthuthukiswa komthambo wokuphuma kwesisu.

Ziyini izinhlungu ezingase zenzeke ngenxa ye-vesicoureteral reflux?

Ukukhathazeka okukhulu nge-vesicoureteral reflux ukuthi ingabangela ukonakala kwesibindi isikhathi eside, ikakhulu uma kwenzeka ukutheleleka komthambo wokuphuma kwesisu njalo. Uma i-urine ezele amabhaktheriya ibuya eya ezinkingeni, ingabangela ukutheleleka okwenza izilonda ezinhlangothini zesibindi.

Ukonakala kwesibindi, okubizwa nangokuthi i-reflux nephropathy, yinkinga embi kakhulu. Lokhu konakala kungathinta ukuthi izinkipho zakho zihlanza kangcono kanjani udoti futhi zigcine ukucindezela kwegazi kufanele. Emacaleni aqatha, kungase kube yimbangela yesifo sesibindi esingapheli, nakuba lokhu kungavamile ngokunakekelwa okufanele kwezokwelapha.

Nawa ama-complications aphambili angase aphucule nge-vesicoureteral reflux engaphathwe noma eqatha:

• Ukutheleleka okuphindaphindayo komthambo wokuphuma kwesisu
• Ukonakala kwesibindi nokwenzakala okungapheli
• Ukucindezela kwegazi eliphezulu (i-hypertension)
• Iprotheni e-urine
• Isifo sesibindi esingapheli
• Ukungasebenzi kwesibindi emacaleni ambalwa aqatha, aqatha
• Izinkinga zokukhula kubantwana abanezinkinga ezinkulu zesibindi

Izindaba ezinhle ukuthi ngokubeka iliso okufanele nokuphatha, abantwana abaningi abane-vesicoureteral reflux bagwema izinhlungu ezinkulu. Amacala alula avame ukuqina ngokwemvelo njengoba abantwana bekhula, futhi ngisho namacala aphakathi angaphathwa kahle ngokunakekelwa kwezokwelapha.

Ukukhulelwa kungase kube nezinto ezikhethekile kubesifazane ababe ne-vesicoureteral reflux njengabantwana. Nakuba abesifazane abaningi abane-reflux yomlando banezimo ezinempilo zokukhulelwa, labo abanezilonda zesibindi bangadinga ukulandelelwa eduze ngenxa yokucindezela kwegazi eliphezulu noma ukushintsha kwesibindi.

Ngokwemvelo, ukuphindaphinda okukhulu kokubili (okuthinta izinso zombili) kungabangela ukonakala okukhulu kwesinso okudinga ukuhlanzwa kwegazi noma ukuhlinzwa. Kodwa-ke, leli zinga lezingxaki aliqondakali uma abantwana bethola ukunakekelwa okufanele kwezokwelapha nokulandelwa.

Ukuvimbela kanjani ukuphindaphinda kwe-vesicoureteral?

Njengoba ukuphindaphinda okuningi kwe-vesicoureteral kukhona kusukela ekuzalweni ngenxa yendlela uhlelo lokukhishwa lwe-urinary oluthuthukisayo, ayikho indlela yokuvimbela uhlobo oluyinhloko lalesi simo. Kodwa-ke, ungathatha izinyathelo zokunciphisa ingozi yezingxaki nokuphindaphinda okwesibili.

Iqhinga elibaluleke kakhulu lokuvimbela ukugwema ukutheleleka kwe-urinary tract, okungenza kube kubi ukuphindaphinda okukhona noma ngezinye izikhathi kubangele ukuphindaphinda okwesibili. Imikhuba emihle yokusebenzisa igumbi lokugezela idlala indima ebalulekile ekuqondeni uhlelo lokukhishwa lwe-urinary.

Nazi izinyathelo ezisebenzayo ezingasiza ekuvimbeni izingxaki:

• Khuthaza ukuphuma kwesisu njalo, okuphelele
• Qinisekisa ukungenisa okwanele kwamanzi nsuku zonke
• Phatha isiphithiphithi ngokushesha nangokuphumelelayo
• Hlola ukuhlanzeka okuhle kwezitho zangasese
• Susa kusuka phambili uye emuva ngemuva kokusebenzisa igumbi lokugezela
• Khishwa ngokushesha ngemuva kokuziphatha ngokobulili (kwabantu abadala nabasha)
• Gwema ukugqoka amabhabhu nama-soaps aqinile endaweni yezitho zangasese

Emindenini enomlando wokuphazamiseka kwe-vesicoureteral, ukuhlola kwasekuqaleni kwabazalwane kungasiza ekutholeni isimo ngaphambi kokuthi izingxaki zithuthuke. Nakuba ungakwazi ukuvimbela ukuphindaphinda ngokwalo, ukuqala ngokushesha kuvumela ukuqapha nokuphathwa okuhle.

Ukufundisa abantwana imikhuba enempilo yokukhishwa kusukela ebuntwaneni kubaluleke kakhulu. Lokhu kuhlanganisa ukungagcini isifu ngezikhathi ezide, ukuthatha isikhathi sokuqeda isisu ngokuphelele, nokulondoloza ukunyakaza kwesisu okujwayelekile ukuze kugwenywe isiphithiphithi.

Uma ingane yakho ihlonishwe ukuthi inenkinga ye-vesicoureteral reflux, ukulandela uhlelo lokwelapha lodokotela wakho ngokucophelela yindlela engcono kakhulu yokuvimbela izinkinga zesikhathi eside. Lokhu kungafaka ukusebenzisa ama-antibiotics okuvimbela, ukuya ekuhlolweni okuqhubekayo, nokulandela izimpawu zokutheleleka kwezinso.

Ihlonishwa kanjani i-vesicoureteral reflux?

Ukuhlola i-vesicoureteral reflux kuvame ukuqala lapho ingane inezifo ezivamile zokutheleleka kwesistimu yomchamo noma lapho odokotela bethola izimpawu ngesikhathi sokuhlola okuvamile. Umhlinzeki wakho wezinsizakalo zezempilo uzoqala ngomlando wezokwelapha onemininingwane kanye nokuhlolwa komzimba.

Ivivinyo eliyinhloko elisetshenziswa ukuhlola i-vesicoureteral reflux libizwa ngokuthi yi-voiding cystourethrogram (VCUG). Ngalesi sivivinyo, ipayipi elincane lifakwa esibindini nge-urethra, futhi i-dye ebonakalayo isetshenziswa ukugcwalisa isibe. Ama-X-ray athathwa ngenkathi ingane yakho ibhukula ukuze kubonwe ukuthi umchamo ubuyela emuva kwi-ureters.

Nakuba i-VCUG ingase izwakale ingakhululekile, ngokuvamile iyaphikelela futhi inikeza isithombe esicacile sokuphindaphinda. Ivivinyo libonisa futhi izinga lokuphindaphinda, okusisiza udokotela wakho ukuthi anqume indlela engcono kakhulu yokwelapha.

Izivivinyo ezengeziwe udokotela wakho angase azincoma zifaka:

• I-ultrasound yesibindi ukuhlola izinkinga zesakhiwo
• I-nuclear scan (DMSA) ukubheka ukweluka kwesibindi
• Ukukhiqizwa komchamo ukuhlola ukutheleleka okusebenzayo
• Izivivinyo zegazi ukuhlola umsebenzi wesibindi
• I-ultrasound ehlanganisiwe ne-contrast ezimweni ezithile

Kubantwana abasebancane nabantwana, odokotela bangase basebenzise i-nuclear medicine test ebizwa ngokuthi yi-nuclear cystogram esikhundleni se-VCUG. Le test isebenzisa inani elincane lezinto ezinobukhulu besakhiwo esikhundleni sama-X-ray futhi ingase ingabi lukhulu kubantwana abancane kakhulu.

Uma ingane yakho inesifo esiningi se-UTI, udokotela wakho angase acele ukuhlolwa ngisho noma ezinye izimpawu zingabonakali. Ukuhlolwa kwasekuqaleni kubalulekile ngoba kuvumela ukulandelela nokuphatha ngaphambi kokuba konakale ukwenzakala kwesibindi.

Ngesinye isikhathi, ukubuyela emuva kwezinto (reflux) kutholakala ngengozi ngesikhathi sokuhlolwa kwezinye izimo. Lokhu kuvame kakhulu uma abantwana benza i-ultrasounds ngenxa yezinye izizathu, futhi odokotela baphawula ukushintsha ezinso okubonisa ukuthi kungenzeka kube khona ukubuyela emuva.

Iyini impilo yokuwelapha ukubuyela emuva kwe-vesicoureteral?

Ukwelashwa kokubuyela emuva kwe-vesicoureteral kuncike ezintweni eziningi, kufaka phakathi izinga lokubuyela emuva, iminyaka yengane yakho, ukuthi izifo ze-UTI zivela kangakanani, nokuthi kukhona ubufakazi bokulimala kwesinso. Izimo eziningi ezilula azidingi ukwelashwa okuqhubekayo ngaphandle kokulandelela ngokucophelela.

Ngokubuyela emuva kwezinga eliphansi (amazinga 1-2), odokotela bavame ukuncoma indlela "yokulinda nokubona" ngokulandelela okuvamile. Abantwana abaningi bakhula bekhulu ukubuyela emuva okulula njengoba ama-ureters abo ekhula abe makhulu futhi i-valve mechanism ilungile ngokwemvelo. Ngalesi sikhathi, ukuvimbela ukutheleleka kwezindlela zokukhishwa kwesisu kuba yiyona nto ebaluleke kakhulu.

Ukuvimbela ngama-antibiotic kuvame ukusetshenziswa kubantwana abane-UTIs eziphindaphindayo noma ama-reflux aphezulu. Ingane yakho ithatha umthamo omncane wansuku zonke wama-antibiotic ukuvimbela ibhaktheriya ekukhuleni endleleni yokukhishwa kwesisu. Ama-antibiotic avamile asetshenziswayo afaka i-trimethoprim-sulfamethoxazole noma i-nitrofurantoin.

Nawa amaqhinga amakhulu okwelapha udokotela wakho angancoma:

• Ukubuka okuqhubekayo ngokuhlola okuvamile
• Ama-antibiotic amancane ansuku zonke okuvimbela
• Izindlela zokugcoba ezingena kakhulu
• Ukulungiswa okuhlinzwayo (ukufakwa kabusha kwe-ureter)
• Ukuhlinzwa kwe-laparoscopic okusiziwe yi-robotic

Ngokubuyela emuva okuphakathi nendawo okukhulu okungaphuli noma kubangele ukutheleleka okuvamile, ukwelashwa okuhlinzwayo kungadingeka. Inketho engangeni kakhulu ukugcoba into ehlanganisa eduze kwendawo lapho i-ureter ingena khona esibindini. Lokhu kudala i-valve mechanism engcono futhi kwenziwa njengendlela yokwelashwa kwabantu abangena esibhedlela.

Ukulungisa ngokusebenza, okuthiwa ukufakwa kabusha kwe-ureter, kuhilela ukubekwa kabusha kwe-ureter ukuze iye embilini nge-angle engcono ngethonela elide ngedonga lembili. Lolu cingo lunezinga eliphezulu kakhulu lokubuyela esimweni esihle kodwa ludinga ukuhlala esibhedlela nesikhathi sokuphulukana.

Ukuhlinzwa okusizwa yi-robotic kunikeza imiphumela efanayo emihle njengokuhlinzwa okuvulekile kwendabuko kodwa ngezinsiza ezincane futhi kungenzeka ukuphulukana okusheshayo. Udokotela wakho uzoxoxa ngendlela engcono kakhulu ngokuya ngesimo esithile sengane yakho.

Isinqumo sokuthi nini kufanele ulandele ukwelashwa ngokuhlinzwa kuncike ezintweni ezifana nokutheleleka okuphazamisayo naphezu kokuvimbela ama-antibiotic, ukwenzakala kwesibindi, ukukhetha komndeni, namandla engane okukhuthazelela ukusetshenziswa kwama-antibiotic isikhathi eside.

Ungayiphatha kanjani i-vesicoureteral reflux ekhaya?

Ukuphatha i-vesicoureteral reflux ekhaya kugxile ekuvimbeleni ukutheleleka kwezindlela zokukhishwa komchamo nokusekela impilo yonke yengane yakho yokukhishwa komchamo. Imikhuba emihle yansuku zonke ingenza umehluko omkhulu ekuthuthukiseni izinkinga nokusiza ingane yakho ukuba izizwe ikhululekile.

Imikhuba yasekamu ibalulekile kubantwana abane-vesicoureteral reflux. Khuthaza ingane yakho ukuba iye emathilongweni njalo usuku lonke kunokuyibamba isikhathi eside. Qiniseka ukuthi bathatha isikhathi esanele ukuze bakhiphe imbili ngokuphelele, njengoba ukushesha kungashiya umchamo osaleyo owandisa ingozi yokutheleleka.

Nawa amasu abalulekile okuphatha ekhaya:

• Qinisekisa ukuthatha amanzi amaningi nsuku zonke, ikakhulukazi amanzi
• Yenza ukuphumula kwamathilongweni njalo ngemizuzu engu-2-3
• Sombulula isiphithiphithi ngokushesha ngokudla namanzi
• Gcina uhlanzeko oluhle lwamasu
• Qapha izimpawu zokutheleleka kwezindlela zokukhishwa komchamo
• Nikeza ama-antibiotic alayikiwe ngokuqondile njengoba kuqondiswe
• Gcina idayari yezimpawu uma kunconywe udokotela wakho

Uketshezi ludlala indima ebalulekile ekuhlanzweni kwezitsha ezinobhaktheriya ohlelweni lwesikhumba. Khuthaza ingane yakho ukuba iphuze amanzi amaningi usuku lonke, kodwa gwema amanani amaningi ngaphambi kokulala uma ukwetsheka ebusuku kuyinkinga.

Ukuvimbela kungenza ukubuyela emuva kube kubi ngokucindezela isikhumba futhi kuthonye izindlela ezijwayelekile zokwetsheka. Faka ukudla okunamafutha amaningi ekudleni kwengane yakho futhi uqinisekise ukuthi iphuza amanzi anele. Uma ukuvimbela kuqhubeka, xoxa nodokotela wakho ngezinketho zokwelapha eziphephile.

Qaphela izimpawu zokuqala zokutheleleka kwezindlela zokwetsheka, njengoba kubanda, ubuhlungu ngesikhathi soketsheka, ukwetsheka njalo, noma ukushintsha kombala noma iphunga lomchamo. Ukubamba ukutheleleka ngokushesha kuvumela ukwelashwa okusheshayo futhi kungavimbela ukufinyelela ezinso.

Uma ingane yakho ithola ama-antibiotics okuvimbela, yinike ngesikhathi esifanayo nsuku zonke futhi uqedele ikhosi ephelele ngisho noma ingane yakho izizwa ilungile. Ungalokothi udlulise izilinganiso noma uyeke imithi ngaphandle kokukhuluma nodokotela wakho kuqala.

Kufanele ulungiselele kanjani ukubonisana nodokotela wakho?

Ukulungiselela ukuvakashela udokotela wakho kusiza ukuqinisekisa ukuthi uthola okuningi kakhulu ekuqokweni kwakho futhi ungakhohlwa imibuzo ebalulekile noma ulwazi. Qala ngokubhala phansi noma yiziphi izimpawu ozibonile nokuthi zenzeke nini.

Gcina idayari elula yemikhuba yokugeza yengane yakho, kufaka phakathi ukuthi iwetsheka kangakanani, noma yiluphi ubuhlungu noma ukungakhululeki, kanye nezibonakaliso zokutheleleka okungenzeka. Qaphela noma yiziphi izigameko zokubanda, ngisho noma zibonakala zingenahlangene nezimpawu zokwetsheka ngaleso sikhathi.

Letha lezi zinto ezibalulekile ekuqokweni kwakho:

• Uhlu lwemithi namasuplimenti amanje
• Umbhalo wezimpawu zakamuva kanye nesikhathi sazo
• Imiphumela yokuhlola yangaphambili kanye nemibhalo yezokwelapha
• Amakhadi yomshuwalense kanye nokuhlonza
• Uhlu lwemibuzo ofuna ukuyibuza
• Olwazi lokuxhumana lodokotela abaphatha ingane yakho

Bhala imibuzo yakho kusengaphambili ukuze ungayikhohlwa ngesikhathi sokuqokwa. Imibuzo evamile ingafaka ukubuza ngokumisa imisebenzi, ukuthi nini kufanele ucingo ngezimpawu ezinkulu, noma ukuthi ukwelashwa kungadinga isikhathi esingakanani.

Uma ingane yakho ikhulile ngokwanele, yenza ibe yingxenye ekulungiseleleni ukuqokwa. Chaza ukuthi kuyokwenzekani ngezindlela ezifanele iminyaka yayo futhi uyikhuthaze ukuba ibuze imibuzo yayo. Lokhu kuyisiza ukuba izizwe ikhululekile futhi ihileleke ekunakekelweni kwayo.

Cabanga ukuthi ulethe ilungu lomndeni omethembayo noma umngani ozosiza ukuba ukhumbule ulwazi oluxoxwe ngesikhathi sokuqokwa. Ukubheka kwezokwelapha kungaba okucindezelayo, ikakhulukazi uma uxoxa ngezinketho zokwelapha noma imiphumela yokuhlola.

Lungela ukuxoxa ngomlando wezokwelapha womndeni wakho, ikakhulu noma yiziphi izinkinga zezinso, izinkinga zomgogodla, noma i-vesicoureteral reflux kubazalwane noma abazali. Ulwazi lolu lusiza udokotela wakho ukuthi ahlole izici eziyingozi futhi ahlele ukunakekelwa okufanele.

Iyini into ebalulekile nge-vesicoureteral reflux?

I-Vesicoureteral reflux iyimo elilawulekayo elithuthuka ngokwemvelo njengoba izingane zikhula. Nakuba idinga ukulandelelwa kanye nokwelashwa ngezinye izikhathi, izingane eziningi ezine-reflux ziqhubeka ziphila impilo evamile, enempilo ngaphandle kwezinkinga zesikhathi eside.

Into ebaluleke kakhulu okumele uyikhumbule ukuthi ukutholakala kwangaphambi kwesikhathi nokunakekelwa kwezokwelapha okufanele kungavimbela izinkinga ezinkulu. Ngokuxhumana okuhle neqembu lakho lokunakekelwa kwezempilo nokunaka impilo yomgogodla yengane yakho, ungasiza uqinisekise imiphumela emihle kakhulu.

Izimo eziningi ze-reflux ezinzima ziyaphela ngokwazo ngesikhathi izingane zifinyelela ebudaleni besikole. Ngisho noma ukwelashwa kudingeka, izinketho zezokwelapha neze-surgical namuhla ziyasebenza kakhulu futhi azicindezeli njengakuqala.

Hlala uqinile futhi khumbula ukuthi awuwedwa ekusingatheni lesi simo. Ithimba lakho lokunakekelwa kwezempilo likhona ukukusekela wena nengane yakho kuzo zonke izinyathelo, futhi ngokunakekelwa okufanele, ukubuyela emuva kwe-vesicoureteral akudingeki kuvimbele imisebenzi yengane yakho noma impilo yayo yesikhathi esizayo.

Imibuzo evame ukubuzwa mayelana nokubuyela emuva kwe-vesicoureteral

Ingabe ingane yami izothola ukukhula okubuyela emuva kwe-vesicoureteral?

Ezingane eziningi ziyakhula ukubuyela emuva kwe-vesicoureteral okuthambile kuya kokuphakathi njengoba zikhula. Njengoba ingane yakho ikhula, ama-ureters ayo aba makhulu futhi i-angle lapho axhumana khona ne-bladder iyancipha, idala umsebenzi ongcono we-valve. Izifundo zibonisa ukuthi cishe u-80% wezingane ezine-reflux ye-grade 1-2 zizobona ukuthuthuka phakathi kweminyaka emi-5. Izilinganiso eziphezulu ze-reflux azinamkhawulo wokuzixazulula, kodwa ukuthuthuka okukhulu kusenokwenzeka. Udokotela wakho uzolandelela intuthuko yengane yakho ngokuhlola okujwayelekile nezivivinyo ukuze abone ukuthi i-reflux ishintsha kanjani ngokuhamba kwesikhathi.

Ingabe ingane yami ingabamba iqhaza emisebenzini evamile nezemidlalo?

Izingane ezine-vesicoureteral reflux ngokuvamile zingabamba iqhaza kuzo zonke imisebenzi yabantwana evamile, kufaka phakathi imidlalo kanye nokuqubha. Isimo ngokwalo alikwambeki umkhawulo umsebenzi womzimba, futhi ukuhlala usebenzayo kubalulekile empilweni jikelele. Kodwa-ke, kubalulekile ukugcina uketshezi oluhle ngesikhathi semidlalo futhi ukhuthaze ukuphumula okujwayelekile kwamagumbi okugezela. Uma ingane yakho ithola ama-antibiotics okuvimbela, qiniseka ukuthi iyaqhubeka nemithi yayo njengoba ilotshwe ngisho nasezikhathini ezimatasa zemisebenzi. Xoxa nodokotela wakho uma unokukhathazeka mayelana nemisebenzi ethile, kodwa izingane eziningi azidingi ukumisiwe kwemisebenzi yazo yansuku zonke.

Ingabe ukubuyela emuva kwe-vesicoureteral kubangela ubuhlungu engwaneni yami?

Ukubuyela emuva kwe-vesicoureteral ngokwalo ngokuvamile akulimazi. Abantwana abaningi abane-reflux bazizwa beqondene ngokuphelele usuku nosuku futhi bangase bangazi ukuthi banalesi simo. Ubuhlungu ngokuvamile buvela kuphela uma kutholakala ukutheleleka komchamo, okuyingozi ebangela ukungakhululeki ngesikhathi sokuthamba, ubuhlungu besisu, noma ubuhlungu emhlane. Abanye abantwana bangase babe nokungakhululeki okuncane uma i-bladder yabo igcwele kakhulu, kodwa lokhu akuveli ngqo ku-reflux. Uma ingane yakho ikhala ngebuhlungu obuqhubekayo, ikakhulukazi ngomkhuhlane, xhumana nodokotela wakho ngokushesha njengoba lokhu kungabonisa ukutheleleka okudinga ukwelashwa.

Kubaluleke kangakanani ukuba ingane yami ibe nokubonisana kokulandelela?

Izinhlelo zokulandelela zihluka kuye ngokulingana kwe-reflux nesimo esithile sengane yakho. Abantwana abane-reflux ephansi bangadinga ukuhlolwa njalo ngenyanga eziyi-6-12, kanti labo abanezinga eliphezulu noma ukutheleleka okuvamile bangadinga ukuqapha okuvamile. Ukulandelela okuvamile kufaka uvivinyo lwomchamo ukuhlola ukutheleleka, i-ultrasounds ukuqapha ukukhula kwesibindi nokuqina, kanye nezifundo ezivamile zokubuka izithombe ukuze kubonwe ukuthi i-reflux iyancipha yini. Udokotela wakho uzokwakha uhlelo olufanele izidingo zengane yakho. Phakathi kokubonisana, xhumana nomhlinzeki wakho wezinsizakalo zezempilo uma ubona izimpawu zokutheleleka komchamo noma ezinye izimpawu ezikhathazayo.

Ingabe abanye abantwana bami bangaba ne-vesicoureteral reflux na?

Kukhona ithuba elikhulayo lokuthi abafowabo nodadewabo bomntwana onale reflux ye-vesicoureteral nabo bangaba nale simo. Izifundo zibonisa ukuthi abafowabo nodadewabo banethuba elingu-25-30% lokuba nale reflux, okuphezulu kakhulu kunabantu abavamile. Yingakho odokotela abaningi becela ukuhlolwa kwabafowabo nodadewabo, ikakhulu uma basencane noma babe ne-infections yomchamo. Ukuhlolwa kuvame ukubandakanya i-ultrasound kanye nezinye izivivinyo uma kutholakala ukungapheleli. Noma kunjalo, ukuba nomntwana oyedwa onale reflux akusho ukuthi bonke abantwana bakho bayoba nayo, futhi abafowabo nodadewabo abaningi baphuma bephilile ngokuphelele. Xoxa ngezincomo zokuhlola nodokotela wakho ngokuya ngesimo sakho somndeni.