6 Zochitika Zopanda Phindu Zimene Zingagwiridwe

Zambiri mwa izi zimakhudza amuna okha

Urology ndizopadera zachipatala zomwe zimayenderana ndi njira ya mkodzo mwa amuna ndi akazi komanso ndi abambo obadwa mwa amuna. Matenda ambiri okhudza ubongo ndi aakulu, monga benign prostatic hypertrophy ndi kusakanikirana , ndipo akhoza kuyesedwa ndi a urologist kuchipatala. Komabe, mavuto ena amtunduwu ndi oopsa ndipo amafunika kuchipatala kuti athandize thanzi labwino.

Ngakhale kuti urology amaonedwa kuti ndi opaleshoni, mavuto ambiri okhudza ubongo, kuphatikizapo mavuto oopsa-amagwira ntchito zosiyanasiyana. Choncho, urologists ayenera kukhala ndi chidziwitso cha mankhwala am'kati, maukwati, maubata, matenda a maganizo, ndi zina zotheka kuti azichiza bwino matenda. Komanso, urologists, monga akatswiri onse, nthawi zambiri amayendera ndi madokotala ena kuti azisamalira bwino.

Malinga ndi bungwe la American Urological Association, pali asanu ndi awiri a urology subspecialties:

• urology ana
• kupatsirana kwa impso
• mbuzi (impso miyala)
• kusabereka kwa amuna
• Urology (ganizirani ubweya wosagwira ntchito)
• neurourology (ganizirani zovuta zokhudzana ndi kupweteka kwa erectile)
• urologic oncology (khansa)

Nazi zochitika zisanu ndi zidzidzidzi zoopsa zomwe muyenera kuzidziwa. Kuzindikira zizindikiro zawo kudzaonetsetsa kuti mankhwalawa akufulumira komanso othandiza. Zambiri mwazimene zimakhudza amuna; Komabe, zina zimakhudza amuna ndi akazi.

1 -

Kupembedza

Uthabwala umapangidwira kuti umapangidwira kuti uli ndi vuto lalikulu. Kufuna kudzikonda kumatanthawuza kuti ndikumangirira maola oposa anai, osagwirizana ndi kukakamiza kugonana. Kuwonjezera pamenepo, kudzikonda sikungathetseretu kupulumutsidwa.

Fomu yofala kwambiri ndi yotsika kapena ischemic priapism. Pogwiritsa ntchito zizindikiro, matupi am'kati, omwe amapanga mthunzi wa mbolo, amakhala okhwima pamene glans kapena nsonga ndizosalala. Kuwonjezera apo, mbolo ndi yabwino kwambiri, yomwe ndi chifukwa chokwanira kuti amuna ambiri ayambe kupeza chithandizo chamankhwala mwamsanga.

Kufuna kudzikonda kumachitika chifukwa cholepheretsa kutuluka; Ndizovuta matenda a chipinda cha penis.

Pafupifupi 25 peresenti ya milandu ya priapism imayamba chifukwa cha matenda odwala maselo a khansa, khansa ya m'magazi kapena khansa ya m'magazi. Kugwiritsa ntchito mankhwala osokoneza bongo, mofanana ndi cocaine, MDMA (ecstasy), methamphetamine (crystal meth), ndi chamba, zingathenso kumatsogolera ku priapism. Kuonjezera apo, kupweteka kwapadera kungakhale ndi zotsatira zowawa za mankhwala ochizira monga calcium-channel blockers, antipsychotics ndi warfarin (magazi ochepa).

Kuchepetsedwa kochepetsetsa kutuluka kwa magazi kungachititse zotsatirazi:

• Edema (kutupa)
• Hypoxia
• Acidosis
• Fibrosis
• Kupanda mphamvu
• Necrosis (imfa yamagazi)

Ngati sanasamalidwe, priapism ikhoza kusokoneza kugonana komweku. Choncho, chithandizo chofulumira n'chofunika. Pakutha nthawi yaitali kuti chisamaliro chisachitike, chiopsezo chachikulu chokhalitsa penile. Cholinga cha mankhwala ndi kupuma, kapena kuchepetsa kupuma kwa penile.

Mpweya wamagazi wa penile ukhoza kukopeka kuti atsimikizidwe kuti munthu ali ndi matenda aakulu. Poyamba, kuperewera kwa mankhwala kumatha kuchiritsidwa ndi mankhwala opatsirana pseudoephedrine (sympathomimetic) kapena baclofen (minofu yotsegula). Kawirikawiri, mankhwalawa samagwira ntchito bwino kwambiri kuti singano yeniyeni yayikulu imayikidwa mu thupi kapena pamthunzi wa mbolo ndipo magazi amachotsedwa kapena kuchotsedwa. Phenylephrine amalowetsedwa mu mbolo.

Pseudoephedrine, yomwe imayambitsa kayendedwe ka chifundo, imagwiritsidwa ntchito pochiza priapism chifukwa zolemba zimagwirizanitsa ndi kuwonetsera kwapadera. Pseudoephedrine counters zotsatirazi zapasympathetic. Zindikirani, kutsegulira ndikutetezedwa ndi chisomo chachisomo. (Ophunzira azachipatala amakumbukira kusiyana kumeneku pogwiritsa ntchito mnemonic "mfundo ndi kuwombera.")

Pazirombo zoopsa za priapism, akhoza kuikidwa opaleshoni yopangira opaleshoni.

2 -

Testicular Torsion

Mosiyana ndi zomwe ena angakhale mukukhulupirira, matepi sangasinthe malo. Komabe, chingwe cha spermatic, chomwe chimapereka magazi ku epididymis ndi testis, chingathe kupotoza.

Kuthamanga kwapadera kumakhudza ana ndi anyamata koma akutha msinkhu uliwonse. Kuthamanga kwapadera sikupezeka kawirikawiri kwa amuna a zaka 30 kapena kuposerapo.

Pali zifukwa ziwiri zomwe zimapangitsa kuti tizirombo ta testicular tizilombo toyambitsa matenda tizilombo toyambitsa matenda tizilombo toyambitsa matenda.

Anyamata kapena amuna omwe ali ndi vuto lopweteka amayamba kumva kupweteka koopsa panthawi inayake yotsatiridwa ndi nyongolotsi. Nsupa ndi kusanza zimaphatikizapo ululu. Kuwonjezera apo, anyamata ndi amuna omwe amapereka mazunzo amodzimodzi amakhala ndi mbiri ya ululu woterewu, kenako amatsitsimutsira kachidutswa kokha.

Mbiri yonse yachipatalayi ndi kuunika kwa thupi ndizofunika kwambiri pozindikira kupweteka kwa testicular. Ultrasound imatsimikizira kuti matendawa ndi otani, koma ngati kufufuza kwa ultrasound sikukupezeka, kufufuza nthawi yomweyo n'kofunika. Kuwonjezera pa kutsimikizira kuti matendawa ndi otani, ultrasound imatha kuwonetseratu zovulaza, zomwe zingayambitse kupweteka kwamtunduwu.

Monga momwe zimakhalira, nthawi ndizofunika kwambiri. Ngati opaleshoni ikuchitika mkati mwa maola asanu ndi limodzi oyambirira, mwayi wopulumutsa testis ndi 80 peresenti. Ngati maola oposa 12 apita, kupambana kwa opaleshoni kumapita pansi pa 20 peresenti.

Kuchita opaleshoni kumaphatikizapo kutaya kapena kusasunthika kwa tinthu. Nthawi yokwanira imaperekedwa kuti mudziwe ngati kuyendetsa kwa testis ikuyambiranso, ndipo ichi revascularization chimatsimikiziridwa ndi Doppler ultrasound. Pankhani ya necrosis ya testis, orchiectomy, kapena kuchotsedwa kwa nyamayi, ikuchitidwa.

3 -

Kusungirako kwabwino kwa Urinary

Kusunga kwapamwamba kwambiri kwa urin (AUR) kumawoneka makamaka mwa amuna omwe ali ndi benign prostatic hypertrophy (BPH) kapena kuwonjezera kwa prostate. Kumbukirani kuti prostate ikuzungulira urethra, ndipo kukula kwake kumachepetsa mkodzo.

Ngakhale kuti ambiri mwa amuna omwe ali ndi BPH, AUR akhoza kuchitika chifukwa cha zinthu zosiyanasiyana zomwe zimalepheretsa kutaya chikhodzodzo kuphatikizapo zotsatirazi:

• Matenda a shuga
• Matenda a Parkinson
• Multiple sclerosis
• Mankhwala monga opiates ndi anticholinergics
• Magazi amachotsa kachiwiri ku hematuria

AUR nthawi zambiri amapezeka m'zipatala kapena kuchipatala pamene odwala amamwa mankhwala omwe amachepetsa kutaya chikhodzodzo komanso amakhala ndi mphamvu zochepa zotuluka pabedi ndikuyendayenda. Komanso, kudzimbidwa, komwe kumakhala kofala m'zipatala, kungachititse kuti kusungunuka kwa umuna kukhale kovuta kwambiri.

Kawirikawiri, AUR ndi vuto lopweteka. Komabe, mwa anthu ena okhala ndi chipsinjo chosatha cha chikhodzodzo, matendawa sangakhale opweteka. Ngati sichikutsatiridwa, AUR ingapitirize kusefukira, ndipo patatha masiku angapo, pangakhale kulephera kwa nthenda. Choncho, AUR ayenera kuthandizidwa mofulumira kuti athetse ululu ndi kupeŵa mavuto.

Kulephera kwenikweni kwa mphuno kumayambitsidwa ndi kukhazikitsidwa kwa catheter yakulepheretsa kukhetsa mkodzo. Amuna omwe ali ndi BPH, amatha kugwiritsa ntchito catheter yokhotakhota chifukwa prostatic urethra imakhala pambali. Ngati kugwiritsidwa kwa mkodzo kumapezeka, katswiri wa urojekist adzafunika kuthetsa AUR pogwiritsira ntchito cystoscopy, dilrerative dilrerators ndi zina zotero.

4 -

Gangniine ya Fournier

Chimake cha Fournier ndi chosowa. Ndiwo mawonekedwe a nthenda yotchedwa "necrotizing fasciitis" ("matenda odyera thupi") omwe amakhudza ziwalo za amuna ndi perineum, kapena kuchoka kwa malo ogulitsa nyumba pakati pa khungu ndi anus.

Mofanana ndi matenda enaake omwe amachititsa kuti matendawa asafe , matendawa amadya minofu yofewa. Ndi matenda a Fournier, matendawa amakhudza madartos, Scarpa's ndi Colles 'fascias.

Nkhumba ya Fournier imakula mofulumira, ndipo ngati mankhwala akuchedwa, zinthu zoipa zimachitika.

Nazi zina mwazifukwa zomwe zimapangitsa kuti chitukuko cha Fournier chikule:

• Zosafunika zowonongeka
• Matenda a shuga
• HIV / AIDS
• Zosakaniza zovuta
• Kuperewera kwapadera
• Khansa

Kugonjetsedwa ndi matenda a Fournier ndibwino kwambiri ndipo kumaphatikizapo zizindikiro zotsatirazi:

• Kumva ululu
• Kupweteka kwapadera
• Fever
• Cellulitis
• Kukhalitsa
• Eschars
• Necrosis
• Chigoba (kuponyera pansi pa khungu)

Chodziwika ndi chifuwa cha Fournier, ululu umene wolembayo amafotokoza umakhala wosiyana ndi momwe thupi limayendera.

Chigoba cha Fournier chimatengedwa ndi kuchotseratu kapena kuchotseratu minofu yakufa kapena yokhala ndi matenda osakanikirana komanso kuthandizira ma antibayotiki ambiri. Kawirikawiri, opaleshoni yowonjezereka imafunika, ndipo nthawi yomweyo minofu yonse yakufa imachotsedwa, opaleshoni yokonzanso imagwiritsidwa ntchito. Mwa kuyankhula kwina, chithandizo choyenera cha chigoba cha Fournier ndi njira yayitali.

Chifukwa ma testes ali ndi magazi awo osiyana, amatha kupulumutsidwa mwa anthu omwe ali ndi ziphuphu za Fournier. Ma testes akhoza kulowa mu "thumba la chiwindi" pochiritsa kuti athe kutsogolera.

Kusamalira bwino chilonda ndi kusintha kawirikawiri kavalidwe ndizofunikira pakuchira. Kuwonjezera apo, amuna omwe ali ndi shuga ayenera kukhala ndi magawo awo a shuga akulamuliridwa ndi kulandira zakudya zokwanira kuti athe kuchiritsa machiritso.

Kafukufuku amasonyeza kuti chiwerengero cha anthu omwe amamwalira chimafa pakati pa 20 ndi 40 peresenti.

5 -

Paraphimosis

Paraphimosis imapezeka mwa amuna osadulidwa ndipo motero amakhala ndi khungu. Kawirikawiri, vutoli limapezeka mwa amuna omwe akugona akugona pabedi kwa nthawi yaitali ngati kuchipatala. Pachikhalidwe ichi, chiwombankhanga chimatulutsa kachilombo ndi kutupa kapena kusungunuka mumtundu, ndipo ululu wa penile umayamba. Kwa anthu omwe asintha maganizo, kupweteka kumeneku sikungadziŵike kwa nthawi ndithu mpaka nthawi yayitali kwambiri ndipo mbolo imakhala yochepa kwambiri mpaka kuchepa kwa magazi kumadera (ischemia).

Chithandizo cha paraphimosis chimaphatikizapo kuchepetsa kutengera kwa glands, ndikuyankhira mmalo mwake. Njirayi ndi yopweteka kwambiri koma ndi yofunika kuti mupeze mankhwala oyenera. Chifukwa kuchepetsa uku ndikumvetsa kupweteka kwambiri, mankhwala opweteka, mapeni a penile, komanso sedation angakhale ofunika.

Monga zifukwa zina zomwe zafotokozedwa m'nkhani ino, paraphimosis ndizochitika mwamsanga zamankhwala zomwe zimafuna kuti madokotala asamawonongeke nthawi zonse.

6 -

Pyphonephritis ya Emphysematous

Pyelonephritis ndi matenda opatsirana m'makina a impso. Pamene matendawa amayamba chifukwa cha mabakiteriya otulutsa mpweya , amatchedwa emphysematous pyelonephritis . Pyphyonephritis ya emphysematous kawirikawiri imapezeka mwa anthu omwe ali ndi shuga ndipo kawirikawiri imayambitsidwa ndi E. Coli. Matendawa amatha kufalikira komanso amayambitsa sepsis, yomwe ili kuopseza moyo. Zonsezi, emphysematous pyelonephritis ndizowopsya.

Anthu omwe ali ndi emphysematous pyelonephritis angathe kuyembekezera mankhwala ndi ma antibayotiki amphamvu ndi chithandizo chochirikiza. Chithandizo chowonjezera cha pyelonephritis chimadalira momwe matendawa afalikira mkati mwa impso. Ngati kachilombo kamangothamangitsidwa ndi parenchyma, chithandizo chodziletsa chingagwire ntchito. Chithandizo chodziletsachi chimaphatikizapo kukhazikitsa nephrostomy chubu kuti asunge zinthu zodzaza. Ngati matenda a impso akufalikira ndipo sepsis ilipo, kuchotsa opaleshoni ya impso (nephrectomy) kungafunike.

7 -

Kutsiliza

Mwamwayi, zambiri mwazidzidzidzi zowonongeka kwazomwe zikuchitika nthawi zambiri. Komabe, zikhalidwe zonsezi ndi matenda ndizochitika mwamsanga ndipo zimafuna chithandizo chamankhwala mwamsanga. Ngati inu kapena wokondedwa mukuganiza kuti pali vuto lililonse, chonde funsani thandizo lachangu ndi dokotala wanu mwamsanga. Ndizifukwa zonsezi, nthawi ndizofunika kwambiri ndipo chithandizo chamankhwala n'chofunika kuti tipewe kulumala kapena imfa.

Pamapeto pake, monga tafotokozera kale, zambiri mwazimenezi zimakhudza amuna. Komabe, kuyamwa kwapamwamba kwambiri kumakhudzanso amayi, ndipo pyelonephritis imakhudza amayi achikulire.

Ngakhale mukuganiza kuti mwina mukukumana ndi mavutowa ndipo simukudziwa, nthawi zonse ndibwino kutsatirana ndi dokotala za zizindikiro zomwe zimayambitsa nkhawa zanu poyamba. Mukhozanso kupempha chilolezo kwa dokotala wa urologist pa zovuta zilizonse zomwe mungakhale nazo pazitsamba zamakono ndi ziwalo zanu zamkati. Chonde kumbukirani kuti dokotala wanu alipo kuti akuthandizeni kupeza chithandizo chamankhwala chomwe mukuchifuna ndikuchifuna.

_Zotsatira:

_{Chamie K, Rochelle J, Shuch B, Belldegrun AS. Urology. Mu: Brunicardi F, Andersen DK, Billiar TR, Dunn DL, Hunter JG, Matthews JB, Pollock RE. eds. Mfundo za Schwartz za Opaleshoni, 10e . New York, NY: Hill ya McGraw; 2014.}

_{Heidenreich J. Chaputala 39. Zochitika Zachilengedwe Zoterezi. Mu: Stone C, Humphries RL. eds. Kufufuza Kachilendo ndi Kuchiza Mankhwala Odzidzimutsa, 7e . New York, NY: Hill ya McGraw; 2011.}

_{"Necrotizing Fasciitis: Matenda Achilendo Makamaka Odwala" kuchokera ku CDC: http://www.cdc.gov/features/necrotizingfasciitis/}

_{Sorenson MD, ndi al. "Fournier's Gangrene: Population Based Epidemiology ndi Zotsatira." Journal of Urology 2009.}