He aha ke koʻikoʻi o ka Urethral?

Ke hōʻino ʻia ka urethra e nā kumu like ʻole, hoʻokumu ʻia nā ʻiʻo palapū a ʻaelike i ka wā o ke kaʻina hana ho'ōla, e hoʻohaiki ana i ka lumen urethral a i ʻole e ālai loa ʻia. Hoʻomānoanoa ka epithelium lining a hele hapa i ka metaplasia i loko o ka epithelium squamous stratified. Lilo ka papa propria i discontinuous, a ua pani nui ʻia ke ʻano sinusoidal vascular o ka corpus spongiosum e ka ʻiʻo hoʻopili fibrous, kahi e hui pū ai me ka ʻiʻo spongy me ka ʻole o kahi palena maopopo. ʻO ka hopena o kēia mau hoʻololi āpau, ʻo ia ka urethral stricture.

ʻO ke koʻikoʻi o ka urethral kekahi o nā kūlana maʻamau i ke ʻoki urological. I nā makahiki i hala iho nei, me ka hoʻomohala ʻana o nā ʻoihana e like me ka halihali a me ke kūkulu ʻana, a me ka hoʻonui ʻia ʻana o ka hoʻohana ʻana i nā mea hana intraurethral a me nā kaʻina hana ʻoki, ua piʻi aʻe kona nui ma nā ʻāina i hoʻomohala ʻia a me nā ʻāina e ulu ana. ʻO nā kumu maʻamau o ke koʻikoʻi o ka urethral e pili ana i nā mea hānau mua, inflammatory, traumatic, iatrogenic, a me idiopathic.

No ka mea, ʻoi aku ka lōʻihi o ka urethra kāne ma mua o ka urethra wahine a ʻokoʻa hoʻi i ke kūlana anatomical a me ke ʻano o nā ʻiʻo, ʻoi aku ka maʻalahi o ka trauma a me ka maʻi. Me nā kumu pilikanaka, pili nui kēia maʻi i nā kāne makua.

1. Nā kumu o ke koʻikoʻi o ka Urethral

Hiki ke hoʻokaʻawale ʻia ke koʻikoʻi o ka urethral ma ke ʻano he spastic a organic paha.

ʻO ka spastic urethral stricture kahi hanana manawa pōkole i hoʻokumu ʻia e ka ʻūlū ʻana o ka sphincter urethral waho. Hiki i nā mea kōkua ke komo pū me ka urethritis, urethral calculi, intraurethral instrumentation, a i ʻole ka hana moekolohe maʻamau. Hiki ke mālama ʻia nā spastic strictures me ka mālama piha ʻana, me ka wehe ʻana i nā mea kōkua, nā ʻauʻau sitz mahana, nā sedatives, nā analgesics, a me nā antispasmodics.

Hiki ke hoʻokaʻawale ʻia nā strictures organik i ʻekolu mau pūʻulu e pili ana i ke kumu:

① ʻO ke koʻikoʻi o ka urethral congenital, e like me ka stenosis meatal a i ʻole nā ​​​​​​kiwikā urethral.

② ʻO ke koʻikoʻi o ka urethral inflammatory, ka hopena paha mai ka gonorrhea, ka maʻi puʻupuʻu, a i ʻole nā ​​maʻi kikoʻī ʻole. He paʻakikī ke ʻano o ka stricture a he koʻikoʻi pinepine ke ʻano o ka haiki ʻana. Ma hope o ka kaohi mua ʻana i ka maʻi, ʻo ka mālama ʻana e pili ana i ka hoʻonui ʻana o ka urethral. Eia kekahi, ʻo ka catheterization indwelling hiki ke hana i ka urethral stricture.

③ ʻO ke ʻano maʻamau ka traumatic urethral stricture, ma muli o ka ʻeha nui o ka urethral me ka hoʻokele mua ʻole a i ʻole ka lohi.

Ma ke ʻano pathological, ʻokoʻa loa ke kekelē, ka hohonu, a me ka lōʻihi o ka stricture. ʻO ka maʻamau, hoʻokahi wale nō stricture, ʻoiai he nui nā strictures gonococcal. Hiki i nā strictures ke lilo i maʻi lua, e alakaʻi ana i ka urethral diverticula, ka mumū periurethral, ​​prostatitis, a i ʻole epididymo-orchitis. Inā hoʻomau ka pale ʻana o ka mimi no ka manawa lōʻihi, hiki ke hopena i ka hydronephrosis, ka hemahema o ka renal, a me ka uremia.

2. Hōʻike Lapaʻau o ka Urethral Stricture

ʻOkoʻa nā hōʻailona o ka urethral stricture ma muli o kona kekelē, ka nui, a me ka holomua. Eia nā hōʻailona nui:

ʻO ka mea mua, ka paʻakikī o ka mimi ʻana, me ka paʻa ʻana o ka mimi i nā hihia koʻikoʻi. I ka wā mua, ʻike nā mea maʻi i ka hoʻoluhi ʻana i ka puka ʻana o ka mimi, ka lōʻihi o ka manawa mimi, a me ka māhele ʻana o ke kahe mimi. Mālie mālie, e lahilahi ke kahe a pōkole ka laulā, a laila e holomua ana i kahi ʻano dribbling. Ke ʻūlū ka ʻiʻo detrusor akā ʻaʻole hiki ke lanakila i ke kūʻē ʻana o ka urethral, ​​piʻi ka nui o ka mimi i koe, e alakaʻi ana paha i ka incontinence kahe a i ʻole ka paʻa ʻana o ka mimi.

ʻO ka lua, hele pinepine ka urethral stricture me ka urethritis mau. Hiki iā ia ke alakaʻi i nā maʻi ʻōpū lua, nā pōhaku, a i ʻole epididymo-orchitis. Hoʻonui ka urethra proximal ma luna o ka stricture, a ʻo ka stasis urinary e alakaʻi i nā maʻi ʻōnaehana urinary hou, nā abscesses periurethral, ​​urethral fistulae, prostatitis, a me epididymitis. ʻO ka hopena o ka pale ʻana hiki ke hana i ka hydronephrosis a me nā maʻi urinary hou, e alakaʻi hope ana i ka emi ʻana o ka hana renal a i ʻole ka uremia.

ʻO ke kolu, ʻo ka hoʻonui mau ʻia ʻana o ke kaomi intra-abdominal hiki ke alakaʻi i nā pilikia e like me ka hernias, hemorrhoids, a me ka rectal prolapse.

3. Nā Hoʻokolohua Diagnostic no ka Urethral Stricture

1. Ka Palpation Urethral a me ka Hoʻokolokolo Scrotal/Anal

Pono nā maʻi āpau me ka traumatic urethral stricture e hana i nā hoʻokolohua maʻamau anal, rectal, a me ka prostate. ʻO ka neʻe nui ʻana o ka prostate i luna e hōʻike ana i kahi stricture kiʻekiʻe aʻe a i ʻole kahi ʻāpana stricture lōʻihi. Hiki i ka Proctoscopy ke hoʻoholo i ke alo, ka nui, a me kahi o kahi fistula urethrorectal.

2. Hoʻokolokolo Leo Urethral

Hiki i ke kani ʻana o ka urethral ke hoʻoholo i kahi, ke kekelē, a me ka lōʻihi o ke stricture.

3. Urethrography

He kumu koʻikoʻi kēia hoʻokolohua no ke koho ʻana i ke ʻano lapaʻau.

4. ʻO ka Ultrasound Urethral

Hāʻawi kēia i ka pono o ka hoʻokaʻawale maopopo ʻana i nā papa o ka lumen urethral, ​​ka ʻiʻo corpus spongiosum, a me nā ʻiʻo periurethral, ​​e ʻae ana i ka helu pololei ʻana o ka lōʻihi o ka stricture me ka pale ʻana i ka hōʻike pinepine ʻana o ka X-ray mai nā haʻawina hoʻohālikelike.

5. MRI Urethral

Loaʻa i ke kiʻi resonance imaging (MRI) ka waiwai kuhikuhi diagnostic no nā strictures urethral ma hope o nā haki pelvic.

6. Nā mea ʻē aʻe

Hoʻopili pinepine ʻia nā maʻi ʻōpū mimi me nā ʻano urinalysis maʻamau a me nā ʻike bacteriological, he mea nui ia no ke alakaʻi ʻana i ke koho ʻana i nā antibiotic.

4. Ka mālama ʻana i ka Urethral Stricture

ʻO nā ʻano lapaʻau o kēia manawa no ka urethral stricture e pili ana i ka urethral dilation, internal urethrotomy, laser therapy, urethral stent placement, a me ka wehe ʻana o ka urethral reconstruction me ka end-to-end anastomosis a me ka substitution urethroplasty. Pono e koho ʻia ke koho o ka lāʻau lapaʻau ma muli o ke kumu o ka stricture, kahi, ka lōʻihi, nā pilikia, a me ka mōʻaukala ʻoki mua e hoʻomohala i kahi hoʻolālā lapaʻau pilikino no kēlā me kēia maʻi.

Hoʻokuʻu ʻōlelo

Mai nā kumu pūnaewele kekahi o nā ʻike o kēia ʻatikala. Inā he hewa, e ʻoluʻolu e kelepona mai iā mākou no ka wehe ʻana.

ʻO ka ʻike lapaʻau i hāʻawi ʻia ma ʻaneʻi no ka ʻike kuhikuhi wale nō ia a ʻaʻole pono e hoʻohana ʻia ma ke ʻano he kumu no ka hōʻoia ʻana a i ʻole ka mālama ʻana.