Uterine prolapse: he aha ia a pehea e mālama ʻia ai?
Ke iho mai ka ʻōpū mai ka pelvis liʻiliʻi, ua kapa ʻia ʻo uterine prolapse
ʻO ia ke ʻano o ka POP (pelvic organ prolapse), kahi maʻi e hiki ke alakaʻi i ka prolapse (a no laila ka iho ʻana) o ka urethra, pūpū, ʻōpū liʻiliʻi, rectum, vagina a i ʻole ʻōpū, ma muli o ka nāwaliwali nui o nā ʻiʻo pelvic.
ʻO ka maʻamau ma muli o ka hānau ʻana (ʻoi aku ka nui ma mua o hoʻokahi), ka ʻelemakule, ka momona nui, ka ʻeha ʻeha, a i ʻole ka maʻamau o ka hoʻonui ʻana i ke kaomi i loko o ka ʻōpū (e like me ka hana ʻana i kahi hana e pili ana i ka hāpai mau ʻana i nā mea kaumaha), prolapse o ke kino pelvic. hiki ke ʻokoʻa i ke koʻikoʻi.
He paʻakikī ke helu ʻana i ka hopena maoli, no ka mea, ma kāna mau ʻano haʻahaʻa loa, hiki i ka iho ʻana o kekahi o kēia mau kino ke asymptomatic loa a ʻaʻole koi ke kanaka i nā ʻōlelo aʻo olakino.
Wahi a ka ICS (International Continence Society) ʻo ka prolapse pae mua a me ka lua e pili ana i ka 48% o ka heluna wahine, ke kolu a me ka ʻehā degere prolapse 2% o nā wahine.
I ka hihia kūikawā o ka uterine prolapse, hana kēia i ka wā e iho ai ka ʻōpū a hiki i kona noho ʻana i ka ʻōpū.
ʻO ka mea maʻamau, ʻike ka mea maʻi i ka ʻeha a me ka manaʻo o ka encumbrance ma ka ʻāpana genital.
ʻO ia ke kumu e pono ai ka hoʻoikaika ʻana i ka papahele pelvic, ka hana pale.
Uterine prolapse: he aha ia?
Ke hiki mai ka uterine prolapse, nalowale ka ʻōpū i kona pilina physiological a iho i loko o ka ʻōpū.
ʻOi aku ka nui o ka puka ʻana i loko o ka ʻōpū, ʻoi aku ka paʻakikī o ka prolapse:
- ʻo kahi hapa liʻiliʻi wale nō o ka ʻōpū i komo i ka 1st degere uterine prolapse
- i ka 2nd degere uterine prolapse, hiki i ka ʻōpū i loko o ka vaginal introitus,
- i ka 3rd degere uterine prolapse, puka ka ʻōpū i waho o ka puka o ka ʻōpū,
- I ka 4th degree uterine prolapse, puka ka ʻōpū mai ka ʻōpū.
Akā, aia kekahi ʻokoʻa ʻē aʻe: ʻaʻole i piha ka prolapse i ka wā e komo ai ka ʻōpū i loko o ka ʻōpū i ka wā e paʻa ai inā pau ka paheʻe a puka i waho ke kino.
ʻO ke kumu nui, ma ke ʻano o ka ʻōpū, ʻo ka haʻalulu o ka papahele pelvic
ʻO kēia, aia i loko o ka'āpana pelvic ma ke kumu o ka'ōpū o ka'ōpū, e pili ana i nāʻiʻo, nā mea pili a me nā ligaments a hana i kahi hana mua:ʻoiaʻiʻo, mālama ia i nā'ōpū pelvic (uterus, urethra, bladder, intestine) i kahi kūpono.
Inā ʻeha a nāwaliwali paha, paheʻe kēia mau mea i lalo a hoʻoulu i nā pilikia he nui.
Hope e hoʻopaʻa i ka ʻōpū i ka wā o ka hāpai ʻana, hoʻonoho ʻia ka ʻōpū ma waena o ka ʻōpū, ka rectum, nā puka lou a me ka ʻōpū, i loko o ke pelvis liʻiliʻi.
Ke olakino ka papahele pelvic, ʻo ka ʻōpū wale nō e puka mai i kekahi mau kenimika i loko o ka ʻōpū.
Nā kumu
ʻOiai he nui nā kumu, ʻo ke kumu nui o ka hāʻule ʻana o ka uterine prolapse ʻo ia ka hānau ʻana: ʻo ke poʻo o ke pēpē, i ka wā o ka hoʻokuke ʻana, hele ma ke kahawai vaginal a hiki ke hōʻino i nā hale pili a me nā ʻiʻo.
ʻOi aku ka nui o ka prolapse i ka wā o ka hana lōʻihi a i ʻole ka paʻakikī o ka hānau ʻana a ʻoi aku ka pinepine i nā wahine multiparous.
ʻO kekahi kumu pinepine o ka hāʻule ʻana o ka ʻōpū he menopause, i ka wā e hoʻololi ai nā ovaries i kā lākou hana a nāwaliwali nā ʻiʻo ma muli o ka nalowale ʻana o nā fibers elastic i hana ʻia e ka waiwai hormonal hou.
Eia nō naʻe, hiki i ka uterine prolapse ke hiki mai i nā hihia o
- obesity
- hoʻopaʻa paʻa mau,
- hana kaumaha,
- ʻo ka haʻuki e pili ana i ka hāpai mau ʻana i nā mea kaumaha,
- bronchitis mau (ma muli o ka ʻū e hoʻonui ai i ke kaomi intra-abdominal).
ʻO ke kumu kumu o ka hoʻoulu ʻana o ka ʻōpū he ʻeha pelvic papahele akā, ma ke ʻano he kānāwai (koe ke ʻano ʻino loa a ʻaʻole nui ka pēpē), ʻaʻole paha e hoʻoulu ʻia ka hoʻoulu ʻana o ka ʻōpū.
Aia kekahi mau mea pilikia:
- ka nui o nā ʻāpana,
- ke elemakule
- ka ʻoki ʻana i nā ʻāpana pelvic,
- nā maʻi collagen congenital,
- ka ʻaʻa maʻi ma muli o ka maʻi obstructive pulmonary maʻi.
ʻAʻole ʻike pinepine ka poʻe i loaʻa i ka hāʻule ʻana o ka ʻōpū haʻahaʻa
He ʻokoʻa ka hihia o ka prolapse uterine haʻahaʻa a koʻikoʻi, ʻo ka hōʻailona mua i hāʻawi ʻia e ka manaʻo o ka encumbrance ma ke kiʻekiʻe o ka vagina.
I ka puka ʻana mai o ka ʻōpū mai loko mai o ka ʻōpū, ʻike ʻia ka manaʻo kaumaha ma ke pelvis, me he mea lā he kino ʻē.
He pinepine ka pilikia o ka wahine i ka mimi ʻana, ka leaka ʻole o ka mimi (incontinence) a i ʻole manaʻo paha ʻo ia he pono e hoʻokaʻawale i ka ʻōpū.
ʻAʻole ʻike pinepine ʻia ka paʻakikī i ka defecation.
Ma waena o nā hōʻailona nui o ka uterine prolapse aia ka paʻakikī o ka moe kolohe, a i ʻole ka ʻeha ʻeha i ka wā like.
ʻO ka incontinence ka hōʻailona e pili ana i ka maikaʻi o ke ola o ka mea maʻi.
Inā lele ka mimi ma hope o ka ho'āʻo ʻana, inā he hāpai i ke kaumaha a i ʻole ka ʻuhū, hoʻāʻo mākou e hoʻoponopono iā lākou me nā hoʻomaʻamaʻa e hoʻoikaika ai i ka papahele pelvic a - ma hope wale nō - hiki iā mākou ke hoʻomau i ka hana ʻoki.
Inā, ma ka ʻaoʻao ʻē aʻe, ʻo ka incontinence ma muli o ka wikiwiki, a ʻo nā poho ma hope o ka hoʻoulu ʻana i ka voiding ikaika loa, ʻaneʻane ʻaʻole hoʻomaʻamaʻa ʻia ke ʻoki ʻana no ka mea ʻoi aku ka maikaʻi o ka hoʻoponopono hou ʻana.
No ka pale ʻana i nā hōʻailona mai ka lilo ʻana i "chronic", a mai ka piʻi ʻana o ka ʻino a hiki i ka hoʻopilikia ʻana i ke ola o kēlā me kēia lā, pono e hoʻokaʻaʻike i kāu kauka maʻi i ka wā e ʻike ʻia ai kēia mau hōʻailona.
Ma waena o nā hoʻopiʻi koʻikoʻi o ka prolapse vaginal, ʻo ia ka maʻi maʻi maʻi (ma muli o ka hamo ʻana ma waena o ka ʻōpū extruded a me nā paia o ka ʻōpū) a me ka prolapse o nā ʻāpana pelvic ʻē aʻe.
ʻO kahi hopena, ʻo ia ke kumu, ma ke ʻano like, e ka nāwaliwali o ka papahele pelvic.
ʻike,
ʻIke ʻia e ke kauka maʻi, a i ʻole ka urologist, ma o ka hoʻokolohua pelvic: ma hope o ka hoʻolohe ʻana i nā hōʻailona o ka mea maʻi, e ʻimi ke kauka i ke kahawai vaginal a loiloi i ke kūlana o ka ʻōpū me ka hoʻohana ʻana i ka ʻōpū. speculum. ʻO ka hope, noi ʻo ia i ka wahine e ʻaelike i nā ʻiʻo o ka papahele pelvic e hoʻomaopopo inā hoʻomau kēia i kāna hana a inā ʻaʻole, akā, nāwaliwali loa.
I nā hihia liʻiliʻi wale nō e pono ai ka hoʻokolokolo hou ʻana e like me ka ultrasound a i ʻole ka nuclear magnetic resonance: ma ka laulā, koho ka gynecologist e hoʻokō iā lākou inā ʻaʻole hiki ke hoʻokumu me ka maopopo i ka paʻakikī o ka prolapse.
Uterine prolapse: hiki ke ho'ōla a me ka ho'ōla
ʻO ka hoʻomaʻamaʻa ʻana no ka hāʻule ʻana o ka ʻōpū e pili ana i ka paʻakikī o ka paheʻe a inā pili kekahi mau ʻāpana pelvic.
Ma keʻano laulā, koe naʻe nā hihia o ke koʻikoʻi koʻikoʻi, ua koho ʻia ka mālama conservative, e hoʻololi i ka ʻokiʻoki wale nō inā ʻaʻole ia.
ʻAʻole pono ka mālama ʻana i ka prolapse uterine papa 1
Na kāu kauka e aʻo iā ʻoe e lilo i ke kaumaha a pale i ka hāpai kaumaha.
E aʻo pū ʻo ia iā ʻoe pehea e hana ai i kekahi mau hana hoʻoikaika kino i kapa ʻia ʻo "Kegel exercises".
Aia kēia mau mea i nā ʻokiʻoki manawaleʻa o nā ʻiʻo e kākoʻo ana i nā ʻāpana pelvic: ma hope o ka hoʻokaʻawale ʻana i ka ʻōpū, hoʻopaʻa ʻia nā ʻiʻo o ka papahele pelvic no 5-10 kekona a hoʻokuʻu ʻia no ka manawa like.
Pono e hana hou ʻia ka hoʻomaʻamaʻa 2-3 mau manawa i ka lā, e hana ana i ka series o 10 a mālama pono i ʻole e hoʻoneʻe i nā ʻiʻo o ka ʻōpū, nā ʻāʻī a me nā wāwae.
I ka hihia o ka 2nd, 3rd a me 4th degere uterine prolapse, inā ʻaʻohe hopena o ka lāʻau lapaʻau-rehabilitative therapy, pono ke ʻoki.
I kēlā me kēia hihia, hoʻāʻo ʻia e pale i kēia ala ma ka hoʻonohonoho ʻana i kahi lāʻau conservative kūikawā.
Ua kuhikuhi ʻia nā wahine menopausal i nā estrogens, no ka mea, ʻo ko lākou emi ʻana - i nā poʻe maʻi kahiko - e hoʻonāwaliwali ai ka papahele pelvic.
A laila, hana ʻia kahi ʻenehana kipi me ke apo a i ʻole cube pessaries
Hana ʻia me ka silicone, ke pani nei lākou i nā hana ʻoki.
Hoʻohana wale ʻia ka pessary cube i ka lā e kū ana ka wahine a wehe ʻia i ke ahiahi ma mua o kona moe ʻana.
ʻO ke apo pessary, i hoʻohana ʻia no nā wahine i paʻakikī i ka hoʻokomo ʻana a me ka wehe ʻana i kēlā me kēia lā, hoʻokomo ʻia e ke kauka a mālama ʻia no 6 mau mahina me kahi hoʻomaha lā 20-30 ma waena o nā pōʻai lapaʻau.
Hoʻokomo ʻia ka pessary i loko o ka ʻōpū a mālama i ka pale ʻana i nā ʻōpū pelvic mai ka paheʻe ʻana: inā ʻae maikaʻi ka wahine iā ia, hiki i kēia ʻano lapaʻau ke kūpono no ke ola.
Inā ʻaʻole hāʻawi kēia mau lāʻau i nā hopena i makemake ʻia, e hana ʻia ke ʻoki.
Nui nā ʻano hana hana, akā, ʻo ka maʻamau, hoʻohana ʻia ka hysterectomy a me ka hoʻokuʻu ʻana o ka ʻōpū.
I ka hihia mua, mālama ʻia no nā wahine ʻaʻole makemake hou / hiki ke loaʻa nā keiki, hoʻoneʻe ʻia ka ʻōpū ma o ka ʻoki ʻana o ka ʻōpū, hana maʻamau a i ʻole ma o ka laparoscopy invasive liʻiliʻi.
ʻO ka hoʻokuʻu ʻana o ka ʻōpū, ma ka ʻaoʻao ʻē aʻe, ʻo ia ka hoʻihoʻi ʻana i ke kino i ke kūlana ma o ka hoʻoikaika ʻana i nā ligaments o ka papahele pelvic ma o ka hoʻohana ʻana i kahi mea synthetic a i ʻole ka hana ʻana i kahi hoʻololi kiko.
ʻO nā pilikia o ka ʻokiʻoki ʻana:
- ka hoʻi hou ʻana o ka prolapse,
- ka paʻa ʻana o ka mimi,
- ʻaʻa ʻole o ka mimi,
- pilikia i ka moe kolohe,
- areflexic pūpū.
ʻO ka wānana e pili ana i ka paʻakikī o ka prolapse uterine a me nā kumu i hoʻomaka ai.
E heluhelu pū nō hoʻi
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