Iningi lalezi zithinta amadoda kuphela
I-urology yiyona okhethekile kwezokwelapha ephathelene ne-urinary tract kokubili amadoda nabesifazane kanye nesistimu yokuzala yesilisa emadodeni. Izinkinga eziningi ze-urological zingapheli, njenge- benign prostatic hypertrophy kanye nokungahlambuluki komchamo , futhi zingahlolwa yi-urologist emtholampilo. Kodwa-ke, izinkinga ezithile ze-urological ziphuthumayo futhi zidinga ukwelashwa ngokushesha ukuze kuqinisekiswe impilo yesikhathi esizayo.
Nakuba urology kubhekwa njengophethiloli yokuhlinzeka, izinkinga eziningi ezinengqondo-kuhlanganise nezimo eziphuthumayo-zithinta izinhlelo ezihlukahlukene zomzimba. Ngakho-ke, i-urologists kumele ibe nolwazi lwezokwelapha zangaphakathi, ukubeletha, ukubeletha, ukugula kwengqondo, nokuningi ukuphatha kangcono izindaba zezempilo. Ngaphezu kwalokho, izazi ze-urologists, njengabo bonke ochwepheshe, zivame ukubonisana nezinye izinhlobo zodokotela ukuze zihlinzeke ngokucophelela.
Ngokusho kwe-American Urological Association, kunezinto eziyisikhombisa ze-urology subspecialties:
- urology yezingane
- ukufakelwa kabusha kwezinsolo (izinso)
- i-calculi (izinso zezinso)
- ukungabi namuntu
- urology wesifazane (cabanga ukungathinteki kwamagciwane)
- i-neurourology (cabanga ukuphazamiseka kwe-voiding ne-erectile disys function)
- i-urologic oncology (umdlavuza)
Nazi izinkinga eziyisithupha eziphuthumayo zokungazi ukuthi kufanele wazi ngani. Ukukwazi ukubona izimpawu nezimpawu zabo kuzoqinisekisa ukwelashwa okusheshayo nokusebenzayo. Eziningi zalezi zimo zithinta amadoda; Nokho, ezinye zithinta kokubili amadoda nabesifazane.
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PriapismAmahlaya ayenzeka mayelana nokuziqhenya amakholwa akhomba kakhulu lesi simo. Ukuzikhethela kuchazwa ngokuthi ukulungiswa okuhlala amahora angaba amane, okungahambisani nokugqugquzela ngokocansi. Ngaphezu kwalokho, ukuxhaswa okunamandla akukwazi ukukhululeka ngokujula .
Ifomu elivame kakhulu ukugeleza okuphansi noma ukukhishwa kwe-ischemic priapism. Ngokuzikhukhumeza, izidumbu ze-cavernosal, ezifaka umshini we-penis, zinzima ngenkathi i-glans noma iphoyinti ingenhla. Ngaphezu kwalokho, i-penis inothando kakhulu, okuyisizathu esanele sokuba amadoda amaningi afune usizo lwezempilo ngokushesha.
Ukuziqhenya ngokuvamile kubangelwa ukuvinjelwa kokuphuma kwamanzi; i- compartment syndrome ye-penis.
Amaphesenti angaba ngu-25 amacala e-priapism ahlobene nesifo se-sickle cell, umdlavuza we-metastatic noma i-leukemia. Ukungasebenzisi kabi izidakamizwa, njenge-cocaine, i-MDMA (ecstasy), i-methamphetamine (i-crystal meth), kanye nobuni, nakho kungaholela ekuziphatheni okukhulu. Ukwengeza, ukuthanda izinto ngokuyinhloko kungaba umthelela omubi wemithi kadokotela njengama-blockers, ama-antipsychotics kanye ne-warfarin (igazi elincane).
Ukunciphisa okuqhubekayo ekugezeni kwamanzi kungaholela kulokhu okulandelayo:
- I-Edema (ukuvuvukala)
- I-Hypoxia
- Acidosis
- I-Fibrosis
- Ukungabi namandla
- I-Necrosis (ukufa kwezicubu)
Uma kushiywe kungalashwa, ukuthandaza kungabhubhisa umsebenzi ozayo wocansi. Ngakho, ukwelashwa okusheshayo kuyadingeka. Uma isikhathi eside sokuthi ukungathandwa kwabathintekayo kungaphenduliwe, ingozi enkulu yokukhubazeka okungapheli kwe-penile. Umgomo wokwelapha ukuvutha, noma ukwehlisa ukuvuvukala kwe-penile.
Amagesi e-penile angadonsela ukuze aqinisekiswe ukuthi ukuxilongwa kwe-priapism kuyatholakala. Okokuqala, ukuphoqa umzimba kungaphathwa ngemithi yomlomo pseudoephedrine (a sympathomimetic) noma i-baclofen (i-relaxant muscle). Ngokujwayelekile, lemithi yokwelapha yomlomo ayisebenzi konke okwenziwe ngakho inaliti enkulu (i-gauge engu 18) efakwe emzimbeni womzimba noma e-shaft ye-penis negazi igxiliwe noma isuswe. I-Phenylephrine isilaliswe ngaphakathi kwe-penis.
I-pseudoephedrin, evuselela uhlelo lokuzwelana, isetshenziselwa ukuphatha ukuthandaza ngoba ukuphazamiseka kuhlanganiselwe ukufaka ama-parasympathetic. Izibalo ze-pseudoephedrine lezi zithonya eziphazamisayo. Inothi, i-ejaculation iyanqanyulwa yisistimu yomzwelo ezwelayo. (Abafundi bezokwelapha bakhumbula lokhu kuhlukaniswa besebenzisa i-mnemonic "iphuzu nokudubula.")
Ezimweni ezimbi zokwehluleka, ukufakwa kwegazi kungafakwa.
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I-Torsion yobufakaziNgokuphambene nalokho abanye abangase bakholwe ngakho, amacwecwe angeke ashintshe izindawo. Kodwa-ke, intambo ye-spermatic, ehlinzeka igazi nge-epididymis ne-testis, ingajika.
Ukuvuthwa okubufakazi ngokuvamile kuthinta abantwana nezingane ezincane kodwa kungenzeka kunanoma yisiphi isikhathi. Ukuhlukunyezwa okuyisifiso akuvamile kubantu abaneminyaka engama-30 nangaphezulu.
Izimbangela ezimbili eziyingozi zokuhlukunyezwa kwe- testicular zifaka amathemikhali angenasidingo kanye nezicubu ze-testicular.
Abafana noma amadoda ane-torsion testicular aqala ukuzwa ubuhlungu obunzima endaweni elandelwayo ngokulandela ukuvuvukala kwesicongechunge. Ukudabuka nokuhlanza kuhambisana nobuhlungu. Ngaphezu kwalokho, abafana nabesilisa abanikezela nge-torsion testicular ngokuvamile banomlando wobuhlungu obulandelayo bese kulandelwa ukubeka kabusha i-testicle ngokwayo.
Kombili lo mlando womtholampilo nokuhlolwa kwangokwenyama kuyisihluthulelo ekutholeni ukuhlushwa kwe-testicular. I-Ultrasound iqinisekisa ukuxilongwa, kodwa uma ukuhlolwa nge-ultrasound kungatholakali, ukuhlolwa okusheshayo kokuhlinzwa kuyadingeka. Ngaphezu kokuqinisekisa ukuxilongwa, i-ultrasound ingakwazi futhi ukulawula ukulimala, okungabangela ukuqhuma komzimba.
Njengokuqala, isikhathi siyisisekelo. Uma ukuhlinzwa kwenziwa emahoreni ayisithupha okuqala, ithuba lokulondoloza i-testis ngamaphesenti angu-80. Uma amahora angaphezu kuka-12 edlulayo, izinga lokuphumelela lokuhlinzeka liyehla ngaphansi kwamaphesenti angama-20.
Ukwelashwa kuhilela ukuvuthwa noma ukungahambisani nalesi sihloko . Isikhathi esanele sinikezwa ukunquma ukuthi ukuqhutshelwa kwe-testis kuqala futhi lokhu kuvascularization kuqinisekiswa ngeDoppler ultrasound. Endabeni ye-necrosis ye-testis, i-orchiectomy, noma ukususwa kwe-testicle, kwenziwa.
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Ukugcinwa okunamandla kwe-UrinaryUkugcinwa kwe-urinary ngokucophelela (AUR) kwenzeka kakhulu emadodeni ane-benign prostatic hypertrophy (BPH) noma ukwandiswa kwe-prostate. Khumbula ukuthi i-prostate iyasizungezile i-urethra, futhi ukukhulisa kwayo kuvimbela ukugeleza komchamo.
Nakuba ngokuvamile evamile emadodeni ane-BPH, i-AUR ingabonakala njengomphumela wezinto ezihlukahlukene ezivimbela ukukhipha isisu okuhlanganisa okulandelayo:
- I-neuropathy ye-diabetes
- Isifo sikaParkinson
- Multiple sclerosis
- Imithi efana ne-opiates ne-anticholinergics
- I-blood clots i-secondary i-hematuria
I-AUR ivame ukuvela esimweni sokugula noma esibhedlela lapho iziguli zithatha imithi eyanciphisa ukukhipha isisu futhi inamandla okulinganisa ukuphuma embhedeni futhi uhambe. Ngaphezu kwalokho, ukuqothulwa, okuyinto evamile nasezilungiselelweni zesibhedlela, kungenza ukugcinwa kwe-urinary kube kubi nakakhulu.
Ngokuvamile, i-AUR yisimo esibuhlungu. Kodwa-ke, kwabanye abantu abane-compcompensation engapheli yesikhumba, lesi simo angeke sibe buhlungu. Uma kushiywe kungalashwa, i-AUR ingaqhubeka nokungaqhubeki kokungahlambuluki, bese kuthi emva kwezinsuku ezimbalwa, ukuhluleka kwe-renal. Ngakho-ke, i-AUR kumele iphathwe ngokushesha ukuze inciphise ubuhlungu futhi ivikele izinkinga.
Ukungaphumeleli okunamandla kokuqeda isilwane kuqala ukuphathwa ngokufaka i-catheter ye-urethral ukukhipha umchamo. Emadodeni anesifo se-BPH, i-catheter ekhonjiwe isetshenziswa ngoba i-urethra ye-prostatic isendaweni ekhoneni. Uma kusetshenziswe umchamo we-urinary, i-urologist kuzodinga ukukhulula i-AUR isebenzisa i-cystoscopy, i-dilreter irethral nokunye.
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I-Fournier's GangreneI-fournier ye-gangrene ayivamile. Luhlobo lwe-fasciitis (i-"meat-eating") ethinta izidakamizwa zesilisa kanye ne-perineum, noma umdwebo wezindlu zangasese phakathi kwe-scrotum ne-anus.
Njenganoma iyiphi i- fasciitis ene-necrotizing , ukutheleleka kudla ngezicubu ezithambile. Nge-fournier ye-gangrene, lesi sifo sithinta ama-dartos, ama-fascias ama-Scarpa kanye nama-Colles.
I-fournier ye-gangrene iqhubekela phambili ngokushesha, futhi uma ukwelashwa kwephuzile, izinto ezimbi zenzeka.
Nazi ezinye izinto ezibeka ingozi ezithintekayo ekwakhiweni kwesigebengu se-Fournier:
- Ukuhlupheka okungcono kwe-perineum
- Isifo sikashukela
- I-HIV / AIDS
- Izindlela zokuguqulwa kwe-Urethral
- Iphunga eliqondiswayo
- I-Cancer
Ukutheleleka nge-fournier's gangrene kuyinto enhle kakhulu futhi kufaka phakathi izimpawu nezimpawu ezilandelayo:
- Ubuhlungu obunzima
- Ubuhlungu be-Perineal
- Fever
- Cellulitis
- Ukungahlali
- Eschars
- I-Necrosis
- I-Crepitus (ephoqa ngaphansi kwesikhumba)
Inothi nge-gangnium ye-Fournier, ubuhlungu obuchazwe isiguli ngokuvamile akufani nokuhlolwa ngokomzimba.
I-fournier ye-gangrene iphathwa ngokususwa noma ukuxilongwa kwezicubu ezifile noma ze-necrotic kanye nokuphathwa kwama-antibiotics amaningi. Ngokuvamile, kudingeka ukuhlinzekwa okungaphezu kweyodwa, futhi uma zonke izicubu ezifile zisusiwe, kwenziwa ukuhlinzwa okuvuselelayo. Ngamanye amazwi, ukwelashwa okuphumelelayo kwesigebengu se-Fournier kuyinkqubo ende.
Ngenxa yokuthi ama-testes anegazi lawo elihlukile, ngokuvamile angagcinwa kubantu abane-fournier's gangrene. Ama-testes angafakwa "esikhwameni sezinkukhu" ngesikhathi sokutakula ukuze kube lula ukuphathwa.
Ukunakekelwa okufanele kwezilonda nokuguqulwa izingubo njalo kubalulekile ngesikhathi sokuphumula. Ngaphezu kwalokho, amadoda anesifo sikashukela kufanele abe namazinga abo e-glucose alawulwa futhi athole ukudla okwanele ukuze kube lula ukuphulukisa ukulimala.
Ucwaningo lubonisa ukuthi izinga lokufa kwe-Fournier lokugqekeza liphakathi kwamaphesenti angu-20 no-40.
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I-ParaphimosisI-paraphimosis ivele kuphela kubantu abangasokile futhi ngaleyo ndlela babe nejwabu. Ngokuvamile, lesi simo sibonakala emadodeni alala embhedeni isikhathi esiningi esifana nesibhedlela. Kulesi sikhundla, ijwabu libuyele futhi i-edema noma ukuvuvukala iqoqa ipeni, futhi ubuhlungu be-penile buyaqhubeka. Kubantu abaguqukile, lobu buhlungu bungase bungabonakali isikhathi esithile kuze kube yilapho sekudlulile futhi ipeni iba yinkimbinkimbi yesondlo ekunciphiseni ukugeleza kwegazi endaweni (ischemia).
Ukwelashwa kwe-paraphimosis kuhilela ukunciphisa okuncane kwezinhlayiya, ukuyibuyisela esimweni sayo esivamile. Le nqubo iyabuhlungu kakhulu kepha kuyadingeka ukuze ukwelashwa okufanele. Ngoba lokhu ukunciphisa kuyinto ebuhlungu kakhulu, imithi yokuhlunguphazwa, izivimbe ze-penile, ngisho nokuhlelwa phansi kungadingeka.
Njengeminye imibandela echazwe kulesi sihloko, i-paraphimosis iyisimo esiphuthumayo sezokwelapha esizodinga ukunakekelwa ngokushesha ngaphambi kokuba umonakalo unomphela.
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I-Pyelonephritis emphysematousI-Pyelonephritis ukutheleleka komgogodla wezinso. Uma lesi sifo sibangelwa amagciwane akhiqiza igesi, kuthiwa i- emphysematous pyelonephritis . I-pyelonephritis emphysematous ngokuvamile ivela kubantu abanesifo sikashukela futhi ngokuvamile ibangelwa u-E. Coli. Lokhu ukutheleleka nakho kungasakazeka ngendlela ehlelekile futhi kubangele ukuhlaselwa, okuyingozi yokuphila. Konke kukho konke, i-pyphyonephritis emphysematous inhle kakhulu.
Abantu abane-emphysematous pyelonephritis bangalindela ukwelashwa nge-antibiotics emithi kanye nokunakekelwa okusekelayo. Ukwelashwa okwengeziwe kwe-pyelonephritis kuncike ekutheni ukutheleleka kusakaze kangakanani ngaphakathi kwezinso. Uma ukutheleleka kugcinwe ku-parenchyma, ukwelashwa okunamandla kungasebenza. Leli cala elilondolozayo lihlanganisa ukubekwa kwe-nephrostomy tube ukuze kukhishwe impahla egcwele ama-pus. Uma ukutheleleka kwezinso kusakazeke kakhulu futhi kubuye kube khona, ukukhishwa kwezinso (nephrectomy) kungadingeka.
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IsiphethoNgenhlanhla, eziningi zalezi zethulo eziphuthumayo zesimo sengqondo zenzeka ngokungajwayelekile. Noma kunjalo, zonke lezi zimo nezifo ziphuthumayo futhi zidinga ukwelashwa ngokushesha. Uma wena noma othandekayo usola noma iyiphi yalezi zinkinga, sicela uxhumane nezinsizakalo eziphuthumayo nodokotela wakho ngokushesha. Ngayo yonke le mibandela, isikhathi siyisisekelo sokweqile futhi ngokushesha ukunakekelwa kwezempilo kuyadingeka ukuvimbela ukukhubazeka esikhathini esizayo noma ngisho nokufa.
Encwadini yokugcina, njengoba kuboniswe ngaphambili, iningi lalezi zimo zithinta amadoda. Noma kunjalo, ukugcinwa kwe-urinary okunamandla nakho kungathinta abesifazane, futhi i-pyelonephritis ngokuvamile ihlasela abesifazane abasebasha abadala.
Ngisho noma usola ukuthi ungase ubhekene nenye yalezi zimo futhi kuvela ukuthi awukho, ngaso sonke isikhathi umqondo omuhle ukulandela nodokotela mayelana nezimpawu ezibangele ukukhathazeka kwakho kuqala. Ungase futhi ucele ukuhanjelwa kudokotela we-urologist nganoma yikuphi ukukhathazeka okungenzeka ube nakho mayelana ne-urinary tract yakho kanye nezitho zangasese. Sicela ukhumbule ukuthi udokotela wakho ukhona ukuze akusize uthole ukunakekelwa kwezempilo oyifunayo futhi oyidingayo.
Imithombo:
Chamie K, Rochelle J, Shuch B, uBelldegrun AS. Urology. Ku: Brunicardi F, Andersen DK, B Billiar, Dunn DL, Hunter JG, Matthews JB, Pollock RE. ama-eds. Izimiso Zokuhlinza Schwartz, 10e . ENew York, NY: McGraw-Hill; 2014.
I-Heidenreich J. Isahluko 39. Izimo Eziphuthumayo Ze-Genitourinary. Ku: Stone C, Humphries RL. ama-eds. Ukuhlolwa Kwe-CURRENT & Ukwelapha Emergency Medicine, 7e . ENew York, NY: McGraw-Hill; 2011.
"I-Necrotizing Fasciitis: Isifo Esinamahloni Ngokuyinhloko Sempilo" esivela ku-CDC: http://www.cdc.gov/features/necrotizingfasciitis/
Sorenson MD, et al. "I-Fournier's Gangrene: I-Population Based Epidemiology Nemiphumela." I-Journal of Urology 2009.