Inketho kulabo abangakwazi ukuthatha noma abangatholi imithi emithi
Izinkinga zesibindi ku- sclerosis amaningi zivamile, zithinta cishe amaphesenti angu-80 abantu. Banezimo zezokwelapha nezengqondo futhi, ngoba zingabangela ukutheleleka kwe-urinary, izinkinga zezinso, ukuzihlukanisa komphakathi, nokunciphisa ukuzethemba kanye / noma izinga lokuphila.
Izindaba ezinhle ukuthi kunezindlela eziphumelelayo zokuphatha lesi sibonakaliso esicindezelayo nesingenasisindo se-MS.
Lezi zindlela zokwelashwa zihlanganisa nezendabuko ezifana nezindlela zokuphila zokungenelela kanye nemithi, kanye nokungabi namasiko anjengamajoka e- Botox .
Ngaphambi kokucubungula iBotox njengendlela yokwelapha izinkinga zakho ze- MS-ezihlobene nesibisi , kuwukuhlakanipha ukuqala ukuqonda ukuthi isisindo sisebenza kanjani nokuthi sithinteka kanjani yi-MS.
Umsebenzi we-Bladder umsebenzi
Ngomuntu ophilile, umchamo uhamba ukusuka ezinsweni kuya ezigodini ngokusebenzisa amashubhu amabili okuthiwa urereters. Uma isikhumba sithwele cishe ama-ounces angu-8 omchamo, sandisa, sishukumisela izinzwa ukuba zithumele umthambo womgogodla (obese ubonisa ubuchopho) ukuthi isilonda sidinga ukukhipha. Le nqubo yikho okukunika umuzwa wokuthi udinga ukuvuthwa.
Khona-ke, ngemva kokuthola indawo yokugezela, izinzwa ezisebuchosheni zithumela umzila kumgogodla ukuze ziqalise ukuzwakalisa. Phakathi nalesi sakhiwo, izinkontileka zakho ze-muscular (detraor) (bladder) izikhwama noma uzikhumbuza ukukhipha umchamo kusuka kwesinye.
Ngesikhathi esifanayo, umsila wakho wangaphandle we-sphincter ugxila ukuvumela umchamo ukuba uphumule kwesisu, ngokusebenzisa i-urethra, nangaphandle komzimba.
Ukukhubazeka kwesibindi ku-Multiple Sclerosis
E-sclerosis eminingi, izilonda zivimbela ukuguquka kwesibindi ebuchosheni nasendlini yomgogodla evame ukulawula imisipha ye-detrusor kanye nesisipha sangaphandle se-sphincter.
Lokhu kungaholela ezinkingeni ezintathu ezihlukile zesisindo:
- Inkinga yokugcina isisindo
- Izinkinga zokukhishwa kwesibindi
- Isibhanzana esihlanganisiwe sigcina futhi sikhipha izinkinga
Isibilini Ukugcina Izinkinga (Isikhatshana Esingaqaphile)
Kwamanye abantu abane-MS, imisipha ye-detrusor ingenza isivumelwano (noma ifinyelela) uma kungacabangi ukuthi futhi (uma isisindo sakho sithwele umchamo omncane) okwenza uzizwe sengathi udinga ukuvota sonke isikhathi. Lezi zimpawu zibhekwa njengokuphuthumayo komchamo kanye nemvamisa. Ungase futhi uqaphele ukuthi uvuka ebusuku ukuze usebenzise indlu yokugezela, noma ungase ulahlekelwe umchamo-okuthiwa ukukhuthaza ukungahambisani .
Izinkinga zokukhishwa kwesibindi (isambiso esiphelele)
Kwabanye, i-reflective voiding ayiphumelelanga ngakho isisindo saphezulu-siyakhula ngaphandle kokufaka uphawu ebuchosheni nasemgodleni womgogodla umuntu adinga ukuwahambisa. Lokhu kungaholela ekuvuthweni komchamo, ukungabaza ekuqaliseni ukuchama, noma ukulahleka okungalawulwa komchamo okuthiwa ukungaqhubeki kwemvelo.
Isitoreji Sokugcina Isivinini Nezinkinga Zokuxosha
Noma kunjalo abanye abantu bathola inhlanganisela yezinhlobo ezimbili zezinkinga zesisu. Kulesi sibonelo, izilonda ze-MS ebuchosheni nomgogodla kubangela ukungasebenzi kahle phakathi kwe-detrusor muscle kanye nemisipha yangaphandle ye-sphincter, okwenza ukuba bobabili bakhonze ngesikhathi esifanayo.
Lo mcube ugibela isisindo esibangela ukuphuthuma komchamo (njengokudinga ukuzulazula ngokuzumayo), ukungabaza ukuqala ukuchama, ukuvuthwa komchamo (abantu abaningi bembatha i-pad absorbent), noma ukulahleka komchamo.
Ukwelashwa Kwendabuko Yenkinga Engaphezu Kakhulu noma Isibilini Esikhathini SakwaMas
Uma unayo i-MS futhi uhlangabezana nezimpawu zesilonda esingasebenzi ngokweqile (njengokuthi unesifiso sokuzulazula ngokuzumayo nokuvuthwa kaningi) isazi sakho sezinzwa zegazi singase sikhuthaze kuqala ukungenelela kwempilo kanye nemithi yokulwa ne-anticholinergic.
Ukungenelela okuvamile okubandakanya ukuphila kufaka phakathi ukukhawulelisa i-caffeine nokusetshenziswa kotshwala nokugwema uketshezi emva kokudla kokudla nangaphambi kokulala.
I-neurologist yakho ingase iphinde ikhuthaze ukuthi abesifazane bagqoke i-pad engenayo noma amadoda agqoke i-catheter yokukhondla ukuxazulula izinkathazo zokulahlekelwa komchamo emini emphakathini.
Imithi e-anticholinergic efana ne-Detrol (tolterodine) noma i-Vesicare (solifenacin succinate) ingaba usizo ekunciphiseni izimpawu zokuvama kwamanzi, ukuphuthuma, nokungaziphathi kahle-nakuba kungabangela imiphumela emibi njengokungaqothulwa, ukulala, nomlomo owomile. Ungamangali nakuba kufanele uzame umbhangqwana ngaphambi kokuthola imithi eyokusebenzela.
Imithi emisha ebizwa ngokuthi i-Myrbetriq (mirabegron) isebenza ngokuphumula imisipha esungeze isisu, ivumela ukuba ibambe umchamo. Ucwaningo lubonisa ukuthi lusebenza ngendlela efana ne-anicholinergics ekunciphiseni ukungahambisani kwamagciwane (ngaphandle kwalawo asebenzayo njengeVesicare).
Ucwaningo lubonisa ukuthi kungcono ukubekezelela, njengoba kungabangela umlomo owomile, umphumela omningi wokulimaza we-anticholinergics amaningi. Lokhu kuthiwa, imiphumela emibi ejwayelekile ye-Myrbetriq ihlanganisa ikhanda, izimpawu ezibandayo, ukwanda kwengcindezi yegazi, kanye nokutheleleka kwamagciwane.
I-Botox May Kungaba Isinyathelo Esilandelayo Uma Imithi Engasebenzi
Uma uqhubeka nokuzwa izinkinga zokukhipha isisu ezihlobene ne-MS yakho naphezu kwemithi ye-anticholinergic, i-neurologist yakho ingancoma i-onabotulinumtoxin A (i-BOTOX) -yindlela yokwelashwa evunyelwe yi-United States Food and Drug Administration (FDA) yokwelapha ukungahambisani nesisu esikhwameni esingasebenzi.
Ingabe i-Botox isebenza ekwelapheni isambatho esingasebenzi ngokweqile ku-MS?
Ucwaningo olunzulu e- Urology yaseYurophu luhlolisise imiphumela yeBotox ekunciphiseni ukungaziphathi kahle kubantu abanekhanda elingasebenzi kakhulu kusuka ku-MS noma ukulimala komgogodla. Imiphumela yocwaningo yathola ukuthi emva kwamasonto angu-12, abathintekayo abane-MS abaphathwa nge-Botox babhekana nokungahambisani kwamaminithi angu-1.5 ngosuku ngosuku kunabalingani abane-MS abaphathwa nge-injection ye-placebo.
Ngaphezu kwalokho, isifundo sathola ukuthi abahlanganyeli abane-MS baphathwa nge-BOTOX bavinjiswe cishe ngamamitha ayizi-86 ngamaminithi amaningi ngaphandle komhlangano ababambe iqhaza.
Yini Ongayilindela Phakathi Ne-Botox Injection Yakho
Udokotela wakho uzoqala ukuhlola ngaphakathi kwesikhumba sakho usebenzisa i-cystoscope-ithubhu elincane elinesikhamera ekugcineni.
Udokotela uzobe ejoqa imisipha ye-detrusor ezindaweni eziningi (ezungeze ku-30) ne-Botox, okwenza ukuba uphumule. Lokhu kuvumela isilonda ukuthi ibambe umchamo owengeziwe ukuze imisipha ingasebenzi noma ihlwithe sonke isikhathi, ngaleyo ndlela ukunciphisa izimpawu zokuphuthuma komchamo, imvamisa, nokungaziphathi kahle.
Imiphumela emibili ejwayelekile kakhulu ye-BOTOX yilezi:
- ukutheleleka kwe-urinary tract
- Ukugcina umchamo esithombeni
Ukuze uvimbele ukutheleleka kwesibindi kungenzeki ngenxa yenkambiso, udokotela wakho cishe uzobeka imithi yokulwa nemithi ngaphambi, ngesikhathi, nangemva kwezinsuku ezimbalwa emva kokwelashwa kwe-BOTOX.
Futhi, ngenxa yobungozi bokugcina umchamo emva kokwelapha kwe-Botox, udokotela wakho uzofuna ukuqinisekisa ukuthi ukhululekile ukwenza ukuhlunga okuhlanzekile okuzenzekelayo ngaphambi kokuthola ukwelashwa, njengoba lokhu kuwumphumela ovamile.
Eqinisweni, ocwaningweni lwezokwelapha okukhulunywe ngaye ngenhla ku-Urology yaseYurophu, cishe amaphesenti angu-30 abahlanganyeli ababengakaze bazitholele ngokweqile ngaphambi kweBotox (futhi iningi labahlanganyeli abane-MS), kwakudinga ukuzakhela ukugoma ngemuva kokuphathwa kwe-Botox .
I-Botox nayo iphethe isixwayiso sebhokisi ngokusemandleni ayo okubangela imiphumela engathà sina, ngisho nezingozi ezisongela ukuphila njengezinkinga zokugwinya, ukukhuluma noma ukuphefumula ngenxa yokunciphisa imisipha. I-toxin ye-botulinum ingase isakaze nakwezinye izindawo zomzimba futhi ibangele inani lezimpawu ezibucayi ezinjengobuthakathaka obukhulu bomzimba noma imibono. Nakuba kungavamile, lezi zixwayiso zigcizelela ukubaluleka kokuxoxisana nodokotela wakho ngokucophelela nangengqondo ngaphambi kokuba usebenzise iBotox.
Izwi elivela
Izinkinga zase-Urinary ku-MS zivamile, ngakho ungazizwa ukhathazekile noma uhlazekile ukuxoxa nabo nodokotela wakho. Izindaba ezinhle ukuthi kunezinto eziningi zokuphila nezindlela zokwelapha ezingakusiza ukuphatha izimpawu kanye nezinkinga ezingase zibe khona-futhi iBotox nayo iyindlela enengqondo uma ezinye izindlela zokwelapha zingasebenzi.
> Imithombo:
> I-Allergan. (NgoJanuwari 2016). Kuvunywe yi-US Yokudla Nezidakamizwa Zokuphatha. Umhlahlandlela wemithi: i-Botox.
> Cruz F et al. Ukusebenza nokuphepha kwe-OnabotulinumtoxinAziguli ezibangelwa ukungahambi kahle kwe-Urinary ngenxa ye-Neurogenic Detrusor Ukuqapha: I-Randomised, Double-Blind, i-Placebo-Controled Trial. Eur Urol. 2011 Oct; 60 (4): 742-50.
> Maman K et al. Ukuqhathanisa Ukusebenza Nokuphepha Kwezokwelashwa Kwezokuphathwa Kwesisindo Esingasebenzi: Ukuhlaziywa Kwezincwadi Zesistimu kanye Nokuqhathanisa Nezimo Eziphuthumayo. Eur Urol . 2014, 65 (4): 755-65.
> National MS Society. (2016). Ukukhubazeka kwe-Urinary no-MS .
> I-Weckx F, i-Tutolo M, i-De Ridder D, i-Van der Aa F. Indima ye-Botulinum Toxin A ekuSebenziseni Isibilini Se-Neurogenic. Humusha U-Androl Urol . 2016 Feb; 5 (1): 63-71.