Uninzi lwezi zinto zichaphazela amadoda kuphela
I-urology yinto ekhethekileyo yonyango ejongene nephepha lokucoca kumadoda kunye nabasetyhini kunye nenkqubo yokuzala inkunzi kumadoda. Uninzi lweengxaki zesifo sengqondo ezingapheliyo, ezinjenge- benign prostatic hypertrophy kunye nokungahambisani nokuvuthwa kwamanzi , kwaye unokuhlolisiswa ngu-urologist eklinikhi. Nangona kunjalo, iingxaki ezithile zeengxaki zeengxaki zixakeka kwaye zifuna unyango lwangokukhawuleza ukuqinisekisa impilo ezayo.
Nangona i-urology ithathwa njengophando olukhethekileyo, iingxaki ezininzi ezinengxaki zeengxaki-kuquka nezoxakeka-zichaphazela iinkqubo ezahlukeneyo zesigqeba. Ngaloo ndlela, i-urologists kufuneka ibe nolwazi lwamachiza angaphakathi, i-gynecology, isifo sesifuba, isifo sengqondo, kunye nokunye ukuphucula kakuhle imicimbi yempilo. Ngaphezu koko, i-urologists, njengazo zonke iingcali, zihlala ziqhagamshelana nezinye iintlobo zamagqirha ukubonelela ngononophelo.
Ngokombutho we-American Urological Association, kukho ezisixhenxe ze-urology subspecialties:
- utyando lwezingane
- intshontsho (iinjongo) ukutshintshwa
- i-calculi (amatye amatye)
- ukungabi namntwana
- ubundlobongela besifazane (cinga ukungahambi kakuhle kwamanzi)
- i-neurrorology (cinga iziphazamiso ze-voiding kunye ne-erectile disys function)
- i-urologic oncology (umhlaza)
Nazi iindlela ezi-6 eziphuthumayo ezingxamisekileyo ezifunekayo. Ukukwazi ukuqonda iimpawu zabo kunye neempawu ziya kuqinisekisa unyango olukhawulezayo nolusebenzayo. Uninzi lwezi meko zichaphazela amadoda; Noko ke, ezinye zichaphazela amadoda namabhinqa.
1 -
UkuzikhethelaAmajokhi ayenziwe malunga nokunyaniseka akholwa yinto ebalulekileyo yile meko. Ukuzikhethela kukuchazwa njengendlela yokulungiswa kweeyure ezingaphezu kweeyure ezine, ezingenanto nantoni yokuvuselela ngokwesondo. Ukongezelela, ukuxhaswa kwamandla akukwazi ukukhululeka ngokunyuka.
Ifom yezona ziqhelekileyo zihamba ngokukhawuleza. Ngokuxhamla, izidumbu ze-cavernosal, ezenza i-shaft ye-penis, zinzima xa i-glans okanye i-tip isicacid. Ukongezelela, i-penis yintsikelelo enkulu, isizathu esaneleyo sokuba amadoda amaninzi afune unyango lwangoko.
Ukuzikhethela ngokuqhelekileyo kubangelwa ukuphazamiseka kwe-outflow; ngokuqhelekileyo isifo segumbi lesipilisi.
Amaphesenti angama-25 eengxaki zokuxhamla zixhomekeke kwisifo segciwane lesigane, umhlaza wesifo se-metastatic okanye i-leukemia. Ukusetyenziswa kakubi kwezidakamizwa, njenge-cocaine, i-MDMA (ecstasy), i-methamphetamine (crystal meth), kunye ne-marijuana, kunokukhokelela ekuthineni. Ukongezelela, ukunyaniseka kungabangela impembelelo yamachiza omzimba njengama-blockers-channel blockers, antipsychotics kunye ne-warfarin (igazi elincinci).
Ukunciphisa ukunciphisa ukuhamba kwamanzi kungabangela oku kulandelayo:
- I-Edema (ukuvuvukala)
- Hypoxia
- Acidosis
- Fibrosis
- Ukungabi namandla
- I-Necrosis (ukufa kwesisu)
Ukuba ukushiywa kungakhange kulandelelwe, ukuxhaswa komzimba kungonakalisa umsebenzi wesondo ozayo. Ngoko ke, unyango olukhawulezayo luyimfuneko. Kuthe ixesha elide lihamba lingahambi, unomngcipheko omkhulu wokungasebenzi ngokusisigxina. Injongo yonyango i- detumescence, okanye ukunciphisa ukuvuvukala kwe-penile.
Iigesi zegazi zePenile ziyakuthatyathwa ukuqinisekisa ukuxilongwa kwezinto eziphambili. Ekuqaleni, ukuxhaswa kwempilo kungaphathwa ngemithi yomlomo pseudoephedrine (i sympathomimetic) okanye i-baclofen (i-muscle relaxer). Ngokuqhelekileyo, nangona kunjalo, le miyeza yomlomo ayisebenzi yonke into ukuze inaliti enkulu (18 gauge) ifakwe emzimbeni womzimba okanye kwi-shaft yepenis negazi lifunwa okanye lisuswe. I-Phenylephrine ifakwe kwi-penis.
I-Pseudoephedrin, eyenza isistim sevelwano, isetyenziselwa ukuphatha ukunyaniseka ngenxa yokuba izilungiso zixhaswa yi-input parasympathetic input. Izibalo ze-Pseudoephedrine ezi mphumela. Ingqalelo, ukujongwa kwimijondolo kuxoxwa yinkqubo enobubele. (Abafundi bezonyango bakhumbula oku kwahlukileyo usebenzisa i-mnemonic "iphuzu kunye nokudubula.")
Kwiimeko ezibuhlungu zokuxhatshazwa, kungenziwa i-shunt yokuhlinzwa.
2 -
I-Tortic TesticularNgokuchasene noko abanye abanakho ukukholelwa, ama-testicles akakwazi ukutshintsha indawo. Nangona kunjalo, intambo ye-spermatic, ehambisa igazi kwi-epididymis kunye ne-testis, ingajika.
I-torsion testicular ivame ukuchaphazela abantwana kunye namakhwenkwe amakhwenkwe kodwa angenzeka nanini na. I-torsion testicular ayifumaneki kubantu abaneminyaka engama-30 nangaphezulu.
Imiba emibini yengozi ye- torsion testicular iquka amathambo angabonakaliyo kunye nezicubu ze-testicular.
Amakhwenkwe okanye amadoda anesiphelo esithandabuzayo sokuqala kwintlungu ebuhlungu kwinqanaba elithile lilandelwa ukuvuvukala kwetekisi. Isihlunu kunye nokuhlanza kuhamba kunye nentlungu. Ukongezelela, amakhwenkwe namadoda athoba nge-testicular torsion ahlala eneembali zentlungu elandelwayo ngokulandelwa kwetekisi.
Zomibini le mbali yeklinikhi kunye nokuhlolwa komzimba kubalulekile ekufumaneni i-tortic testicular. I-ultrasound iqinisekisa ukuxilongwa, kodwa ukuba uvavanyo lwama-ultrasound alufumaneki, ukuhlola ngokukhawuleza kuyimfuneko. Ukongeza kokuqinisekisa ukuxilongwa, i-ultrasound inokuphinda ilawulwe i-malignancy, enokubangela ukuba i-torsion testerular.
Njengaye, ukuchitha ixesha kukungundoqo. Ukuba utyando lwenziwa kwiiyure zokuqala ezintandathu, ithuba lokulondoloza i-testis ngama-80 ekhulwini. Ukuba ngaphezulu kweeyure ezingama-12 kudlulayo, izinga lokuphumelela lotyando liyehla ukuya ngaphantsi kwama-20 ekhulwini.
Uphando lubandakanya ukuhlaziywa okanye ukungaqiniseki kwetekisi. Ixesha elaneleyo linikezelwa ukuchonga ukuba ukusabalalisa ukuya kwi-testis kuqala kwakhona, kwaye oku kuhlaziywa kuqinisekiswa ngeDoppler ultrasound. Kwimeko ye-necrosis ye-testis, i-orchiectomy, okanye ukususwa kwetekisi, kwenziwa.
3 -
Ukugcinwa kweeUriyoUkugcinwa kwe-urinary ngokuqhelekileyo (AUR) kwenzeka ngokuqhelekileyo kumadoda ane-prostatic hypertrophy (BPH) okanye ukwandiswa kweprotate. Khumbula ukuba i-prostate iyakujikeleza i-urethra, kwaye ukukhulisa kwayo kuvimbela ukuhamba komchamo.
Nangona ininzi eqhelekileyo kumadoda ane-BPH, i-AUR inokubakho ngenxa yezinye izinto ezahlukileyo ezivimbela ukukhupha i-bladder kuqukwa kuquka oku kulandelayo:
- I-diabetes neuropathy
- Isifo sikaParkinson
- Isifo sokugubhuka
- Amayeza afana ne-opiates kunye ne-anticholinergics
- Igazi livala i-hematuria yesibini
I-AUR isoloko isenzeka kwisigulana okanye esibhedlele xa izigulane zithatha imishanguzo eyancipha ukutshabalalisa i-bladder kunye nokukwazi ukuphuma kumbhedlele. Ngaphezu koko, ukuqhenyiswa, okuqhelekileyo kwizicwangciso zesibhedlele, kungenza ukugcinwa kwe-urinary kube nzima nakakhulu.
Ngokuqhelekileyo, i-AUR yimeko ebuhlungu. Nangona kunjalo, kwabanye abantu abanomvuzo ongapheliyo we-bladder, le meko ayinakubuhlungu. Ukuba ishiywe ingaphendulwanga, i-AUR ingaqhubeka nokuphuphuma kokungaqhubi, kwaye emva kweentsuku eziliqela, ukuhluleka komnxeba. Ngaloo ndlela, i-AUR kufuneka iphathwe ngokukhawuleza ukuze inciphise intlungu kwaye ikhusele iingxaki.
Ukungaphumeleli kwe-renal ngokuphambili kulamkelwa ngokubeka i-catheter yokurhoxisa ukucoca umchamo. Kubantu abano-BPH, i-catheter ephihliweyo isetyenzisiweyo kuba i-prostate urethra ifakwe kwinqanaba. Ukuba u-urric stricture ukhona, i-urologist iya kufuneka ikhuphe i-AUR isebenzisa i-cystoscopy, dilressers urethral nokunye.
4 -
GangniI-fournier igqirha ayinqabile. Yindlela yokwenza i-fasciitis (i-"eating-meat") echaphazela izifo zesini kunye ne-perineum, okanye umda we-real estate phakathi kwe-scrotum kunye ne-anus.
Njengokuba nayiphi na i- fasciitis ene-necrotizing , intsholongwane idla ngokusebenzisa izicubu ezithambileyo. Nge-fournier igulane, le ntsholongwane ithinta i-dartos, i-Scarpa kunye ne-Colcias fascias.
I-fournier igqirha iyaqhubeka ngokukhawuleza, kwaye ukuba unyango lulibazisekile, kwenzeka izinto ezimbi.
Nazi ezinye izinto ezijongene nobungozi ezibangela ukuphuhliswa kwe-fournier gangrene:
- Ngamahlwempu ekuhlambulukeni
- Sikashukela
- HIV / AIDS
- Iimpawu zokurhweba
- Ikhefu eliphambili
- Cancer
Usulelo lwe-fournier lwe-gangnium lukhulu kakhulu kwaye luquka ezi zibonakaliso neempawu ezilandelayo:
- Intlungu
- Intlungu
- Fever
- Cellulitis
- Ukunyusa
- Abahlalutyi
- Necrosis
- I-Crepitus (ukuphanga ngaphantsi kwesikhumba)
Inqaku kunye ne-Fournier's gangrene, intlungu echazwe isigulane ngokuqhelekileyo ayikho ngokulingana nokuhlolwa komzimba.
I-fournier igqirha iyaphathwa ngokususwa okanye ukuxoxwa kwezinto ezifayo okanye ezithintekayo kunye nokulawulwa kwee-antibiotic. Ngokuqhelekileyo, kufuneka utyando olungaphezu kweyodwa, kwaye emva kokuba zonke izicubu ezifileyo zisuswe, utyando olwenziwa ngokutsha luyenziwa. Ngamanye amazwi, unyango oluphumelelayo lwe-Fournier's gangrene yinkqubo ende.
Ngenxa yokuba ii-testes zinegazi, ziyakwazi ukugcinwa kubantu abane-4nier gangrene. Iimvavanyo zingafakwa "kwisikhwama somlenze" ngexesha lokuphulukana ukuze kuqhutywe phambili ulawulo.
Ukunyamekelwa kwilonda elifanelekileyo kunye neenguqu zokugqoka rhoqo kubalulekile xa kuphulukana. Ukongezelela, amadoda anesifo sikashukela kufuneka abe namazinga e-glucose alawulwayo kwaye afumane ukutya okwaneleyo ukulungiselela ukuphulukiswa kwilonda.
Uphando lubonisa ukuba izinga lokufa kwe-Fournier's gangrene liphakathi kwama-20 no-40 ekhulwini.
5 -
ParaphimosisI-Paraphimosis iphela kuphela kubantu abangalukanga kwaye ngoko banesigqabi. Ngokuqhelekileyo, le meko ivela kumadoda alala phantsi ebhedeni ixesha elide elifana nesibhedlele. Kule ndawo, ijwabu libuyele kwakhona kunye ne-edema okanye ukuvuvukala iqokelela kwi-penis, kwaye intlungu ye-penile iqhubeka. Kubantu abanolwazi olushintshileyo, le ntlungu ingabonakali ixesha elithile kuze kube yithuba elide kwaye ipenis iba yintsholongwane yecandelo lokunciphisa ukuhamba kwegazi kwindawo (ischemia).
Unyango lwe-paraphimosis luquka ukunciphisa ukulandelwa kweengqungquthela, ukuyibuyisela kwisimo sayo esifanelekileyo. Le nkqubo ibuhlungu kakhulu kodwa kuyimfuneko yokonyango olufanelekileyo. Ngenxa yokunciphisa ubuhlungu buhlungu, imilenze yeentlungu, iibhloko ze-penile, kunye ne-sedation ingafuneka.
Nje ngezinye iimeko ezichazwe kule nqaku, i-paraphimosis yinyango engxamisekileyo yonyango efuna ukunikwa ngonyango kwangaphambili ngaphambi kokuba umonakalo unomphela.
6 -
Emphysematous PyelonephritisI-Pyelonephritis yintsholongwane ye-urinary yintsholongwane. Xa le ntsholongwane ibangelwa ibhaktheriya evelisa igesi, ibizwa ngokuba yi- emphysematous pyelonephritis . I-pyphyonephritis emphysematous ngokuqhelekileyo ivela kubantu abanesifo sikashukela kwaye idlalwa nguElili. Olu sulelo luyakwazi ukusasaza inkqubo kwaye lubangele i-sepsis, eyingozi yobomi. Konke kuzo zonke, i-pyphyonephritis e-emphysematous ihle kakhulu.
Abantu abane-emphysematous pyelonephritis banokulindela unyango nge-antibiotics ene-intravenous kunye nokunyamekela. Ukonyango olongezelelweyo lwe-pyelonephritis kuxhomekeke ekubeni usulele kangakanani ukusuleleka kwintsholongwane. Ukuba intsholongwane igcinwe kwi-parenchyma, unyango olulondolozayo lungasebenza. Olu unyango olulondolozayo lubandakanya ukubeka ityhubhu ye-nephrostomy ukuze ikhuphe izinto ezizaliswe ngamapusi. Ukuba intsholongwane yeengso ixhaphake kwaye i-sepsis ikhoyo kwakhona, ukukhutshwa kwezibilini (i-nephrectomy) kunokufuneka.
7 -
IsipheloNgethamsanqa, ezininzi zezi ngxubusho zengxakeko ezingxamisekileyo zenzeka ngokungaqhelekanga. Nangona kunjalo, yonke le miqathango kunye nezifo ziphuthumayo kwaye zifuna ingqwalaselo yonyango ngokukhawuleza. Ukuba wena okanye othandekayo uyakrokrela nayiphi na le ngxaki, nceda uqhagamshelane neenkonzo eziphuthumayo kunye nodokotela wakho ngokukhawuleza. Ngazo zonke le miqathango, ixesha liyinto engundoqo kunye nokugqithiswa kwangoko kunyango kuyimfuneko ukukhusela ukukhubazeka kwangaphambili okanye nokufa.
Kwinqaku lokugqibela, njengoko kukhankanywe ngaphambili, ezininzi zeemeko zichaphazela amadoda. Nangona kunjalo, ukugcinwa kwamanzi okuvutha kakhulu kunokuchaphazela nabasetyhini, kwaye i-pyelonephritis ixhaphaza abafazi abasetyhini abadala.
Nangona ucinga ukuba unokuhlangabezana nale yeemeko kwaye kuvela ukuba awukho, kuhlale kuluvo oluhle lokulandela kunye nodokotela malunga neempawu ezibangele ukukhathazeka kwakho kwindawo yokuqala. Ungaphinde ucele ukuthunyelwa kwi-urologist kuyo nayiphi na inkxalabo onokuyenza ngayo ngeendlela zakho zokuvuthwa kwamanzi. Nceda ukhumbule ukuba ugqirha wakho ukhona ukukunceda ufumane unyango lwempilo olufunayo kwaye uludinga.
Imithombo:
Chamie K, Rochelle J, Shuch B, eBelldegrun AS. Urology. Ku: Brunicardi F, Andersen DK, Billiar TR, Dunn DL, Hunter JG, Matthews JB, Pollock RE. eds. I-Schwartz Iimigaqo zoPhando, 10e . New York, NY: McGraw-Hill; 2014.
I-Heidenreich J. Isahluko 39. Iziganeko zezoLimo zeNkathazo. Ku: I-Stone C, i-Humphries RL. eds. UKUHLAWULWA KWENKQUBO YOKUPHATHWA KUNYE NEZONYAKA ZEMPILO YEMPILO, 7e . New York, NY: McGraw-Hill; 2011.
"I-Necrotizing Fasciitis: Isifo Esiqhelekileyo Siphephile" kwi-CDC: http://www.cdc.gov/features/necrotizingfasciitis/
Sorenson MD, et al. "I-Fournier's Gangrene: I-Population Based Epidemiology kunye neziphumo." I-Journal of Urology 2009.