Inketho kulabo abangenako ukuthatha okanye abangafumani imiphumo kwimithi
Iingxaki zesiswini kwi- multiple sclerosis ziqhelekileyo, zichaphazela malunga nama-80 ekhulwini abantu. Zineempembelelo zonyango kunye nengqondo, njengoko zinokubangela izifo zokungcungcutheka kwamanzi, iingxaki zeengso, ukuhlukana kwezentlalo kunye nokunciphisa ukuzithemba kunye / okanye umgangatho wobomi.
Iindaba ezilungileyo kukuba kukho iindlela ezifanelekileyo zokulawula le mpawu ephazamisayo kunye ne-MS.
Ezi zonyango ziquka iinkcubeko ezifana nezindlela zokuphila kunye namachiza, kunye nokungenjalo zendabuko ezifana neenjini zeBotox .
Ngaphambi kokuqwalasela i-Botox njengonyango kwiingxaki zakho ze- MS-ezihlobene ne-bladder , kuqiqa ukuqonda ngokucacileyo ukuba isisombululo sisebenza njani kwaye sichaphazeleka njani yi-MS.
Umsebenzi weBladder Health
Ngomntu onempilo, umchamo uhamba ukusuka kwiintso ukuya kwiindawo ezikhungayo ngokusebenzisa ezimbini izibatho ezibizwa ngokuthi i-ureters. Emva kokuba i-bladder ithwele malunga nee-ounces ezi-8 ze-urine, iyakwandisa, ivuselele iimbilini ukuze ithumele umqondiso kwintambo yomgogodla (leyo ibonisa intsingiselo yengqondo) ukuba i-vestile idinga ukukhupha. Le nkqubo yintoni eyenza unomuvo wokuba ufanele ucole.
Emva koko, emva kokuba ufumane indawo yokuhlambela, iimbilini ezisengqondweni zithumela umqondiso kwintambo yomgogodla ukuze uqalise i-voiding reflex. Ngethuba le-reflex, i-detrusor yakho (i-bladder) yezivumelwano ze-muscle okanye ikhupha ukukhupha umchamo kwi-bladder.
Ngexesha elifanayo, umsila wakho wangaphandle uhlalisa umchamo ukuvumela ukuba umchamo uphume kwi-bladder, nge-urethra, nangaphandle komzimba.
I-Bladder Dysfunction kwi Multiple Sclerosis
Kwi-multiple sclerosis, izilonda zesibindi sokutshintshwa kwentsholongwane ebuchosheni kunye nentambo yomgogodla ngokuqhelekileyo ukulawula i-detrusor muscle kunye ne-outer sphincter muscle.
Oku kunokukhokelela kwiingxaki ezintathu ezihlukeneyo:
- Isambatho sigcina iingxaki
- Iingxaki zokukhupha iingxaki
- I-bladder ehlanganisiweyo igcina kunye nokukhupha iingxaki
Isambatho Ukugcina Iingxaki (Isibhambathiso Esingasebenzi)
Kwamanye abantu abane-MS, isisundu se-detrusor sinakho isivumelwano (okanye sichaza) xa kungacingi ukuba (xa i-bladder yakho ithwele umchamo omncinci) ukwenza ukuba uzive ngathi ufuna ukuchukumisa lonke ixesha. Ezi zimpawu zibhekiswa njengongxamiseko lwe-urinary kunye namaxesha amaninzi. Ungabona kwakhona ukuba uvuka ebusuku ukuze usebenzise indlu yokuhlambela, okanye unokufumana ukulahleka komchamo-ekuthiwa unxusa ukungahambisani .
Iingxaki zokukhupha izibilini (Isisombululo esipheleleyo)
Kwabanye, i-reflection vocking ayinamandla kangangokuba i-bladder-ihamba ngaphandle kokubonakalisa ingqondo kunye nomgudu womgudu umntu ofuna ukuwukhupha. Oku kunokukhokelela ekubeni umchamo uqhubeke, ukungabinqikazi ekuqaliseni ukucoca, okanye ukulahleka okungalawulekiyo komchamo okubizwa ngokuthi ukungcola kokungahambi.
I-Storage Bladder kunye neZiphumo zokuThumela
Kusenjalo abanye abantu bafumana intlangano yeendlela ezimbini zeengxaki zesibhanxa. Ngalesi sihlandlo, izilonda ze-MS ebuchosheni kunye nentambo yomgudu kubangela ukungahambi kakuhle phakathi kwe-detrusor muscle kunye nemisipha yomzimba yangaphandle, obangela ukuba bobabini bankontileka ngexesha elinye.
Oku kubambelela umchamo kwi-bladder ebangela ukuphuthunyiswa kwe-urinary (njengokuba kufuneka ulungise ngokukhawuleza), ukukhawuleza ekuqalekeni, ukucima umchamo (abantu abaninzi banxiba ipakiti engabonakaliyo), okanye ukulahleka komchamo.
IziNyango zeNdabuko zeNgqungquthela ezingasebenzi okanye eziseSpastic kwi-MS
Ukuba unayo i-MS kwaye ufumana izibonakaliso zesikhumba esipheleleyo (njengokuba ufumana unqweno ngokukhawuleza ukuzula kunye nokucoca rhoqo) i-neurologist yakho iya kuqala iphakanyise ukungenelela kwendlela yokuphila kunye neyeza zokulwa ne-anticholinergic.
Ukungenelela okuqhelekileyo kokuphila kubandakanya ukunciphisa i-caffeine kunye nokusetyenziswa kotywala kunye nokuphepha ukukhupha emva kokutya kunye nangaphambi kokulala.
I-neurologist yakho inokuphinda icetyise ukuba abafazi banxibe ipakethe e-absorbent okanye amadoda agqoke i-catheter yokunciphisa ukukhathazeka kwanaluphi na ukulahleka komchamo ngelilanga ngaphandle koluntu.
Amachiza e-Anticholinergic afana neDeterrol (tolterodine) okanye iVesicare (solifenacin succinate) inokukunceda ekunciphiseni iimpawu zokuvutha kwamanzi, ukuphuthuma kunye nokungaziphathi-nangona kungabangela iziphumo ezimbi ezingathandekiyo njengokuzibamba, ukulala, kunye nomlomo owomileyo. Musa ukumangaliswa nangona kufuneka uzame isibini ngaphambi kokufumana unyango olusebenza kuwe.
Iyeza elitsha elibizwa ngokuba yi-Myrbetriq (mirabegron) lisebenza ngokukhulula umsizi ojikeleze isisu, ukuvumela ukuba ubambe umchamo. Uphando lubonisa ukuba lusebenza ngolu hlobo njenge-anicholinergics ekunciphiseni ukungabikho kwamanzi okuvuthwa kwamanzi (ngaphandle kokusebenza ngendlela eyiyo njengeVesicare).
Uphando lubonisa ukuba kunokunyamezeleka kangcono, njengoko kungabangela umlomo owomileyo, umphumo othe wanciphisa umda we-anticholinergics ezininzi. Oku kuthetha ukuba, iziphumo eziqhelekileyo zemizila ye-Myrbetriq ziquka intloko, iimpawu ezibandayo, ukwanda kwengcinezelo yegazi kunye nokusuleleka kwe-urinary tract tract.
I-Botox Mhlawumbi Yibe Isinyathelo Esilandelayo Ukuba Imithi Ayisebenzi
Ukuba uqhubeka ufumana i-bladder ukukhupha iingxaki ezinxulumene ne-MS yakho nangona unyango lwe-anticholinergic, i-neurologist yakho ingancoma i-onabotulinumtoxin A (BOTOX) -yonyango evunyiweyo yi-United States Yokutya kunye neDrug Administration (FDA) ekuphatheni ukungahambisani nokugqithisa.
Ngaba i-Botox isebenza ekuPhatheni isantya esingaphezulu kwe-MS?
Uphando olubanzi kwi- Urology yaseYurophu yahlola imiphumo yeBotox ekunciphiseni ukunganyaniseki kubantu abanomdla wokungabikho komsebenzi kwi-MS okanye umonakalo wentambo yomgogodla. Iziphumo zesifundo zafumanisa ukuba emva kweveki ezili-12, abathathi-nxaxheba be-MS abaye baphathwa ngeBotox bafumana ukungabikho kwamanzi okuhamba nge-1.5 kangaphantsi kweentsuku kunabathathi-nxaxheba be-MS abaphathwa ngejoza ye-placebo.
Ukongezelela, isifundo safumanisa ukuba abathathi-nxaxheba be-MS baphathwe nge-BOTOX bavale malunga ne-86 milliliters ngaphezulu komchamo ngaphandle kokuthatha inxaxheba ababenendawo yokubeka indawo.
Yintoni ongayilindela Ngethuba le-Botox Injection yakho
Ugqirha wakho uza kuhlola kuqala ngaphakathi kwesikhumba sakho usebenzisa i-cystoscope-ityhubhu encinane enekhamera ekugqibeleni.
Ugqirha uya kwandula i-detrusor muscle kwiindawo ezininzi (malunga ne-30) kunye neBotox, ebangela ukuba uphumule. Oku kuvumela ukuba i-vestile ibambe umchamo ongakumbi ukuze i-muscle ingayisebenzanyanga okanye idibanise onke amaxesha, ngaloo ndlela iyanciphisa iimpawu zokuphuthunyiswa kwe-urinary, ukuphindaphindiweyo kunye nokungabikho.
Imiphumo emibili echaphazelekayo yeBOTOX yile:
- usulelo lwezonyango
- Ukugcina umchamo kwi-bladder
Ukuze ukhusele ukusuleleka kwintsholongwane engabonakali ngenxa yenkqubo, ugqirha wakho uya kubeka i-antibiotics ukuba ithathe ngaphambi, ngexesha, kunye neentsuku ezimbalwa emva kwonyango lwe-BOTOX.
Kwakhona, ngenxa yobungozi bokugcinwa kwamanzi emva kwonyango lweBotox, ugqirha uya kufuna ukuqinisekisa ukuba ukhululekile ukwenza ucoceko olucoca ngokuzenzekelayo ngaphambi kokunyangwa, kuba oku kusebenza ngokuqhelekileyo.
Enyanisweni, kwisifundo sekliniki esakhankanywe ngasentla kwi-Urology yaseYurophu, malunga nama-30 ekhulwini abathathi-nxaxheba ababengakaze bafune ukuzicoca phambi kweBotox (kwaye baninzi babathathi-nxaxheba be-MS), babedinga ukuzithengisa ukulandelwa kwamanzi emva kokuphathwa kweBotox .
I-Botox nayo iphethe isilumkiso esinokubangela ukuba ingozi ibe yingozi, nokuba nemiphumo ebungozi yobomi njengeengxaki zokugwinya, ukuthetha okanye ukuphefumla ngenxa yokudakalisa kwemizimba. I-toxin ye-botulin ingasasazeka kwezinye iindawo zomzimba kwaye ibangele inani leempawu ezinzulu ezifana nobubuthakathaka obukhulu bomzimba okanye ubunzima bombono. Ngelixa lingaqhelekanga, ezi zilumkiso zigxininisa ukubaluleka kokuxoxwa ngononophelo kunye nogqirha wakho ngaphambi kokuba uphume eBotox.
ILizwi
Iingxaki ze-Urinary kwi-MS ziqhelekile, ngoko ungakhathazeki okanye uhlazeke ukuxoxa nabo nodokotela wakho. Iindaba ezilungileyo kukuba kukho iindlela zokuphila kunye nezonyango ezinokukunceda ukulawula iimpawu kunye neengxaki ezinokwenzeka-kunye neBotox inokukhetha ukuba ezinye iindlela zokwelapha azisebenzi.
> Imithombo:
> Allergan. (NgoJanuwari 2016). Uvunywe yi-US Food and Drug Administration. Isikhokelo seMithi: iBotox.
> Cruz F et al. Ukusebenza kunye noKhuselo lwe-OnabotulinumtoxinA kwizigulane nge-Urinary Incontinence ngenxa ye-Neurogenic Detrusor Ukunyamekela: I-Randomized, Double-Blind, i-Placebo-Controlled Trial. Eur Urol. 2011 I-Oct; 60 (4): 742-50.
> Maman K et al. UkuQhathaniswa koBuchule kunye noKhuselo lweZonyango zezoNyango zoLawulo lwe-Bladder engasebenzi. Eur Urol . 2014 uMbhi; 65 (4): 755-65.
> I-MS Society Society. (2016). Dysfunction kunye ne-MS .
> Weckx F, Tutolo M, De Ridder D, Van der Aa F. Indima ye-Botulinum Toxin A ekwelapheni i-Neurogenic Bladder. Tshintsha u-Androl Urol . 2016 Feb; 5 (1): 63-71.