Amatshe ezinso

Itshe lezinso lingumsindo oqinile owakhiwe ngamakristalu amancane. Itshe elilodwa noma amaningi angaba sezinso noma e-ureter ngasikhathi sinye.

Amatshe ezinso ajwayelekile. Ezinye izinhlobo zisebenza emindenini. Zivame ukuvela ezinganeni ezingaphambi kwesikhathi.

Kunezinhlobo ezahlukene zamatshe ezinso. Imbangela yenkinga incike ohlotsheni lwetshe.

Amatshe angakha lapho umchamo uqukethe izinto eziningi kakhulu ezakha amakristalu. Lezi zinhlayiya zingakhula zibe ngamatshe ngaphezu kwamasonto noma izinyanga.

• Amatshe e-calcium ajwayelekile kakhulu. Zivamise ukwenzeka emadodeni aphakathi kweminyaka engama-20 kuya kwengama-30. I-calcium ingahlangana nezinye izinto zakhe itshe.
• I-oxalate yiyona evame kakhulu kulezi. I-oxalate ikhona ekudleni okuthile okufana nesipinashi. Kutholakala futhi kuma-vitamin C supplements. Izifo zamathumbu amancane zandisa ubungozi kula matshe.

Amatshe e-calcium nawo angakha ngokuhlanganiswa ne-phosphate noma i-carbonate.

Ezinye izinhlobo zamatshe zifaka:

• Amatshe e-cystine angakha kubantu abane-cystinuria. Lesi sifo sisebenza emindenini. Kuthinta abesilisa nabesifazane.
• Amatshe e-Struvite atholakala kakhulu kwabesilisa noma kwabesifazane abaphindaphinde izifo ezithinta umchamo. La matshe angakhula abe makhulu kakhulu futhi angavimba izinso, i-ureter, noma isinye.
• Amatshe e-uric acid atholakala kakhulu kwabesilisa kunabesifazane. Kungenzeka nge-gout noma ngamakhemikhali.
• Ezinye izinto, njengemithi ethile, nazo zingakha amatshe.

Ingcuphe enkulu yamatshe ezinso ukungaphuzi uketshezi olwanele. Amatshe ezinso kungenzeka kakhulu uma wenza umchamo ongaphansi kwelitha elilodwa (ama-ounces angama-32) ngosuku.

Ungahle ungabi nezimpawu kuze kube yilapho amatshe ehambisa phansi amashubhu (ureters) lapho umchamo ungena khona esinyeni sakho. Uma lokhu kwenzeka, amatshe angavimba ukuphuma komchamo ezinso.

Uphawu oluyinhloko ubuhlungu obukhulu obuqala bume ngokungazelelwe:

• Ubuhlungu bungazwakala endaweni yesisu noma ohlangothini lwangemuva.
• Ubuhlungu bungadlulela endaweni ye-groin (ubuhlungu be-groin), amasende (ubuhlungu besende) emadodeni, kanye ne-labia (ubuhlungu besitho sangasese) kwabesifazane.

Ezinye izimpawu zingabandakanya:

• Umbala womchamo ongajwayelekile
• Igazi emchameni
• Amakhaza
• Imfiva
• Isicanucanu nokuhlanza

Umhlinzeki wezokunakekelwa kwempilo uzokwenza ukuhlolwa komzimba. Indawo yesisu (isisu) noma emuva ingazizwa ibuhlungu.

Ukuhlolwa okungenziwa kufaka phakathi:

• Ukuhlolwa kwegazi ukuhlola i-calcium, i-phosphorus, i-uric acid, namazinga e-electrolyte
• Ukuhlolwa kokusebenza kwezinso
• Ukuhlolwa komchamo ukubona amakristalu bese ubheka amaseli abomvu egazini emchameni
• Ukuhlolwa kwetshe ukuthola uhlobo

Amatshe noma ukuvinjelwa kungabonakala ku:

• Iskena se-CT esiswini
• Ama-x-ray esiswini
• I-pyelogram efakwa emithanjeni (IVP)
• Izinso ultrasound
• Phinda wenze kabusha i-pyelogram

Ukwelashwa kuya ngohlobo lwetshe nokuqina kwezimpawu zakho.

Amatshe ezinso amancane kakhulu adlula kuhlelo lwakho eyedwa.

• Umchamo wakho kufanele uhlushwe ukuze itshe ligcinwe futhi lihlolwe.
• Phuza okungenani izingilazi zamanzi eziyisithupha kuya kweziyisishiyagalombili ngosuku ukukhiqiza inani elikhulu lomchamo. Lokhu kuzosiza ukudlula kwetshe.
• Ubuhlungu bungaba bubi kakhulu. Imithi yezinhlungu ezithengiswayo (isibonelo, ibuprofen ne-naproxen), kungaba iyodwa noma ihambisana nezidakamizwa, ingasebenza kakhulu.

Abanye abantu abanezinhlungu ezinzima zamatshe ezinso badinga ukuhlala esibhedlela. Ungadinga ukuthola uketshezi nge-IV emthanjeni wakho.

Kwezinye izinhlobo zamatshe, umhlinzeki wakho angahle anikeze umuthi wokuvimbela amatshe ukuba akhe noma asize ukudiliza nokususa okubangela itshe. Le mithi ingafaka:

• I-Allopurinol (yamatshe e-uric acid)
• Imithi elwa namagciwane (yamatshe e-struvite)
• I-diuretics (amaphilisi wamanzi)
• Izixazululo ze-phosphate
• I-sodium bicarbonate noma i-sodium citrate
• Amaphilisi wamanzi (i-thiazide diuretics)
• I-Tamsulosin yokuphumuza i-ureter nokusiza ukudlula kwetshe

Kuhlinzwa kaningi uma:

• Itshe likhulu kakhulu ukuthi lingazidlulisela ngokwalo.
• Itshe liyakhula.
• Itshe livimba ukugeleza komchamo futhi lidale ukutheleleka noma ukulimala kwezinso.
• Ubuhlungu abunakulawulwa.

Namuhla, izindlela eziningi zokwelapha azihlaseli kakhulu kunangesikhathi esedlule.

• I-Lithotripsy isetshenziselwa ukususa amatshe amancane kancane kunesentimitha elilodwa (1.25 amasentimitha) atholakala ezinso noma ku-ureter. Isebenzisa umsindo noma ukushaqisa amagagasi ukuhlephula amatshe abe yizicucu ezincane. Ngemuva kwalokho, izingcezu zamatshe zishiya umzimba emchameni. Kubizwa nangokuthi i-extracorporeal shock-wave lithotripsy noma i-ESWL.
• Izinqubo ezenziwa ngokudlulisa ithuluzi elikhethekile ngokusika okuncane esikhunjeni sakho emhlane wakho nasezinsweni zakho noma kuma-ureters kusetshenziselwa amatshe amakhulu, noma lapho izinso noma izindawo ezizungezile zakhiwe ngokungalungile. Itshe lisuswa ngepayipi (endoscope).
• I-Ureteroscopy ingasetshenziselwa amatshe endaweni engezansi yomchamo. Kusetshenziswa i-laser ukuqhekeza itshe.
• Imvamisa, ukuhlinzwa okuvulekile (nephrolithotomy) kungadingeka uma ezinye izindlela zingasebenzi noma zingenzeki.

Khuluma nomhlinzeki wakho mayelana nokuthi yiziphi izindlela zokwelashwa ezingakusebenzela.

Uzodinga ukuthatha izinyathelo zokuzinakekela. Iziphi izinyathelo ozithathayo zincike ohlotsheni lwetshe onalo, kepha zingabandakanya:

• Ukuphuza amanzi athe xaxa nezinye iziphuzo
• Ukudla okunye kokudla nokunciphisa okunye ukudla
• Ukuthatha imithi yokusiza ukuvimbela amatshe
• Ukuthatha imithi ukukusiza udlulise itshe (izidakamizwa ezilwa nokuvuvukala, ama-alpha-blockers)

Amatshe ezinso abuhlungu, kepha isikhathi esiningi singasuswa emzimbeni ngaphandle kokudala ukulimala okuhlala njalo.

Amatshe ezinso avame ukubuya. Lokhu kwenzeka kaningi uma imbangela ingatholakali futhi yelashwa.

Usengozini yokuthi:

• Ukutheleleka ngomgudu womchamo
• Ukulimala kwezinso noma isibazi uma ukwelashwa kubambezeleka isikhathi eside kakhulu

Ukuxakaniseka kwamatshe ezinso kungafaka ukuvinjelwa kwe-ureter (acute unilateral obstructive uropathy).

Shayela umhlinzeki wakho uma unezimpawu zetshe lezinso:

• Ubuhlungu obukhulu emhlane wakho noma ohlangothini obungeke buphele
• Igazi emchameni wakho
• Umkhuhlane namakhaza
• Ukuhlanza
• Umchamo onuka kabi noma obukeka unamafu
• Umuzwa ovuthayo lapho uchama

Uma kutholakale ukuthi unenkinga yokuvaleka etsheni, indinyana kufanele iqinisekiswe ngokubanjwa ku-strainer ngesikhathi sokuchama noma nge-x-ray yokulandelela. Ukungabi nezinhlungu akuqinisekisi ukuthi itshe selidlulile.

Uma unomlando wamatshe:

• Phuza uketshezi oluningi (izingilazi eziyisithupha kuya kweziyisishiyagalombili zamanzi ngosuku) ukukhiqiza umchamo owenele.
• Ungahle udinge ukuthatha umuthi noma wenze izinguquko ekudleni kwakho kwezinye izinhlobo zamatshe.
• Umhlinzeki wakho angafuna ukwenza ukuhlolwa kwegazi nomchamo ukusiza ukunquma izinyathelo ezifanele zokuvimbela.

I-renal calculi; I-Nephrolithiasis; Amatshe - izinso; I-calcium oxalate - amatshe; Cystine - amatshe; Struvite - amatshe; Uric acid - amatshe; I-lithiasis ye-Urinary

• Hypercalcemia - ukukhipha
• Izinso zamatshe kanye ne-lithotripsy - ukukhishwa
• Izinso zezinso - ukuzinakekela
• Izinso zamatshe - okufanele ubuze udokotela wakho
• Izinqubo zomchamo ezinamandla - ukukhipha

• Ukwakheka kwezinso
• Izinso - ukugeleza kwegazi nomchamo
• I-Nephrolithiasis
• I-pyelogram efakwa emithanjeni (IVP)
• Inqubo yeLithotripsy

Iwebhusayithi yeAmerican Urological Association. Ukuphathwa kwezokwelapha kwamatshe ezinso (2019). www.auanet.org/guidelines/kidney-stones-medical-mangement- guideline. Kufinyelelwe ngoFebhuwari 13, 2020.

Iwebhusayithi yeAmerican Urological Association. Ukuphathwa kokuhlinzwa kwamatshe: Umhlahlandlela we-AUA / Endourology Society (2016) www.auanet.org/guidelines/kidney-stones-surgical-management- guideline. Kufinyelelwe ngoFebhuwari 13, 2020.

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