Ukuvinjelwa kwe-UPJ

Ukuhlangana kwe-Ureteropelvic (UPJ) ukuvinjelwa lapho ingxenye yenso inamathela kwelinye lamashubhu esinyeni (ureters). Lokhu kuvimba ukuphuma komchamo ezinso.

Ukuvinjelwa kwe-UPJ kwenzeka kakhulu ezinganeni. Imvamisa kwenzeka lapho ingane isakhula esibelethweni. Lokhu kubizwa ngesimo sokuzalwa (esikhona kusukela ekuzalweni).

Ukuvinjelwa kubangelwa lapho kukhona:

• Ukuncipha kwendawo phakathi kwe-ureter nengxenye yezinso ebizwa nge-renal pelvis
• Isitsha segazi esingajwayelekile esiwela i-ureter

Ngenxa yalokho, umchamo uyakha futhi ulimaze izinso.

Ezinganeni ezindala nakubantu abadala, inkinga ingahle ibangelwe izicubu ezibomvu, ukutheleleka, ukwelashwa kwangaphambi kwesikhathi kokuvinjelwa, noma amatshe ezinso.

Ukuvinjelwa kwe-UPJ kuyimbangela ejwayelekile yokuvinjelwa komchamo ezinganeni. Manje isitholakala ngokujwayelekile ngaphambi kokuzalwa ngokuhlolwa kwe-ultrasound. Kwezinye izimo, isimo singahle singabonakali kuze kube ngemuva kokuzalwa. Ukuhlinzwa kungadingeka ekuqaleni kwempilo uma inkinga inkulu. Isikhathi esiningi, ukuhlinzwa akudingeki kuze kube kamuva. Ezinye izimo azidingi ukuhlinzwa nhlobo.

Kungase kungabikho zimpawu. Lapho izimpawu zivela, zingabandakanya:

• Ubuhlungu emuva noma ohlangothini ikakhulukazi lapho udla isisu esifana notshwala noma i-caffeine
• Umchamo wegazi (hematuria)
• Isigaxa esiswini (esiswini)
• Ukutheleleka kwezinso
• Ukukhula kabi kwezinsana (ukwehluleka ukukhula)
• Ukutheleleka ngomgudu womchamo, imvamisa kuba nomkhuhlane
• Ukuhlanza

I-ultrasound ngesikhathi sokukhulelwa ingakhombisa izinkinga zezinso enganeni engakazalwa.

Ukuhlolwa ngemuva kokuzalwa kungabandakanya:

• BUN
• Imvume ye-Creatinine
• Iskena se-CT
• Ama-electrolyte
• IVP - ayisetshenziswa kakhulu
• I-CT urogram - ukuskena zombili izinso nama-ureters anokungafani kwe-IV
• Iskena senuzi sezinso
• Ukuvala i-cystourethrogram
• I-Ultrasound

Ukuhlinzwa ukulungisa ukuvinjelwa kuvumela umchamo ukugeleza ngokujwayelekile. Isikhathi esiningi, ukuhlinzwa okuvulekile (okuhlasela) kwenziwa ezinganeni. Abantu abadala bangalashwa ngezinqubo ezingangenisi kakhulu. Lezi zinqubo zibandakanya ukusikeka okuncane kakhulu kunokuhlinzwa okuvulekile, futhi kungafaka:

• Inqubo ye-Endoscopic (retrograde) ayidingi ukusikwa kokuhlinzwa esikhunjeni. Esikhundleni salokho, kufakwa insimbi encane ku-urethra nasesinyeni naku-ureter ethintekile. Lokhu kuvumela udokotela ohlinzayo ukuthi avule ukuvimba ngaphakathi.
• Inqubo ye-Percutaneous (antegrade) ifaka ukusika okuncane ohlangothini lomzimba phakathi kwezimbambo nesinqe.
• IPyeloplasty isusa izicubu ezibomvu endaweni evinjiwe futhi ixhuma kabusha ingxenye enempilo yezinso ku-ureter enempilo.

I-Laparoscopy nayo isetshenziselwe ukuphatha ukuvinjelwa kwe-UPJ ezinganeni nakubantu abadala abangaphumelelanga ngezinye izinqubo.

Kungabekwa ithubhu ebizwa nge-stent ukukhipha umchamo ezinso kuze kube yilapho ukuhlinzwa kuphola. Ishubhu le-nephrostomy, elibekwe ohlangothini lomzimba ukukhipha umchamo, lingadingeka futhi isikhashana ngemuva kokuhlinzwa. Lolu hlobo lweshubhu lungasetshenziselwa ukwelapha ukutheleleka okubi ngaphambi kokuhlinzwa.

Ukuthola nokwelapha inkinga kusenesikhathi kungasiza ekuvimbeleni ukulimala kwezinso esikhathini esizayo. Ukuvinjelwa kwe-UPJ okutholwe ngaphambi kokuzalwa noma ekuqaleni kokuzalwa kungathuthukisa kukodwa.

Iningi lezingane lenza kahle futhi alinazo izinkinga zesikhathi eside. Ukulimala okukhulu kungahle kwenzeke kubantu abatholwa kamuva empilweni.

Imiphumela yesikhathi eside inhle ngemithi yokwelashwa yamanje. IPyeloplasty inempumelelo enhle yesikhathi eside.

Uma kungalashwa, ukuvinjelwa kwe-UPJ kungaholela ekulahlekelweni unomphela komsebenzi wezinso (ukwehluleka kwezinso).

Amatshe ezinso noma ukutheleleka kungenzeka ezinso ezithintekile, nangemva kokwelashwa.

Shayela umhlinzeki wezempilo uma ingane yakho ine:

• Umchamo onegazi
• Imfiva
• Isigaxa esiswini
• Izinkomba zobuhlungu beqolo noma ubuhlungu ezinhlangothini (indawo ebheke ezinhlangothini zomzimba phakathi kwezimbambo nokhalo)

Ukuvinjelwa kwe-ureteropelvic; Ukuvinjelwa kokuhlangana kwe-UP; Ukuvinjelwa komgwaqo we-ureteropelvic

• Ukwakheka kwezinso

Umdala JS. Ukuvinjelwa komgudu womchamo. Ku: Kliegman RM, St Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Incwadi kaNelson Yezingane. Umhlaka 21. IPhiladelphia, PA: Elsevier; 2020: isahluko 555.

UFrøkiaer J. Ukuvinjelwa kwe-Urinary tract. Ku: Skorecki K, Chertow GM, Marsden PA, Taal MW, Yu ASL, ama-eds. IBrenner neRector's The Kidney. Umhlaka 10. IPhiladelphia, PA: Elsevier; 2016: isahluko 38.

IMeldrum KK. I-Pathophysiology yokuvinjelwa komgudu womchamo. Ku: Wein AJ, Kavoussi LR, Partin AW, Peters CA, ama-eds. ICampbell-Walsh Urology. Umhla ka-11. IPhiladelphia, PA: Elsevier; 2016: isahluko 48.

I-Nakada SY, i-Best SL. Ukuphathwa kokuvinjelwa okuphezulu komgudu womchamo. Ku: Wein AJ, Kavoussi LR, Partin AW, Peters CA, ama-eds. ICampbell-Walsh Urology. Umhla ka-11. IPhiladelphia, PA: Elsevier; 2016: isahluko 49.

UStephany HA, Ost MC. Izinkinga ze-Urologic. Ku: Zitelli BJ, McIntire SC, Nowalk AJ, ama-eds. UZitelli noDavis ’Atlas of Pediatric Physical Diagnosis. Umhla wesi-7. IPhiladelphia, PA: Elsevier; 2018: isahluko 15.