I-cystitis ye-interstitial: kuyini?

La i-cystitis yezangaphakathi is a isifo sesinye akuvamile kodwa kuyakhubaza okuguqule igama layo. Manje sekubizwa ngokuthi i-painful bladder syndrome. Ibonakala ngobuhlungu esiswini esingaphansi futhi ukunxenxa kaningi ukuchama, imini nobusuku. Lezi zinhlungu kanye nalezi zifiso zokuchama ngokuvamile ziba namandla kakhulu, ngezinye izikhathi azibekezeleleki, kangangokuthi i-cystitis ye-interstitial ingaba ukukhubazeka kwangempela komphakathi, ukuvimbela abantu ukuba bashiye amakhaya abo. Ubuhlungu bungase buthinte i-urethra (umzila othwala umchamo usuka esinyeni uwuyise ngaphandle) futhi, kwabesifazane, isitho sangasese sowesifazane (bheka umdwebo). Ukuchama (i ukuchama) kancane noma aqede ngokuphelele lezi zinhlungu. I-cystitis ye-interstitial iyathinta ikakhulukazi abesifazane. Ingamenyezelwa kunoma iyiphi iminyaka kusukela eminyakeni eyi-18. Okwamanje, alikho ikhambi lalesi simo, okucatshangwa ukuthi sinjalo okungapheliyo.

Qaphela ukuthi ungaphambanisi i-cystitis yezangaphakathi et i-cystitis : I-cystitis "yakudala" isifo somchamo esibangelwa amagciwane; I-cystitis ye-interstitial ayikho hhayi ukutheleleka futhi imbangela yayo akwaziwa.

Ukuvama

Ngokusho kwe-Interstitial Cystitis Association yaseQuebec, cishe abantu baseCanada abangu-150 bathintwa yilesi sifo. Kubonakala sengathi i-cystitis yezangaphakathi ayivamisile eYurophu kunaseNyakatho Melika. Kodwa-ke, kunzima ukuthola isilinganiso esinembile senani labantu abathintekile, njengoba lesi sifo sitholakala kancane. Kulinganiselwa ukuthi kunabantu abaphakathi kuka-1 no-7 abane-cystitis ye-interstitial kubantu abayi-10 eYurophu. E-United States, lesi sifo esivame kakhulu sithinta umuntu oyedwa kwabayi-000.

I-Interstitial cystitis ithinta cishe izikhathi ezi-5 kuye kweziyi-10 kwabesifazane abaningi kunabesilisa. Ngokuvamile kutholakala ukuthi uneminyaka ephakathi kuka-30 no-40, kanti u-25% walabo abathintekayo uneminyaka engaphansi kuka-30.

Izimbangela

Ku-cystitis ye-interstitial, udonga lwangaphakathi lwesinye luyindawo yezinto ezingavamile zokuvuvukala. Izilonda ezincane kulolu donga olungaphakathi esinyeni zingavuza igazi elincane futhi zidale ubuhlungu kanye nesifiso sokuthulula umchamo oneasidi esinyeni.

Umsuka wokuvuvukala obonwe ku- i-cystitis yezangaphakathi akwaziwa ngokuqinisekile. Abanye abantu bahlobanisa ukuqala kwayo nokuhlinzwa, ukubeletha, noma ukungenwa yizifo ezimbi kakhulu esinyeni, kodwa ezimweni eziningi kubonakala kwenzeka ngaphandle kwe-trigger. I-Interstitial cystitis cishe iyi-a isifo se-multifactorial, okuhlanganisa izimbangela eziningana.

Abaningi ezizathwini ziyacutshungulwa. Abacwaningi bavusa lezo zokungezwani komzimba, ukusabela yenza ngokuzenzakalelayo noma inkinga yezinzwa odongeni lwesinye. Akushiywa ngaphandle ukuthi izici zofuzo nazo zinomthelela kukho.

Nawa amathrekhi okukhulunywa ngawo kakhulu:

• Ukuguqulwa kodonga lwesinye. Ngesizathu esithile, ungqimba oluvikelayo olungaphakathi kwesinye isinye (amangqamuzana namaprotheni) alusebenzi kahle kubantu abaningi abane-interstitial cystitis. Lolu ungqimba luvamise ukuvimbela izinto ezicasulayo emchameni ukuthi zingathintani ngqo nodonga lwesinye.
• Isendlalelo sokuvikela esingasebenzi kahle kakhulu se-intravesical. Kubantu abane-interstitial cystitis, lolu ngqimba oluvikelayo luzosebenza kancane. Ngakho-ke umchamo ungacunula esinyeni futhi ubangele ukuvuvukala kanye nomuzwa oshisayo, njengalapho kufakwa utshwala esilondeni.
• Into ebizwa I-AFP noma i-antiproliferative factor itholakala emchameni wabantu abane-interstitial cystitis. Kungase kube icala, ngoba kubonakala kuvimbela ukuvuselelwa kwemvelo nokujwayelekile kwamaseli angaphakathi kwesinye.
• Isifo se-Autoimmune. Ukuvuvukala kwesinye kungabangelwa ukuba khona kwamasosha omzimba ayingozi odongeni lwesinye (i-autoimmune reaction). Amasosha omzimba anjalo atholakale kwabanye abantu abane-interstitial cystitis, ngaphandle kokuthi kwaziwe ukuthi ayimbangela noma umphumela walesi sifo.
• I-Hypersensitivity yemizwa esesinyeni. Ubuhlungu obuzwiwa abantu abane-interstitial cystitis kungase kube ubuhlungu “be-neuropathic,” okungukuthi, ubuhlungu obubangelwa ukungasebenzi kahle kwesimiso sezinzwa sesinye. Ngakho, umthamo omncane kakhulu womchamo ungaba ngokwanele "ukuvusa" imizwa futhi uqalise izimpawu zobuhlungu kunokuba nje umuzwa wokucindezela.

Evolution

I-syndrome iqhubeka ngendlela ehlukile kumuntu nomuntu. Ekuqaleni, i- izimpawu bavame ukuvela bese benyamalala ngokwabo. Izikhathi ze ukuxolelwa ingahlala izinyanga ezimbalwa. Izimpawu zivame ukuba zimbi kakhulu ngokuhamba kweminyaka. Kulokhu, ubuhlungu buyanda futhi isifiso sokuchama siba njalo.

Ezimweni ezinzima kakhulu, i- udinga ukuchama kungenzeka izikhathi ezifika kwezingama-60 emahoreni angama-24. Impilo yomuntu siqu neyomphakathi ithinteka kakhulu. Ubuhlungu ngezinye izikhathi bukhulu kangangokuthi ukudumazeka nokukhungatheka kungaholela abanye abantu ekucindezelekeni, ngisho nasekucindezelekeni. ukuzibulala. Ukusekelwa okuvela kwabathandekayo kubaluleke kakhulu.

kwesifo

Ngokusho kweMayo Clinic e-United States, abantu abane i-cystitis yezangaphakathi bathole ukuxilongwa kwabo ngokwesilinganiso Iminyaka emi-4 ngemuva kokuqala kwalesi sifo. E-France, ucwaningo olwenziwa ngo-2009 lwabonisa ukuthi ukubambezeleka kokuxilonga kwakukude kakhulu futhi kuhambelana neminyaka eyi-7,5.²¹. Lokhu akumangazi ngoba i-cystitis ye-interstitial ingadideka kalula nezinye izinkinga zempilo: ukutheleleka komgudu womchamo, i-endometriosis, ukutheleleka kwe-chlamydial, isifo sezinso, isinye "esisebenza ngokweqile", njll.

Le zokuxilonga Kunzima ukukusungula futhi kungaqinisekiswa kuphela ngemuva kokuthi zonke ezinye izimbangela ezingase zikhishwe. Ngaphezu kwalokho, kuwuthando futhi eyaziwa kabi odokotela. Kusengenzeka ukuthi ifaneleka “njengenkinga yengqondo” noma icatshangwe ngodokotela abaningana ngaphambi kokuba kuxilongwe, kuyilapho isici sangaphakathi sesinye esivuvukalayo sisho kakhulu.

Nazi izivivinyo ezivame kakhulu ezenziwa ukuxilonga i-interstitial cystitis:

• Ukuhlaziywa kokuchama. Isiko nokuhlaziywa kwesampula yomchamo kunganquma ukuthi ikhona yini i-UTI. Uma kuziwa ku-cystitis ye-interstitial, awekho ama-microbes, umchamo awunyumba. Kodwa kungase kube negazi emchameni (hematuria) ngezinye izikhathi ngisho elincane kakhulu (i-hematuria encane kakhulu lapho sibona amangqamuzana egazi abomvu ngaphansi kwesibonakhulu, kodwa alikho igazi ngeso lenyama). Nge-cystitis ye-interstitial, amangqamuzana amhlophe egazi angatholakala nasemchamweni.

• I-Cystoscopie nge-hydrodistension yesinye. Lokhu ukuhlolwa kokubheka udonga lwesinye. Lokhu kuhlolwa kwenziwa ngaphansi kwe-anesthesia jikelele. Isinye sigcwaliswa amanzi kuqala ukuze udonga luhlakazeke. Khona-ke, i-catheter enekhamera ifakwa ku-urethra. Udokotela uhlola i-mucosa ngokuyibuka esikrinini. Ubheka ukuba khona kwemifantu emihle noma ukopha okuncane. Ibiziwe glomeruli, lokhu kuphuma kwegazi okuncane kuyisici kakhulu se-cystitis ye-interstitial futhi ikhona ku-95% yamacala. Kwezinye izimo ezingavamile, kukhona ngisho nezilonda ezivamile ezibizwa ngokuthi Izilonda zikaHunner. Kwesinye isikhathi udokotela uzokwenza i-biopsy. Isicubu esisusiwe sibe sesibhekwa ngaphansi kwesibonakhulu ukuze kuqhutshekwe nokuhlolwa.
• Ukuhlolwa kwe-urodynamic okuhlanganisa uyenza ukuhlolwa kwe-cystometry kanye ne-urodynamic kungenziwa futhi, kodwa lezi zivivinyo ziyancipha kancane kancane, ngoba azicacisi kakhulu ngakho-ke azisizi kakhulu futhi ngokuvamile zibuhlungu. Esimeni se-interstitial cystitis, ngalokhu kuhlolwa sithola ukuthi umthamo wevolumu wesinye uyancishiswa nokuthi isifiso sokuchama nobuhlungu buvela ngevolumu ephansi kunomuntu ongaphethwe yi-interstitial cystitis. Lezi zivivinyo nokho zenza kube nokwenzeka ukubona ukushuba kwesinye (isinye esisebenza ngokweqile) esinye isifo esisebenzayo esibangela isifiso sokuchama.
• Ukuhlolwa kokuzwela kwe-potassium. Kwenziwa kancane kancane, ngoba akucaci kahle ngama-negative angama-25% (ukuhlolwa kuphakamisa ukuthi umuntu akanayo i-interstitial cystitis kuyilapho ku-25% ezimweni kunjalo!) Futhi u-4% wamanga (ukuhlolwa kuphakamisa ukuthi umuntu une-interstitial cystitis!) cystitis uma bengakwenzi).

Ngokusebenzisa i-catheter efakwe ku-urethra, isinye sigcwaliswa ngamanzi. Ngemuva kwalokho, iyathululwa futhi igcwaliswe ngesisombululo se-potassium chloride. (Ijeli ye-Lidocaine iqala ukusetshenziswa eduze nokuvuleka kombhobho ukuze kuncishiswe ubuhlungu bokufaka i-catheter.) Ngesilinganiso sika-0 kuya ku-5, umuntu ubonisa ukuthi uzizwa uphuthuma kangakanani. ukuchama nokushuba kobuhlungu. Uma izimpawu zanda lapho zihlolwa ngesisombululo se-potassium chloride, kungase kube uphawu lwe-interstitial cystitis. Ngokuvamile, akukho mehluko okufanele uzwakale phakathi kwalesi sixazululo namanzi.