Ngama-malformations aphikisiwe wezinso, le-fetus ayikwazi ukusebenza futhi ife ezinyathelweni zakuqala zokukhulelwa, kuyilapho isisu esinezinkinga ezingavamile ngokuvamile sisinda. Abantwana abangaba ngu-10% bazalwa benokukhubazeka okungathí sina kwesistimu ye-genitourinary.
Ukuthuthukiswa kwezinso
Ukuthuthukiswa kwezinso ezingenayo i-intrauterin inqubo eyinkimbinkimbi kakhulu. Ubusuku bokuqala (metanephrosis) bubekwe ohlangothini ngalunye lwesifunda senhliziyo. Khona-ke, ngokukhula okuqhubekayo kwengxenye engezansi ye-fetus, ngayinye yazo iqala ukunyakaza kwayo phezulu endaweni yayo yokugcina indawo (ukufuduka) ngenkathi ngesikhathi esifanayo iphenduka i-axis yayo (ukuzungeza). Okubaluleke kakhulu ekuthuthukiseni izinso ezindala ukuhlanganiswa kwazo kanye nama-crew of the ureters. Izinkinga zokufuduka noma zokujikeleza zisezinhlungwini ezikhubazeka kakhulu zezinso. Ngaphezu kwalokho, lapho kwenziwa intuthuko ye-intrauterine, kungenzeka ukuthi uhlangane zombili izinso zokuqala ngokubunjwa kwezinso ezinkulu.
Izinkinga zezinso
Izinkinga zezinso zibhekene nemingcele emithathu eyinhloko:
• Lesi sifo singathinta eyodwa noma zombili izinso.
• Izinkinga eziningana zingahlanganiswa nezinso ezilodwa.
• Ezinye izimo eziphuthumayo ziyingozi, kodwa imiphumela yezimo ezimbi, ezifana nokutheleleka, zifakazela ekutholeni ukuhlukunyezwa. Uma kwenzeka ukuhlukunyezwa okukhulu, ukwehluleka kwezintuthwane kungase kuthuthuke ngokushesha noma ngemva kokuzalwa kwengane.
Izinsalela zesimo sezinso azihambisani nokulungiswa. Lokhu kufaka:
• Izinso zama-pelvic ezisezindaweni zomzimba. Ukhiwa ngenxa yokuphulwa kokufuduka kwinqubo yokuthuthukiswa kwe-intrauterine. Iningi lalezi zimo ezihlukumezayo azibonakali kahle.
• Ukulimala kwezinso. Mhlawumbe ngezihumusho ezahlukene, okuvame kakhulu yizinso ezinamahhashi. Inqubo yokufuduka ivame ukuphulwa.
• Izinso "ezinamazinyane" ezinjenge-massless, i-clumpy mass etholakala esifundeni se-pelvic. Ukhiwa ngesikhathi sokunamathela kwezinso nokuphulwa kokufuduka. Lezinso ezinjalo azikhombisi izimbangela zempilo.
• I-dystopia ye-cross yezinso. Inso eyodwa iseceleni, eceleni kwesinye izinso.
• izinso ze-Thoracic. Kutholakala emgodini wesifuba, okungase kuhlotshaniswe nokuphulwa kwentuthuko ye-diaphragm (i-septum ene-fibrous-muscular ehlukanisa izikhala ze-thoracic nesisu). Lokhu kuyinkinga engavamile kakhulu, ukulungiswa kokuhlinzwa okulukhuni kakhulu.
• Ukuguga (ukungabikho kokuzalwa) kwezinso. Kuyabonakala ukuthi uma umbungu ungazange ubeke isakhiwo, lapho izitho zika-urogenital kufanele zikhule khona. I-aggateral renal renal agenesis iholela ekufeni kombungu.
I-ureter iyishubhu ye-muscle lapho umchamo ovela ezintsheni ugeleza ungene esikhwameni. Ekuqaleni kwezinyathelo zokuthuthukiswa, kungenzeka ukuthi kunezinkinga eziningana, okuvame ukuholela ekuphazanyeni ekuhambeni komchamo. Ukuphazanyiswa kokuhlanganiswa kwe-ureteric primordia (uhlelo lokuqala lwamanzi we-renal) nge-mesonephros (izinso zamabrionic zakudala) kuholela ekuboshweni kokuthuthukiswa kwezinso (ukuphahlazeka). Kwezinye izimo, ukuthuthukiswa kwezinso kubonakala ngokubunjwa kwe-cystic structure (dysplasia) ye-Aplasia ne-renal dysplasia ngokuvamile
Ukuhlukaniswa kwama-ureters
I-ovula ye-ureteric ingakwazi ukugcizelela futhi idale amakhekhe amaningana angaboni kahle aqondiswa phansi. Ngezinye izikhathi kunokwenzeka ukuthelela lezi zikhathi ngokuthuthukiswa kobuhlungu be-syndrome. Olunye uhlobo oluthile lwe-anomaly luba khona lapho ama-buds ezinqubo ezimbili zokuguqula zikhula zibe umbungu - kulokhu, ukuphindwa kabili kwezinso kwenzeka. Ngamunye wabo une-ureter yayo, engena kulesi sambiso ngokwawo noma ehlangene nomunye. Ukuphazamisa uhlelo lwe-drainage lwezinso luvame ukuhambisana nosizi ngenxa yokukhipha umchamo ukusuka ngaphansi kwesigcawu sibe yingxenyana ephezulu yezinso.
Isiphephelo se-septum yerethral
Ngenxa yokwelapha kokuthuthukiswa kwe-septum yerethral (emkhatsini wezingxenye zamalungu ezitho zangasese kanye ne-rectum), ngezinye izikhathi kukhona ukwandiswa kwe-cystic kwesigaba se-ureter sika esikhuphukela ku-lumen yesisu-i-ureterocele. Izinga eliphansi le-ureterocele livela kaningi futhi ngokuvamile akubangeli izinkinga. Ukwandiswa okuphawulekayo kungaba yindawo yokwakhiwa kwamatshe omchamo. Ukwehliswa okubukhali kwe-orifice ye-ureteral kuholela ekuvinjeni. Ngokuvamile ureterocele, urne reflux, kanye nezinso eziphindaphindiwe kabili zihlangene nesiguli esisodwa. Ukukhubazeka okuvame ukubeletha kwezinxenye ezingezansi zomgudu we-urinary yilokhu:
• ama-valve e-posterior-urethral - ukwakheka kwamapulangwe amabili we-membrane emangcwabeni ye-urethra ye-urethra, okuholela ekuphuleni ukuchama;
• i-hypospadias - ukuthuthukiswa okungaphelele kwe-urethra, lapho ukuvula kwayo kwangaphandle kuphezu kwe-penis noma ngisho nase-scrotum, esikhundleni sokuvula ikhanda le-penis.
Amaphutha ajwayelekile
• Ukufakwa kwesiphambeko sesisindo sodonga sesandulela sodonga sesisu nesisu esiswini ngaphansi kwenkaba. Kulesi simo, ukubola kwesipenisi, ukungafaki kwamagundane emakhaleni ase-scrotum ne-inguinal, futhi kumantombazane - ukuhlunga kwe-clitoris nakho kuyabonakala.
• I-Cloaca exgrophy yisici esibi kakhulu lapho kuhlukaniswa khona isisindo zibe yizinxenye ezimbili (kuzo zonke izimbangi ezingena kuzo) kanye nokuthuthukiswa kwe-penis. Kungenzeka ukuthi kuhileleke emathunjini amancane kanye ne-anus, kanye nokuhlanganiswa kwezimo eziphuthumayo nge-hernia yokuzalwa engavamile.
• I-epispadia - iphutha lodonga olungaphezulu lwe-urethra. Uma ihlangene ne-sphincter yesibindi, isiguli singase sihlupheke ngokungahambisani nomzimba. Ukuxilongwa kokuqala kanye nokulungiswa kokukhubazeka kubaluleke kakhulu ezigulini ezinezinkinga ezingenasifo sokubeletha kwezinso nesisu. Ukusebenza kwenziwa ezindaweni ezinkulu ezikhethekile kanye nolwazi olunzulu ekwelapheni izinkinga ze-urogenital ohlelweni lwezingane. Ezandleni ezisebenzayo, iningi lezinto ezingavamile zesibisi lingalungiswa ngempumelelo.