Peshaab rokne wale patthe (pelvic floor)

Pelvic floor ke patthe masane, bachedani aur aant ko sahara dete hain. Yeh woh patthe hain jinhein aap peshaab rokne ke liye kasti hain, aur Urdu mein in ka naam bhi yahi hai: peshaab rokne wale patthe.

Jab yeh patthe kamzor hon to do baatein ho sakti hain. Peshaab nikal sakta hai, aur jin aaza ko yeh uthaye rakhte hain woh neeche khisak sakte hain.

Women's Health Concern aur NHS inform, jo Scotland ki sehat service ki website hai, donon peshaab nikalne ki do bari qismein batate hain. Stress incontinence mein peshaab tab nikalta hai jab masane par zor pare, jaise khaansi, hansi ya chheenk par. Urge incontinence mein achanak aur shadeed jane ki haajat hoti hai, aur bathroom pahunchne se pehle peshaab nikal jata hai.

Prolapse tab hota hai jab bachedani, masana ya aant neeche andaam nihani mein ubhar aaye. NHS ki website kehti hai ke 50 se zyada umar ki auraton mein yeh aam hai, aur European Menopause and Andropause Society (EMAS) kehti hai ke taqreeban aadhi auraton ko kisi na kisi darje ka prolapse ho jata hai, aur menopause ke baad is ki alamaat barh jati hain.

NHS prolapse ki nishaniyan yeh batata hai: pait ke nichle hisse ya andaam nihani mein bojh, be-aaraami ya dabao ka ehsaas, koi ubhaar ya gilti jo aap mehsoos kar sakein ya dekh sakein, jinsi taalluq ke dauran dard ya sunn hona, pakhana karne mein mushkil jaise qabz, aur masane ki tabdeeliyan: yeh lagna ke masana poori tarah khali nahin hua, baar baar peshaab aana, ya khaansi, chheenk ya warzish par thora sa peshaab nikal jana.

Prolapse hamesha alamaat nahin deta. NHS kehta hai ke kabhi kabhi yeh kisi aur cheez ke test mein, jaise smear test mein, pata chalta hai.

NHS ki website hamal aur bachchon ki paidaish ko prolapse ki wajoohaat mein ginti hai, aur NHS inform hamal aur normal delivery ko un cheezon mein ginta hai jo peshaab nikal jane ka imkaan barhati hain. Jin auraton ke kai bachche hue, un ki yeh kahani dahaiyon baad bhi tasveer ka hissa hai.

Phir menopause (mahwari ka band hona) aata hai. Prolapse ke baare mein NHS ki website kehti hai ke yeh umar ke saath zyada aam ho jata hai, khaas taur par menopause ke baad. Pakistan Menopause Society ki sifarishaat stress urinary incontinence ko menopause ke baad ke pehle saalon ki genitourinary symptoms mein ginti hain (Table 1).

NHS zyada wazan, lambe arse ki qabz aur zor lagana, na jane wali khaansi, aur pait ke nichle hisse ka operation, jaise bachedani nikalwana, ko bhi prolapse ki wajoohaat mein ginta hai.

• Peshaab rokne wale patthon ki warzish. NHS ki website ise prolapse ke ilaaj mein ginti hai, aam taur par auraton ki sehat ki maahir physiotherapist ke saath, aur NHS inform ise peshaab nikal jane ke pehle ilaajon mein ginta hai. NHS inform par in patthon ko dhoondne aur in ki warzish ka aik guide bhi hai (hawalon mein link hai). Physiotherapist warzishein aap ke hisaab se bana sakti hai.
• Woh wajoohaat jin par aap kuch kar sakti hain. Zyada wazan, lambe arse ki qabz aur na jane wali khaansi, in mein se har aik par doctor se baat karna faida mand hai. Wazan sambhalna dekhein.
• Mashroobaat. NHS inform sharaab aur caffeine wale mashroobaat, jaise chai, coffee aur kuch gas wali botlein, se bachne ya inhein kam karne ka mashwara deta hai, aur EMAS caffeine aur sharaab ko un cheezon mein ginti hai jo peshaab nikal jane se juri hain. Agar din bhar ketli charhi rehti hai to chai aur caffeine dekhein.
• Poore jism ki taaqat. PMS ki sifarishaat menopause ki umar ki auraton ke liye apne jism ke wazan aur muzahmat (resistance) wali warzish ginwati hain (Table 6). Wazan uthana dekhein.

Jo prolapse tang kar raha ho, us ke liye NHS ki website yeh ilaaj ginwati hai: andaam nihani mein lagane wali cream, goli ya ring ki shakal mein hormone ka ilaaj, andaam nihani ki pessary (plastic ya silicone ka aik chhota aala jo aaza ko sahara deta hai), peshaab rokne wale patthon ki warzish ke saath physiotherapy, aur agar prolapse shadeed ho to operation. Woh kehti hai ke har prolapse ko ilaaj ki zaroorat nahin, aur faisla aap aur aap ka doctor mil kar karte hain. Peshaab nikal jane ke liye NHS inform masane ki tarbiyat (bladder training) ginta hai, aur agar pehle ilaaj kaam na karein to kuch auraton ke liye dawaein ya operation.

NICE NG23 doctoron ko, un auraton ke liye jinhein genitourinary symptoms bhi hon aur masana bhi zaroorat se zyada hassas ho (overactive bladder), peshaab nikal jane aur prolapse par apni alag hidayat ki taraf bhejta hai, jin mein usi jagah lagane wale estrogen ka istemaal bhi shamil hai (1.5.12). EMAS kehti hai ke usi jagah lagane wala estrogen peshaab nikal jane mein bhi madad kar sakta hai.

NHS inform kehta hai ke peshaab nikal jane ki kisi bhi alamat par apne GP se baat karein. Agar aap ko aisi alamaat hain jo prolapse ho sakti hain, to NHS ki website kehti hai ke GP in ke baare mein pooche ga aur muaina kare ga, aur aap keh sakti hain ke muaina lady doctor kare aur kamre mein koi teesra fard (chaperone) bhi maujood ho.

PMS ki sifarishaat doctoron se kehti hain ke prolapse ki alamaat wali auraton ko aage bhejein, aur jaanch karein agar peshaab nikal jana zindagi par asar daal raha ho, peshaab ki infection baar baar ho, ya peshaab mein khoon aaye (Table 2 aur 4).

Jo aurat din mein paanch baar namaz parhti hai, us par peshaab nikal jana bhaari par sakta hai, kyunke is ke saath paaki aur wuzu ke sawal aate hain. Auratein yeh sawal poochti hain, aksar chupke se. Yeh sawal kisi mustanad aalim se poochne ke hain.

Ghar mein peshaab nikal jana chhupana aasaan hai aur is par baat karna mushkil. Agar kisi behan ya aap ki ammi ko bhi yahi masla hai to ise zabaan par le aana shayad woh dhakka ho jis ki aap mein se kisi ko doctor ke paas jane ke liye zaroorat hai.