I-Varicocele

I-Varicocele yisimo sezokwelapha esivamile esithinta amadoda amaningi emhlabeni wonke, okubangela ukungakhululeki kanye nezinkinga ezingase zibe khona zokuzala. I-Varicocele yenzeka lapho imithambo ku-scrotum ikhula, efana nemithambo ye-varicose emilenzeni. Ukuqonda izimbangela, izimpawu, nezindlela zokwelapha i-varicocele kubalulekile empilweni nasenhlalakahleni yamadoda.

Lesi sihloko sihlola i-varicocele, ihlanganisa izimpawu zayo, izimbangela, nokuxilongwa. Sizoxoxa ngezindlela zokwelashwa ezahlukahlukene, okuhlanganisa ukuhlinzwa kanye nezinketho ezingahlinzeki, kanye nezinkinga ezingaba khona nezici eziyingozi. 

Iyini i-Varicocele?

I-varicocele yisifo esivamile esenza imithambo ye-scrotum ikhule. I-scrotum, isikhwama sesikhumba ngemuva komthondo, ngokuvamile siqukethe amasende. I-Varicoceles ifana ne-varicose veins, ebangela ukuvuvukala nokungahambi kahle kwemithambo yomlenze. Nakuba kungekona ukuphila engozini, i-varicoceles ingaba nomthelela omkhulu ekukhuleni kwalabo abazama ukuba nezingane zemvelo. Angathinta abantu abanamasende kunoma ibuphi ubudala, kodwa odokotela bakholelwa ukuthi baningi abakhona lapho bezalwa. Abantu bavame ukuqaphela ama-varicoceles phakathi neminyaka yabo yobusha, okungenzeka ngenxa yokwanda kokujikeleza kwegazi ezithweni zangasese ngesikhathi sokuthomba. Nakuba i-varicoceles ingazibeki izingozi zempilo ngokushesha, idinga ukunakekelwa, ikakhulukazi kulabo abakhathalela impilo yabo yokuzala.

Izimpawu ze-Varicocele

I-Varicoceles ivame ukungabonakali, njengoba ngokuvamile ingabangeli izimpawu. Nokho, amanye amadoda angase abe nezimpawu ezithile. Lokhu kubandakanya: 

• Ubuhlungu obungafihli, obuqhubekayo noma ubuhlungu ku-scrotum, obuvame ukuba ngcono lapho ulele 
• Ukuvuvukala kumasende noma i-scrotum 
• Amanye amadoda angase abone isigaxa esincane ngaphezu kwesende elithintekile
• Kwezinye izimo, i-varicoceles ingaholela ku-testicular atrophy, okubangela ukuba amasende anciphe
• Lesi simo singase sibe nomthelela ezindabeni zokuzala, kwenze kube nzima ngemibhangqwana ukuzuza ukukhulelwa ngemva konyaka bezama. 

Kubalulekile ukuqaphela ukuthi nakuba lezi zimpawu zingenzeka, amadoda amaningi ane-varicoceles ahlala engenazo izimpawu.

Izinkinga ze-Varicocele

Ochwepheshe bezokwelapha bahlala bengaqiniseki ngezimbangela eziqondile ze-varicoceles. Basola ukuthi ama-valve anephutha emithanjeni yentambo yesidoda angase adlale indima. Lawa mavalvu ngokuvamile alawula ukugeleza kwegazi kusuka emasendeni libuyele emzimbeni. Uma zingasebenzi kahle, igazi linganqwabelana emithanjeni, kubangele ukuthi ivuvuke ngokuhamba kwesikhathi.

I-Varicoceles ingathinta abantu abanamasende kunoma ibuphi ubudala. Abaningi kukholakala ukuthi baba khona lapho bezalwa, kodwa ngokuvamile babonakala phakathi neminyaka yobusha. Lesi sikhathi singase sihlobane nokwanda kokugeleza kwegazi esithweni sangasese ngesikhathi sokuthomba. Kwezinye izimo, i-varicoceles ingavimbela ukukhula okufanele kwe-testicle.

Nakuba imbangela eqondile ingakacaci, ukuqonda lezi zici ezingase zibe khona kusiza odokotela babhekane nalesi simo ngokuphumelelayo.

Ukuxilongwa kwe-Varicocele

Odokotela baxilonga i-varicoceles ngokusebenzisa inhlanganisela yezindlela. 

• Umlando Wezokwelapha Nokuhlaziywa Komzimba: Udokotela uzobuza ngezimpawu futhi abuyekeze umlando wezokwelapha wesiguli. Ukuhlolwa komzimba kuyalandela, lapho umhlinzeki ezwa khona i-scrotum yemithambo ekhulisiwe. I-Valsalva maneuvre, ehilela ukuzikhandla ngenkathi ubambe umoya, isiza ukwenza ama-varicoceles abonakale kakhulu phakathi nokuhlolwa.
• I-Pelvic Ultrasound: Lokhu kuhlolwa kwe-imaging okungahlaseli kunikeza umbono oningiliziwe wemithanjeni yamasende.
• Ukuhlaziywa Kwesidoda: Lokhu kuhlolwa kuhlola impilo yesidoda ukubona ukuthi kukhona yini ukukhathazeka kokuzala.
• Ukuhlolwa kwegazi: Amazinga e-hormone, okuhlanganisa i-FSH ne-testosterone, ayahlolwa.

Ngemuva kokuqinisekisa ubukhona be-varicocele, umhlinzeki ubeka ukuqina kwayo. Lezi zinyathelo zokuxilonga zisiza odokotela ukuba bakhe uhlelo lokwelapha olufanele lwesimo esithile sesiguli ngasinye.

Ukwelashwa kwe-Varicocele

Odokotela baphatha i-varicoceles ngezindlela ezihlukahlukene, kuye ngobunzima nezimpawu. 

• Nge-varicoceles yezinga eliphansi, odokotela bavame ukutusa ukwelashwa ekhaya. Lokhu kubandakanya:
  • Ukugwema imisebenzi edala ukungakhululeki
  • Gwema ukugqoka izingubo zangaphansi ezimpintshayo ngesikhathi sokuzivocavoca
  • Ukufaka iqhwa ku-scrotum 
  • Ukusebenzisa imishanguzo yezinhlungu ngaphandle kwe-counter
• Ukuhlinzwa: Indlela evamile yokuhlinzwa i-varicocelectomy, lapho udokotela ohlinzayo esika futhi evala imithambo ethintekile ukuze aqondise kabusha ukugeleza kwegazi. Indlela ye-microsurgical subinguinal isiphenduke indinganiso yegolide ngenxa yamazinga ayo aphansi ezinkinga kanye nemiphumela engcono.
• I-Microsurgical Varicocelectomy: Kuyinqubo yokuhlinza engavamile kakhulu esetshenziselwa ukwelapha i-varicocele, isimo lapho imithambo ku-scrotum ikhula khona. Lesi simo singabangela ubuhlungu, ukungakhululeki, ngisho nokungazali. Phakathi nenqubo, udokotela ohlinzayo usebenzisa isibonakhulu esinamandla amakhulu ukuze abophe ngokucophelela emithanjeni ethintekile, esiza ukubuyisela ukugeleza kwegazi okufanele nokuthuthukisa izinga lesidoda. I-Microsurgical varicocelectomy ivame ukutuswa emadodeni anezimpawu ezihlobene ne-varicocele, ikakhulukazi uma ithinta inzalo noma ibangela ukungakhululeki okukhulu.
• I-Percutaneous Embolisation: Inqubo ehlasela kancane lapho udokotela we-radiologist evimba umthambo onenkinga esebenzisa amakhoyili noma isixazululo esinesibazi. Le ndlela yokufundisa inikeza isikhathi sokululama esisheshayo, iziguli ngokuvamile eziqala kabusha umsebenzi phakathi kwezinsuku ezingu-1-2.

Izingozi ze-Varicocele

Izici eziningana zandisa amathuba okuthuthukisa i-varicocele. 

• Iminyaka yobudala: Abafana abasebasha kanye nabantu abadala abasebasha abaneminyaka engu-15-25 basengozini enkulu. I-Genetics: Abantu abanomlando womndeni babhekene nengozi enkulu. 
• Izici eziningana ze-anatomical, njengezakhiwo ze-vein ezingavamile, zingabeka amadoda athile ku-varicocele. 
• Ukuzikhandla ngokomzimba, ikakhulukazi imisebenzi ehlanganisa ukuma isikhathi eside noma ukuphakamisa izinto ezisindayo, kungase kwandise ingozi. 
• Ngokuphambene, ukuphila unganyakazi kungaphazamisa ukujikeleza kwegazi futhi kukhuphule umfutho we-venous. 
• Imisebenzi ethile, njengokushayela iloli noma umsebenzi wokwakha, ibeka engcupheni enkulu. 
• Ukukhuluphala kanye nokuchayeka ekushiseni ngokweqile ku-scrotum nakho kungafaka isandla ekuthuthukisweni kwe-varicocele. 

Izinkinga ze-Varicocele

I-Varicoceles ingaholela ezinkingeni eziningana, njenge:

• Ama-varicoceles amakhulu angase akhulise ingozi ye-testosterone ephansi, eyaziwa nangokuthi i-hypogonadism yabesilisa. Lesi simo singabangela ukushwabana kwamasende, ukuncipha komdlandla wobulili, ukuncipha kwemisipha, nokucindezeleka.
• Enye inkinga engaba khona yi-azoospermia, lapho kungekho khona isidoda ku-ejaculate, okuholela ukungabi namuntu. 
• Kuyathakazelisa ukuthi i-varicocele iye yaxhunyaniswa nokungazali kwabesilisa, okuthinta i-35-40% yamadoda anezinkinga zokuzala.
• Ukulungiswa kwe-Varicocele, ngenkathi kusebenza, kunezingozi zayo. Lokhu kufaka i-varicocele eqhubekayo noma ephindaphindiwe, ukulimaza, ukutheleleka, kanye nokuthamba kwesende. I-hydrocele (iqoqo lamanzi elizungeze amasende) lingenzeka ezimweni ezingavamile. 
• Ukulungisa okungekona ukuhlinzwa kunengozi eyengeziwe yokusabela kumenzeli ohlukile osetshenzisiwe. Nakuba kuyivelakancane kakhulu, kunengozi encane yokulahlekelwa kwesende. Naphezu kwalezi zinkinga ezingase zibe khona, ukwelashwa kwe-varicocele kusalokhu kubalulekile ekulawuleni izimpawu nokugcina inzalo.

Uzoyibona Nini Udokotela

Amadoda kufanele abonane nodokotela uma eba nezimpawu ze-varicocele noma abe nobunzima bokuthola umlingani wawo abakhulelwe. I-varicocele ngokuvamile ingabangeli ubuhlungu noma ukungakhululeki futhi ingase itholakale ngesikhathi sokuhlolwa kwempilo kahle noma ukwelashwa kokuzala. Kodwa-ke, uma othile ezwa ubuhlungu, ukungakhululeki, noma ukuvuvukala ku-scrotum noma i-groin, kufanele abonane nodokotela wakhe. Uma unokukhathazeka mayelana nekhono lakho lokuba nengane ephilayo, khuluma nodokotela. 

Prevention

Ochwepheshe bezokwelapha basalokhu bengaqiniseki ngezimbangela eziqondile ze-varicoceles, okwenza ukuvimbela kube inselele. Kodwa-ke, abantu ngabanye bangathatha izinyathelo zokuthuthukisa impilo yonke ye-vascular, njenge:

• Ukuvivinya umzimba njalo, njengokubhukuda noma ukuhamba ngokushesha, kukhuthaza ukugeleza kwegazi okunempilo nokujikeleza kwegazi. Zama okungenani imizuzu engu-150 yokuzivocavoca okumaphakathi njalo ngeviki. 
• Ukudla okunothisiwe ngezithelo, imifino kanye omega-3 ama-fatty acids angasiza ekunciphiseni ukuvuvukala emithanjeni yegazi. 
• Ukuhlala u-hydrated kubalulekile. 
• Ukubhema kulimaza imithambo yegazi, ngakho ukuyeka kungathuthukisa impilo yemithambo yegazi futhi kwehlise nengozi yamahlule egazi. 
• Nakuba lezi zinyathelo zingakuqinisekisi ukuvimbela, zinomthelela empilweni yonke. Kubalulekile ukuqaphela ukuthi ama-varicoceles avame ukukhula phakathi nokuthomba ngenxa yokwanda kokugeleza kwegazi kumasende akhula ngokushesha, inqubo engaphezu kokulawula komuntu ngamunye.

Isiphetho

I-Varicoceles, nakuba ngokuvamile i-asymptomatic, ingaba nomthelela omkhulu empilweni yamadoda nokuzala. Ukuqonda izimbangela, izimpawu, kanye nezindlela zokwelapha kubalulekile ekulawuleni lesi simo ngempumelelo. Kusukela ekwelashweni kwasekhaya kuye ekuhlinzweni, izindlela ezahlukahlukene zikhuluma ngama-varicoceles ngokusekelwe ebucayi bawo nomthelela empilweni yomuntu ngamunye.

Ekugcineni, ukuhlala unolwazi mayelana ne-varicoceles kunika amadoda amandla okwenza izinqumo ezinolwazi mayelana nempilo yabo. Ukuhlolwa njalo nokuxhumana okuvulekile nodokotela kuyisihluthulelo sokutholwa kusenesikhathi nokuphatha ngempumelelo. Ngokuthatha izinyathelo ezisebenzayo kanye nokufuna iseluleko sezokwelapha esifike ngesikhathi, amadoda anganciphisa izinkinga ezingase zibe khona ze-varicoceles futhi agcine inhlalakahle yawo yonke.

FAQ sika

1. Iyini imbangela ehamba phambili ye-varicocele?

Isizathu esiqondile se-varicocele asikaqiniseki. Ochwepheshe bezokwelapha bakholelwa ukuthi ama-valve anephutha emithanjeni yentambo yesidoda angase adlale indima. Lawa mavalvu ngokuvamile alawula ukugeleza kwegazi emasendeni, kodwa igazi linqwabelana emithanjeni lapho ingasebenzi kahle, okubangela ukuba ivuvuke.

2. Ingabe i-varicocele ingelapheka?

Nakuba i-varicoceles ingelapheki ngokuphelele, ingaphathwa ngokuphumelelayo. Izinketho zokwelapha zihlanganisa ukuhlinzwa kwe-varicocele kanye nezinqubo ezingezona zokuhlinzwa ezifana ne-varicocele embolisation. Indlela yokwelapha incike ebucayi bezimpawu kanye nezimo zomuntu ngamunye.

3. Ungakwazi yini ukulungisa i-varicocele ngaphandle kokuhlinzwa?

Yebo, i-varicocele ingelashwa ngaphandle kokuhlinzwa. I-Varicocele embolisation, inqubo engeyona yokuhlinzwa eyenziwa yi- i-radiologist yokungenelela, iyindlela ephumelelayo. Kubandakanya ukuvimba umthambo onenkinga usebenzisa amakhoyili noma amakhemikhali, ukuqondisa kabusha ukugeleza kwegazi emithanjeni enempilo.

4. Unciphisa kanjani i-varicocele ngokwemvelo?

Izindlela zemvelo zokuphatha i-varicocele zihlanganisa:

• Ukuzivocavoca njalo ukuthuthukisa ukujikeleza kwegazi
• Egqoke izingubo zangaphansi ezisekelayo
• Ukusebenzisa amaphakethe eqhwa ukuze ukhulule ukungaphatheki kahle
• Ukugcina isisindo esinempilo
• Ukuzijwayeza ukuma kwe-yoga njengo-Ananda Balasana no-Viparita Karani

5. Kuthiwani uma i-varicocele ishiywe ingalashwa?

Uma ishiywe ingalashwa, i-varicocele yezinga eliphezulu ingase ibangele umonakalo unomphela we-testicular. Kungase futhi kuholele ezinkingeni zokuzala, inani eliphansi lesidoda, kanye nekhwalithi yesidoda empofu.

6. Yikuphi ukudla okufanele ngikugweme ku-varicocele?

Ukudla okufanele ukugweme nge-varicocele kuhlanganisa:

• Ukudla okungenamsoco nokudla okugayiwe
• Ukudla okunoshukela omningi
• Izinhlamvu ezihlanjululwe
• I-caffeine eyeqile
• Ukudla okunosawoti

Kunalokho, gxila ekudleni okunothe nge-fiber nokudla okunothe nge-antioxidant njengamajikijolo, i-kale, noshokoledi omnyama.

UDkt. P Vamsi Krishna

MBBS, MS, MCh
CARE Hospitals, Banjara Hills, Hyderabad

Ukuze Ubhukhe Isikhathi, shayela:

+ 91 40-68106529

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