I-Neovagina Formation / Creation

Ukwelashwa Kwe-Uterine Fibroids E-Hyderabad

I-Vaginal agenesis yisifo esingavamile sokuzalwa lapho owesifazane ezalwa ngaphandle kwesitho sangasese sowesifazane nesibeletho noma isitho sangasese sowesifazane esingathuthukisiwe nesibeletho. Kuyisimo esingajwayelekile esithinta owesifazane oyedwa kwabangu-5,000. Lesi simo senza ucansi nokuba nomntwana kungenzeki. 

Kanye ne-vaginal agenesis, kungase kube nezinye izinkinga ezifana nokukhubazeka kwamathambo, izinso, noma inhliziyo. Ucwaningo lukhombisa ukuthi babalelwa ku-30 ​​kwabesifazane abayikhulu abane-vaginal agenesis banokukhubazeka kwezinso njengokuthi nje babe nenso eyodwa noma eyodwa noma zombili izinso. Izinso zingase futhi zihlanganiswe ukukhombisa isimo sesicathulo sehhashi. Cishe i-12 kubo bonke abesifazane abayi-100 abane-vaginal genesis banamathambo angabonakali futhi aba-2 kwabangu-3 balaba besifazane banezinkinga zezitho, izimbambo, noma umgogodla.

Abesifazane abane-agenesis yangasese banezitho zangasese ezivamile zangaphandle. Bangase futhi babe nembobo yesitho sangasese sowesifazane engu-1 kuya ku-3 cm ukushona, eyaziwa ngokuthi “i-dimple yangasese”. Futhi banama-ovari asebenzayo, isikhathi esiningi. 

I-vaginal agenesis ingase ibe uphawu lwezimo ezibanzi, ezihlanganisa— 

• I-Mayer-von Rokitansky-Küster-Hauser's (MRKH) Syndrome - I-MRKH syndrome iwuhlobo oluvame kakhulu lwe-vaginal genesis. Lesi simo sidala ukuthi isitho sangasese sowesifazane nesibeletho singakhuli kahle noma singabibikho kowesifazane. Iphinde ibangele nokunye okungajwayelekile.

• Inhlangano ye-MURCS - Kulesi simo, ngaphandle kokungajwayelekile kwe-MRKH syndrome, kukhona okunye okungahambi kahle okukhona okuhlanganisa ukukhubazeka kwezinso, ubude obufushane, nokungahambi kahle komgogodla.

• I-Complete androgen sensitivity syndrome (AIS) - Kulesi simo, abantu banokubukeka okujwayelekile kowesifazane kodwa abanaso isibeletho, ama-ovaries, amashubhu e-fallopian, umlomo wesibeletho, nesitho sangasese sowesifazane. 

• I-Disgenesis ye-gonadal ehlanganisiwe

Kunezinhlobo ezimbili ze-MRKH syndrome -

1. Thayipha 1 - Uhlobo loku-1 lwe-MRKH yaziwa nangokuthi ukulandelana kwe-Rokitansky noma i-MRKH ehlukile. Kulolu hlobo lwesimo, abantu banesibeletho esilahlekile noma esivimbekile kanye nesitho sangasese sowesifazane esinamashubhu e-fallopian avamile. Azikho ezinye izimpawu ze-syndrome. 
2. Thayipha 2 - Uhlobo 2 i-MRKH yaziwa nangokuthi inhlangano ye-MURCS. Imele i-Mullerian duct aplasia, i-renal dysplasia, kanye ne-cervical somite anomalies. Ngaphandle kwezimpawu ze-MRKH syndrome, abantu abanohlobo 2 lwe-MRKH nabo banezinkinga nezinso zabo kanye nesistimu ye-musculoskeletal.

Ngokuvamile, azikho izimpawu ezicacile ze-agenesis yangasese. Ngakho, akunakwa ezimweni eziningi, kuze kube yilapho intombazane ifinyelela ukuthomba kodwa ingaqali ukuya esikhathini. Lokhu kwaziwa ngokuthi i-amenorrhea. Bangase bazwe ubuhlungu be-cramping kanye nesisu ngenxa yokugcwala kokuya esikhathini kuvimbekile ngenxa yokungabikho kwesitho sangasese sowesifazane. Uma ungasitholi isikhathi sakho sokuya esikhathini lapho uneminyaka engu-15, kufanele uthintane nodokotela. Uma i-vaginal genesis kungenxa ye-MRKH syndrome, khona-ke umuntu angase abe nalezi zimpawu - 

• Thayipha i-MRKH engu-1 - Izimpawu zoHlobo loku-1 lwe-MRKH zihlanganisa ukushona nobubanzi bobulili obunciphile kanye nokuya ocansini okubuhlungu.
• Thayipha i-MRKH engu-2 - Izimpawu zohlobo 2 lwe-MRKH zihlanganisa izimpawu ze-Type 1 MRKH syndrome kanye nokungajwayelekile kwamathambo, izinkinga zezinso noma ukwehluleka, ukukhubazeka kwenhliziyo, ukungezwa okuncane, nezinye izinkinga ezihlobene nezitho.

Izimbangela

Imbangela eqondile ye-vaginal agenesis ayaziwa. Ikhona lapho izalwa futhi yenzeka lapho isimiso sokuzala somntwana singakhuli ngokugcwele lapho isesibelethweni sikanina. Kwabesifazane abane-MRKH syndrome, ezinye izinguquko ezakhini zofuzo eziningana ezihlotshaniswa nokukhula ngaphambi kokuzalwa ziye zabonakala kwabesifazane. Nokho, akucaci ukuthi lezi zinguquko zibangela i-MRKH syndrome noma i-vaginal genesis. Ucwaningo lusaqhubeka mayelana nezimbangela ze-vaginal genes.

Futhi akucaci ukuthi kungani abantu banokungajwayelekile okuthinta izingxenye zomzimba ngaphandle kwesistimu yokuzala, njengoba kubonakala ku-Type 2 MRKH syndrome.

Sifo

I-vaginal genesis ayivamisile ukuxilongwa kuze kube yilapho intombazane isikhule amabele nezinwele zangasese, nokho ingakazitholi izikhathi zokuya esikhathini. Lokhu kungenxa yokuthi izitho zangasese zangaphandle zibonakala zivamile. Ukuxilonga i-agenesis yesitho sangasese sowesifazane, ukuhlolwa ngokomzimba okubandakanya ukuhlolwa kwe-pelvic kanye nomlando wezokwelapha ophelele wenziwa. Ukuhlolwa okwengeziwe okunjengokuhlolwa kwegazi kwe-MRKH syndrome, i-ultrasound yokwakha izithombe zezitho zokuzala zangaphakathi nokungajwayelekile, kanye ne-MRI ukuze kutholwe isithombe esicacile nesinemininingwane eyengeziwe, nakho kwenziwa. 

Kwesinye isikhathi, i-vaginal genesis ingatholwa ezinganeni, uma abazali bazo noma udokotela ethola ukuthi akukho ukuvuleka kwesitho sangasese sowesifazane noma sangemuva. Kungatholakala nasentombazaneni encane uma ihlolelwa inkinga yezinso okusolakala ukuthi inenkinga. 

Ukwelashwa

Kunezinketho ezahlukene zokwelapha ezitholakalayo ze-vaginal agenes, udokotela wakho azozincoma, ngokusekelwe esimweni sakho, kuhlanganise -

Izindlela zokwelapha ezingahlinzeki - 

• Ukuzihlanza – Indlela yokuqala yokwelapha enconyelwa odokotela wukuzikhulisa. Le ndlela ingase ivumele abesifazane ukuthi bakhe isitho sangasese sowesifazane ngaphandle kokudinga ukuhlinzwa. Ngale ndlela, abesifazane abane-agenesis yesitho sangasese sowesifazane kudingeka bacindezele i-dilator esikhumbeni sabo noma ngaphakathi kwesitho sangasese esikhona imizuzu engu-30 kuya emahoreni amabili ngosuku. Lokhu kuholela ekwakhiweni kwe-neovagina. Isikhathi esingcono kakhulu sokwenza lokhu ngemva kokugeza okufudumele njengoba isikhumba sinwebeka kalula ngemva kwalokhu. Ngemuva kwamaviki ambalwa, ungashintshela kuma-dilator amakhulu. Kungase kuthathe izinyanga ezimbalwa ukufeza imiphumela oyifunayo.

• Ukwelula ngocansi – Enye inketho yokwelashwa okungahlinzeki kwe-vaginal genesis kungaba ukuvuleka kwesitho sangasese sowesifazane ngokuya ocansini. Ukugcotshwa kokwenziwa kungase kudingeke futhi kungase kube khona ukopha nobuhlungu njengemiphumela engemihle, ikakhulukazi ekuqaleni.

• Izindlela zokwelapha zokuhlinzwa – Ukuhlinzwa ukwakha i-neovagina esebenzayo kuyaphakanyiswa uma izindlela zokwelapha ezingahlinzeki zingasebenzi. Ngokuvamile, ukwelashwa kokuhlinzwa kunconywa lapho abesifazane bekwazi ukubhekana nokunwetshwa kokulandelela. Ukuhlinzwa kwe-vaginoplasty kungenziwa ngezindlela ezahlukahlukene - 

• Ukunwetshwa okuqhubekayo (inqubo ye-Vecchietti) – Ngale ndlela, umshini omise okwe-olive ufakwa embotsheni yesitho sangasese sowesifazane ukuze kwakhiwe umzila wesitho sangasese sowesifazane. Lo mshini ube usuxhunywa emshinini wokudonsa obekwe ngaphansi kwesisu, nge-laparoscopically. Lo mshini wokudonsa uqiniswa nsuku zonke. Ngenxa yalokhu, idivayisi emise okwe-olive idonselwa ngaphakathi bese kwakhiwa i-neovagina esikhathini esingangeviki elilodwa. Kuyisu elincane elihlaselayo futhi imiphumela ezuziwe iyafana naleyo yokuzikhulisa kodwa ngesikhathi esisheshayo. Ukugcina i-neovagina, ukuzikhulula okuvamile kanye/noma ukuya ocansini kuyanconywa.

• Ukusebenzisa i-graft yesikhumba (Inqubo ye-McIndoe) - Kule nqubo, isikhumba sithathwa ezinqeni zakho ukuze kwakhiwe i-neovagina. Ukusika kwenziwa lapho isitho sangasese sowesifazane sizokwenziwa udokotela ohlinzayo. Khona-ke, udokotela ohlinzayo ufaka i-graft yesikhumba ukuze enze isakhiwo se-neovagina. Khona-ke isikhunta sifakwa emiseleni esanda kwakhiwa. Lesi sikhunta sihlala isonto lonke. Ngemuva kwalokhu, kuzodingeka usebenzise i-dilator yesitho sangasese sowesifazane, okumele ikhishwe ngenkathi usebenzisa indlu yokugezela noma ukuya ocansini. Ngemuva kwezinyanga ezintathu, i-dilator kufanele isetshenziswe kuphela ebusuku. Ukuya ocansini kanye nokuzikhulula okuvamile kuyanconywa ukuze kugcinwe isitho sangasese esisebenzayo.

• Ukusebenzisa ingxenye yekholoni (bowel vaginoplasty) – Kule nqubo, udokotela ohlinzayo uphambukisa ingxenye yekholoni embotsheni esithweni sangasese ukuze akhe isitho sangasese esisha. Bese, ikholoni esele ixhunywa kabusha. Ngemuva kwalokhu kuhlinzwa, ngeke udinge ukusebenzisa i-dilator ye-vaginal nsuku zonke futhi ukugcotshwa kokwenziwa nakho akudingekile kaningi uma uye ocansini.

• Indlela yokudonsa isitho sangasese sowesifazane sangasese – Ngale ndlela, ukusika kwenziwa udokotela ohlinzayo esicutshini esingaphansi kwesitho sangasese sowesifazane. Ukusika kwenziwa kuze kufinyelelwe izicubu ezivamile zesitho sangasese sowesifazane. I-mucosa ibe isidonselwa phansi futhi ngemva kokukhipha izicubu ezine-fibrous ngokweqile, zinamathiselwe eduze neringi ye-hymeneal ngaphandle kokucinana.

• I-Balloon vaginoplasty - Ngale ndlela, ukunwetshwa kwebhaluni kusetshenziselwa ukudala isikhala ku-rectovesical fascia ukuze kwakhiwe i-neovagina.

• Ukusebenzisa i-mucosa ye-buccal – Kule ndlela, i-buccal mucosa isetshenziswa njengolwelwesi lwesitho sangasese sowesifazane esisha. Inezici zokuphulukisa eziphakeme, ngakho-ke, isikhathi sokululama sifushane futhi asikho isibazi esincane. Kodwa-ke, ukulimala emlonyeni ngenkathi kwenziwa ukukhishwa kwe-mucosa kanye nesitho sangasese esiqinile nesifushane ngenxa yezicubu ze-buccal ezinganele kufanele kucatshangelwe.

• I-vaginoplasty kaWilliam – Ngale ndlela, i-labia minora ihlanganiswa ndawonye ukuze kwakhiwe iphakethe eliba yi-neovagina. I-neovagina incane kakhulu, ngakho-ke, ukuguqulwa kuyadingeka kule nqubo njengokusebenzisa izicubu ze-labial ukwakha isikhwama esijulile esizovumela ukuya ocansini okukhululekile.