Ukukhulelwa Emva kwesisu seService Stenosis
I-stenosis yesibeleko ayiqhelekanga kodwa yinto ebangela ukuba abantwana bangabikho . Nge-stenosis yomlomo wesibeleko, ukuvulwa komlomo kunomncinci kunokuba kufanele kwaye kwaye, kwiimeko ezinzima, unokugqitywa. Oku kunokuphazamisa isidoda ukuya kwiqanda kunye nokunyanzelela unyango lwe-fertility njenge- insemination okanye kwi-vitro fertilization .
Malunga neCravix yakho
Ukuze uqonde indlela ubuhlungu be-stenosis obubangelwa ngayo intsholongwane, kufuneka uqonde umlomo wesibeleko .
Umlomo wesibeleko ungumnyango kunye nesigcawu esivela kwisiswini sakho kwisisu sakho. Ekupheleni kwesitya sangasese sisifo se-os ngaphandle okanye ukuvulwa komlomo. Xa unesi-pap smear, iiseli zithatyathwe apha. Unokuyiva le ngxenye yomlomo wakho wesibeleko ngeminwe yakho. Enyanisweni, abanye besetyhini bajonga utshintsho lwentsholongwane njengendlela yokufumanisa i-ovulation .
Oku kunjalo, kuphela yecandelo elingaphandle lomlomo wesibeleko. Umsele wentsholongwane uqhubeka udlulile kwi-os yangaphandle, udala uhlobo lwesitya ukusuka kwisisu ukuya kwisibeleko. "I-tunnel" yomlomo wesibeleko iyaziwa ngokuba ngumsele we-endocervical.
Ekupheleni komsele we-endocervical yi-os yangaphakathi, okanye ukuvula kwangaphakathi komlomo wesibeleko. Yilapho umlomo wesibeleko usuphelile kwaye ubeletho lwakho luqala.
I-stenosis yomlomo wesibeleko inokwenzeka nakweyiphi na yale mimandla, okanye nakwiiyo zonke ngokukhawuleza. Ngokuqhelekileyo, ngokuqhelekileyo, ingxaki ifumaneka kwi-os yangaphandle. Umlomo wesibeleko udlala indima ebalulekileyo ekuzaleni nasekukhulelweni:
- Ngexesha lokuya esikhathini, izicubu ze-endometrial ziphuma kwisibeleko ngomlomo wesibeleko.
- Yindlela yokudoda isisu ukusuka kwi-vagina ukuya kwindlela yokuzala.
- Iqukethe izicubu ezinobumba. Inambuzane yesibeleko iyadingeka ukuze kuncede ukunyuka kwesisu kufikelele kwi-cervix ngexesha lokuvuthwa kwaye kunceda ukukhusela intsholongwane kunye nokugcina ii-microorganisms ezingafunekiyo.
- Ngexesha lokukhulelwa, umlomo wesibeleko udala iplagi ye-mucus ukukhusela umntwana. Ihlala ivalwe ngokuqinileyo, isebenze njengesitywina, ide ifike ngexesha lokuzalwa.
I-Stervosis yeCervical Stenosis Inokuphikisana Neentlobo?
I-stenosis yesibeleko inokuchaphazela kakubi ukuzala, ngokuthe ngqo kunye ngqo.
Ingqungquthela yesidoda ivaliwe okanye iyancipha : Ukuba ukuvulwa komlomo kuvinjiwe okanye kuncinci kunokuba kufanelekile, inambuzane ayikwazi ukuhamba ukuya kwiibhulo zomhlaba (apho zidibana khona kwaye zifake iqanda).
Ukuvutha kwesibindi kunye ne-endometriosis mngcipheko : Ukuphuma kwimizi kunokuvalwa ngokupheleleyo (kwiimeko ezinzima) okanye kubanjwe kwaye awukwazi ukuhamba ngokukhawuleza. Oku kungenza ukuba isibeletho sigcwalise ngegazi, kubangele ubuhlungu nokuvuvukala. Oku kwaziwa njenge-hematometra.
Ukuba intsholongwane iyenzeka, isibeleko sinokuzaliswa ngepus. Ixesha lezonyango leli yi-pyometra.
Nangona umlomo wesibeleko uvulekile kwaye igazi lingadlulela ngaphandle, igazi lokuya esikhathini lingase lihlasele i-tublopian tubes. Oku kungakhokelela kwizilonda ze-endometrial kunye ne-endometriosis.
Ubuncwane obuncinci bomlomo wesibeletho : I-stenosis yesibeleko ibangelwa yi-tissue. Iimpawu ezibomvu zingaphazamisa umkhiqizo wesibeletho somlomo wesibeleko. Ngamanye amaxesha, utyando olwenza ukuba izicubu ezinobungozi zibandakanye ukususwa kweethambo zomlomo wesibeleko, kwaye oko kubeka umlinganiselo wokuvelisa umkhiqizo wesibeletho somlomo wesibeleko.
Ngaphandle kokutya okwaneleyo komlomo wesibeleko , isidoda sinokuba nengxaki yokuhamba kwaye iphile.
Iingxaki ngexesha lonyango lokuzala : zombini i- IUI ne- IVF unyango kufuneka i-catheter ifakwe ngaphakathi kwesibeleko. Nge-IUI, i-catheter ithatha i-sperm ehlanjwe ngokukhethekileyo. I-IVF, i-catheter inemibungu.
Kukho nawuphi na umzekelo, ukuba kuvulwa umlomo wesibeleko okanye umncinci kakhulu ukuba i-catheter idlule, unyango lunokuba nzima. Akunakwenzeka (okanye ucebise) ukunyanzelisa i-catheter. Kukho, nangona kunjalo, ukhetho lokudala indlela. (Okunye ngezantsi apha.)
Umngcipheko ophezulu wokukhulelwa nokukhulelwa kwangaphambi kokuzalwa : Ukwelashwa kwe-cervical stenosis kunokunciphisa umlomo wesibeleko okanye kubangele umonakalo wesibeleko somlomo wesibeleko.
Kamva, ngexesha lokukhulelwa, oku kungakhokelela kwisibeleko somlomo wesibeleko . Isibeleko somlomo wesibeleko xa umlomo wesibeleko ungavaliwe okanye unamandla okwaneleyo ukugcina ukhulelwe kukhuseleko. Kungakhokelela ekulahlekeni kokukhulelwa kwe-sibini okanye ukuzalwa ngaphambi kokuzalwa. Kukho iindlela zokunciphisa umngcipheko, nangona kunjalo. (Jonga ngaphezulu ngaphantsi.)
Yintoni ebangela i-Cervical Stenosis?
Isizathu esiqhelekileyo sesifo senzobele esivela kwintsholongwane sisuka kuhlinzwa ngaphambili.
Ukuba i-smear yephepha ifumana iiseli ezingaqhelekanga, ugqirha wakho unokufuna ukususa isahluko seesishubhu kwisibeleko sakho somlomo. Oku kunokwenziwa njenge-cone biopsy okanye i-LEEP (inkqubo ye-loop electrocautery excision).
Xa umzimba wakho uphilisa kwi-biopsy, izicubu ezibomvu zingenza ngaphezu kovalo lomlomo wesibeleko. Oku kunokukhokelela kwisifo somlomo wesibeletho.
Ezinye izizathu ezinokwenzeka ze-stenosis yomlomo zibandakanya:
- Ukuzalwa komntwana (ozalelwa ngumlomo wesibeleko ovaliweyo okanye omncinci)
- I-dysplasia yomlomo wesibeleko (amangqamuzana anqabileyo)
- Umhlaza wesibeleko okanye umhlaza we-endometri
- Usulelo lwe-uterus okanye umlomo wesibeleko
- Ulwaphulo lwezaphulo kummandla wesibeleko
- I-Asherman's syndrome
- Utyando lwe-Endometrial (uphethiloli owenzelwa ukunciphisa amaxesha amaninzi, alukhuthazelwanga kwabo baceba ukuzala abantwana kwikamva)
- Ukunquma kwexesha
Ukuxilongwa kunye neZimpawu
Ngokuxhomekeka kwimeko enzima, i-stenosis yesibeleko ingafunyanwa xa kuphanda iimpawu, okanye kungabonakali kwaze kwaba yilapho kuhlolwa uvavanyo okanye unyango. Izimpawu ezinokwenzeka ziquka:
- Ukuphuma kwindoda engaqhelekanga
- Akukho xesha okanye ukukhanya okulula
- Iimfampu ezinzulu zesisu
Ukuba le mpawu ivela emva kokuhlinzwa kwintsholongwane, isifo somlomo wesibeleko sisicatshulwa kakhulu.
Ukungabi naluphi na uphawu olubonakalayo lwe-stenosis yomlomo wesibeleko.
Ngethuba lokuvavanya ukuzala , inqanaba lomlomo wesibeleko linokukrokra ukuba kukho ubunzima bokugqiba i-HSG. I- HSG yi-x-ray ekhethekileyo equka ukudlulisa idayi nge-cervix ukuya kwinkqubo yesetyhini yokuzala. Ngokuqhelekileyo, i-catheter ifakwa ngaphakathi kwe-os yangaphandle yomlomo wesibeleko. Idayi ikhutshwa, kwaye ngoko ugqirha uthatha i-x-ray. I-ray-ray kufuneka ibonise ukuba iibhubhu ze-fallopian zivulekile kwaye zijonge umlo wesigxina se-uterine.
Nangona kunjalo, ukuba i-catheter ayikwazi ukufakwa, ibuhlungu kakhulu, okanye idayi ayifuni idlule umlomo wesibeleko, isifo somlomo wesibeleko sinokuba ngumba. Ukuba oko kwenzeka, i-hysteroscopy ivame ukuyalelwa ngokuzayo. Olu vavanyo lokuvuna lungasetyenziselwa ukulungelelaniswa kwesifo somlomo wesibeleko.
Kungenzeka ukuba i-stenosis yesibeleko ifunyanwe ngexesha lotyando lonyango ngokwaso. (Ukuba uzibuza ukuba ungaphoswa njani ngexesha lokuvavanya, kunokwenzeka ukulungiswa kwesifo somlomo wesibeleko emva kokunyanga).
Ngethuba le-IUI okanye i-IVF, ukuba kukho inkathazo yokubeka i-catheter yokutshatyalaliswa okanye ukutshatyalaliswa kombindi, i-stenosis yesibeleko ingaba yinkinga.
Izinyango Zonyango
I-stenosis yomlomo wesibeleko inokunyangwa, nangona kukho umngcipheko wokuba isicatshulwa esibuhlungu siya kugcina umva. Kukho iindlela zokunciphisa ithuba lokunciphisa kwakhona.
Enye indlela yokonyango ibandakanya ukusebenzisa i-dilators. Abahlalutyi beza njengezixhobo ezincinci, ezinyuke ngokukhawuleza ngobukhulu. Ngamanye amaxesha i-dilator encinci kakhulu kakhulu, apho i-wire ingasetyenziswa khona.
Oku kungenziwa kwiofisi yegqirha. I-block ye-paracervical isetyenzisiwe, yinto enomzimba we-anesthetic, ukunciphisa intlungu ngexesha le nkqubo. Ugqirha wakho uqala nge-twinnest dilators, kwaye ngokugqithiseleyo uzisa ubungakanani obulandelayo, de kube kuvulelwe ukuvula.
Ngamanye amaxesha, i-stent ifakwe ukugcina umlomo wesibeleko uvule kwaye ukhusele i-tiscu ebomvu ekuguquleni nokuvala ukuvula. I-stent yinto efana ne-tube. I-stent iya kususwa emva kweveki ezimbalwa.
Ukuba i-dilators ayiphumeli okanye ayifanelekanga, ukuchithwa kwe-hysterscoptic kukukhetha. Le yenkqubo yokucoca igqityiweyo ngexesha le-hysteroscopy. Ukwelashwa kwe-Laser-apho iishubhu ezibomvu ziphefumlelwe nge-laser yezokwelapha-enye indlela enokwenzeka.
Kuyabasetyhini abangazama ukukhulelwa, i-IUD ingafakwa emva kokunyanga i-stenosis yomlomo wesibeleko. IUD isetyenziselwe ukuthintela izicubu ezinqabileyo ekuguquleni. Ukuba ufuna ukukhulelwa kwikamva, i-IUD ingasuswa ngoko.
Kukho iingozi ezinokuthi unyango lwe-stenosis lwentsholongwane. Amathuba aya kuxhomekeka kwindlela yonyango esetyenziswa ngayo, kodwa ezinye zezo ngozi zibandakanya:
- Uterine
- Sulelo
- Isibeleko somlomo wesibeleko (ngexesha lokukhulelwa kwangaphambili)
Ukukhulelwa ngokwemvelo Emva kokuba unyango lweServic Stenosis
Ngamanye amaxesha, i-stenosis yesibeleko yimbangela ebangela ukungabikho kwengqondo. Kule meko, unokukwazi ukukhulelwa ngokwakho emva kokuba unyango. Ugqirha wakho uza kuphakamisa ixesha lokuzama ukukhulelwa ngokwakho, ubuninzi beenyanga ezili-6. Ukuba awukhulelanga, ukhetho olongezelelweyo lokunyanga lwezityalo lunokuqwalaselwa.
IVF kunye ne-IUI Treatment
Ukuba i-stenosis yesibeleko ifunyanwe ngexesha lonyango lwe-IUI kwaye luthintela inkqubo, ugqirha wakho unokubeka isambulo esandulela i-cervix ngokunokwenzeka kunokuba isondele emzimbeni. Ukuphumelela kokukhulelwa kuya kuba nzima ukuba kwenzeke. Nangona kunjalo, emva kokufunyanwa kwe-stenosis yomlomo wesibeleko, ugqirha wakho kufuneka akwazi ukuyiphatha aze abuyele enye i-IUI.
Nge-IVF, ngokugqithiseleyo, ugqirha wakho kufuneka enze i-embryo ukudluliselwa ngaphambi kokuba ujikeleze i-IVF. Oku kuya kubonakalisa nayiphi na ingxaki ezinokwenzeka, kubandakanywa nesifo somlomo wesibeletho.
Kwenzeka ntoni ukuba i-stenosis yesibeleko ifunyanwe ngexesha lomjikelezo we-IVF, ekutshintsheni kwangempela? Ugqirha wakho unokugqiba isigqibo sokuzama ukuxilonga komlomo kwaye uqhubeke nohanjiso. Uphando luxutywe, nangona kunjalo, ngaba oku kunciphisa amazinga okuphumelela ukukhulelwa okanye akunjalo.
Ukunciphisa ubungozi bokukhulelwa
Njengoko kuchazwe ngasentla, unyango lwe-stenosis yomlomo wesibeleko lunokunyusa umngcipheko wesibeleko esingafanelekanga okanye ukuzalwa ngaphambi kokuzalwa. Olunye unyango olunokuthi lunciphise lo mngcipheko lubizwa ngokuba yi- cerclage . I-cerclage yilapho ugqirha wakho egxotha umlomo wesibeleko uvaliwe ekuqaleni kokukhulelwa. I-sutures isuswe emva kokuba ufike kwiiveki ezingama-36, ngoko aziphazamisi ukuphuphuma komlomo wesibeleko kunye nokubeletha.
> Imithombo:
> ULaufer, uMarc R. "Iziphulo zomlomo zentsholongwane kunye nezilonda zomlomo wesibeleko. "UptoDate.com.
> Lin YH1, Hwang JL, Huang LW, Seow KM, Chen HJ, Tzeng CR. "Ukusebenza kwe-reseller cervical resection kwi-stenosis yomlomo wesibeleko. "I-J Minim i-Gynecol. Ngo-2013 uNgo-Dec; 20 (6): 836-41. i-doi: 10.1016 / j.jmig.2013.04.026.
> Singh N1, Gupta P, Mittal S, Malhotra N. "Ukulungiswa kobunzima bezobugcisa ngexesha lokudluliselwa kombindi kunye > izinga > lokukhulelwa kwekliniki. "J Hum Reprod Sci. 2012 Sep; 5 (3): 258-61. i-doi: 10.4103 / 0974-1208.106337.
> Suen MWH1, Bougie O1, Singh SS2. "Ulawulo lwe-hysteroscopic ye-stenotic cervix. "Fertil Steril. 2017 Juni; 107 (6): e19. i-doi: 10.1016 / j.fertnstert.2017.03.027.