Ukuqala Ukukhulelwa Ngemuva Kwesifo Se-Cervical Stenosis
I-stenosis yesibeletho yinto engavamile kepha imbangela engabangela ukuhlukumeza abesifazane . Nge-stenosis yomlomo wesibeletho, ukuvulwa komlomo wesibeletho kuncane kakhulu kunalokho okufanele kube khona futhi, lapho kunzima kakhulu, kungagcwaliswa kuvaliwe. Lokhu kungaphazamisa isidoda sifike emaqanda futhi kuphazamise ukwelashwa kwe-fertility efana ne- insemination noma i- in vitro fertilization .
Mayelana ne-Cervix yakho
Ukuze uqonde ukuthi isifo somlomo wesibeletho singabangela kanjani ukungasebenzi, kudingeka uqonde umlomo wesibeletho .
Umlomo wakho wesibeletho ungumnyango kanye nesigcawu esivela esiswini sakho kuze kufike esibelethweni sakho. Ekupheleni komsele ongasese wesifazane yi-os yangaphandle noma ukuvulwa komlomo wesibeletho. Uma une-pap smear, amaseli asampuliwe lapha. Ungase uzizwe le ngxenye yomlomo wakho wesibeletho ngeminwe yakho. Eqinisweni, abanye besifazane balandela izinguquko zomlomo wesibeletho njengendlela yokuthola ukuvota .
Lokhu, noma kunjalo, kuyisigaba sangaphandle somlomo wesibeletho. Umsele womlomo wesibeletho uqhubeka udlule i-os yangaphandle, udala uhlobo lomhubhe ophuma emaseni kuze kube sebelethweni. "Umhubhe" womlomo wesibeletho uyaziwa ngokuthi umsele wokugcina.
Ekupheleni komsele we-endocervical yi-os yangaphakathi, noma ukuvula kwangaphakathi komlomo wesibeletho. Yilapho isibeletho sakho siphela khona futhi ubeletho lwakho luqala.
I-stenosis yesibeletho ingenzeka kunoma iyiphi yalezi zindawo, noma ngisho nakubo bonke ngesikhathi esisodwa. Kodwa ngokuvamile, inkinga itholakala ku-os yangaphandle. Umlomo wesibeletho udlala izindima ezimbalwa ezibalulekile ekuzaleni nasekukhulelweni:
- Ngesikhathi sokuya esikhathini, izicubu ze-endometrial ziphuma esibelethweni ngomlomo wesibeletho.
- Kuyindlela yokudonswa kwesilisa kusuka ebusweni kuze kube ohlelweni lokuzala.
- Iqukethe izicubu ezikhiqizayo. I-mucus yomlomo wesibeletho iyadingeka ukuze kusize isisu siphumelele kahle emgodini wesibeletho ngesikhathi sokuvuthwa futhi kusiza ukuvimbela ukutheleleka nokugcina izinambuzane ezingadingeki.
- Ngesikhathi sokukhulelwa, umlomo wesibeletho udala ipulaki le- mucus ukuvikela ingane. Iphinde ihlale ivalwe ngokuqinile, isebenza njengophawu, kuze kube yisikhathi sokuzalwa.
I-Stenosis yomlomo wesibeletho iphikisana kanjani nokuzala?
I-stenosis yomlomo wesibeletho ingaba nomthelela omubi ekukhuliseni, ngokuqondile nangokungaqondile.
I-sperm ivinjiwe noma ilinganiselwe : Uma kuvulwa komlomo wesibeletho kuvinjelwe noma kuncane kunalokho okumele kube khona, insimu ayikwazi ukuhambela emaqabeni amancane (lapho ihlangana khona futhi ikhule iqanda).
Ukuvuvukala kwesisu kanye ne-endometriosis engozini : Ukuphuma kwelanga kungavinjelwa ngokuphelele (ezimweni ezinzima) noma kubanjwe emuva futhi kungakwazi ukugeleza kalula. Lokhu kungabangela ukuthi isibeletho sigcwalise igazi, okwenza ubuhlungu nokuvuvukala. Lokhu kwaziwa ngokuthi i-hematometra.
Uma ukutheleleka kwenzeka, lesi sibeletho singagcwaliswa nge-pus. Isikhathi sezokwelapha salokhu i-pyometra.
Ngisho noma i-cervix ivulekile kancane futhi igazi lingase ligele phambili, igazi eliya esikhathini lingase libheke ngezinye izikhathi ngokusebenzisa ama-tubespian tubes. Lokhu kungaholela ezilonda ze-endometrial kanye ne-endometriosis.
Umqubu womlomo wesibeletho ovuthiwe : I-stenosis yesibeletho ivame ukubangelwa izicubu ezibomvu. Izicubu ezibomvu zingaphazamisa ukukhiqizwa kwemisipha yomlomo wesibeletho. Ngezinye izikhathi, ukuhlinzwa okwenza ukuba izicubu ezisabekayo zihilele ukukhipha izicubu zomlomo wesibeletho, futhi lokho kuqhubeka nokunciphisa ukukhiqizwa komkhiqizo wesibeletho somlomo wesibeletho.
Ngaphandle kwemisipha eyanele yomlomo wesibeletho , isidoda singase sibe nenkinga yokuhamba nokusinda.
Izinkinga ngesikhathi sokwelashwa kokuzala : Kokubili ukwelashwa kwe- IUI ne- IVF kudinga ukuthi umcengezi abekwe ngaphakathi kwesibeletho. Njengoba i-IUI, i-catheter ithatha imithi ehlanjululwe ngokukhethekile. I-IVF, i-catheter inemibungu.
Kunoma yikuphi, uma ukuvulwa komlomo wesibeletho kuvinjelwe noma kuncane kakhulu ukuba umgumbathi udlule, ukwelashwa kungaba yinkimbinkimbi. Akunakwenzeka (noma weluleke) ukuphoqa umcengezi ngokusebenzisa. Nokho, kukhona okukhethwa kukho kokudala indlela. (Okuningi ngalokhu ngezansi.)
Ingozi eyengeziwe yokukhulelwa nokubeletha kusenesikhathi : Ukwelashwa kwesisu somlomo wesibeletho kunganciphisa umlomo wesibeletho noma kubangele ukulimala kwezicubu zomlomo wesibeletho.
Kamuva, ngesikhathi sokukhulelwa, lokhu kungaholela emgodleni wesibeletho esingenakuthola . Umlomo wesibeletho awukona lapho umlomo wesibeletho ungavaliwe noma unamandla ngokwanele ukugcina ukukhulelwa kuphephile. Kungase kuholele ekulahlekelweni kokukhulelwa kwesibili noma kokuzalwa ngaphambi kwesikhathi. Kunezinketho zokunciphisa le ngozi, noma kunjalo. (Bheka okuningi ngezansi.)
Yini Ebangela Isisu Se-Cervical Stenosis?
Isizathu esivame kakhulu sokuqina kwesifo somlomo wesibeletho sivela ekuhlinzekeni kwangaphambi komlomo wesibeletho.
Uma i-pap smear ithola amangqamuzana angavamile, udokotela wakho angase adinge ukususa ucezu lwezicubu embelethweni wakho. Lokhu kungenziwa njenge-biopsy noma i-LEEP (i-loop electrocautery excision procedure).
Uma umzimba wakho uphulukisa kusukela ku-biopsy, izicubu ezibomvu zingakha ngaphezu kokuvulwa komlomo wesibeletho. Lokhu kungaholela ekutheni i-stenosis yomlomo wesibeletho.
Ezinye izimbangela ze-stenosis yesibeletho zihlanganisa:
- U-Congenital (ozalwa ngesisu somlomo wesivalo noma esincane)
- I-dysplasia yomlomo wesibeletho (amangqamuzana angenawo ama-precancerous)
- Umdlavuza wesibeletho noma i-endometrial
- Ukwelashwa kwesibeletho noma umlomo wesibeletho
- Ukwelashwa kwezidakamizwa endaweni yomlomo wesibeletho
- I-Asherman's syndrome
- Ukwelashwa kwe-endometrial yokuphumula (ukwelashwa okwenziwe ukunciphisa izikhathi ezinzima, hhayi kunconywa kulabo abahlela ukuba nezingane esikhathini esizayo)
- Ukunqamuka kwesikhathi
Ukuxilongwa Nezimpawu
Ngokuya ngobunzima, i-stenosis yomlomo wesibeletho ingase itholakale lapho ihlola izimpawu, noma ingase ingabonakali kuze kufike ukuhlolwa kokuzala noma ukwelashwa. Izimpawu ezinokwenzeka zifaka:
- Ukuphuma esikhathini okungavamile
- Asikho isikhathi noma ukukhanya okulula kakhulu
- Izikhwama ezinkulu zokuya esikhathini
Uma lezi zimpawu zenzeka ngemva kokuhlinzwa komlomo wesibeletho, i-stenosis yomlomo wesibeletho isolwa ngokuqinile.
Ukungabi nalutho nakho kuyisimo esingahle se-stenosis yomlomo wesibeletho.
Ngesikhathi sokuhlolwa kokuzala , isifo somlomo wesibeletho singase sikholelwe uma kunzima ukugcwalisa i-HSG. I- HSG i-x-ray ekhethekile ehilela ukudlulisa idayi nge-cervix kuze kube ohlelweni lwesifazane lokuzala. Ngokuvamile, i-catheter ifakwa ngaphakathi kwe-os yangaphandle yomlomo wesibeletho. Idayi idedelwa, bese kuthi udokotela athathe ama-x-ray. Ama-x-ray kufanele akhombise ukuthi ngabe ama-tubespial tubespies avulekile futhi abheke isimo se-uterine cavity.
Kodwa-ke, uma i-catheter ingenakubekwa, iyabuhlungu kakhulu, noma idayisi ayifuni kudlule umlomo wesibeletho, isifo somlomo wesibeletho singase sibe inkinga. Uma kwenzeka lokhu, i-hysteroscopy ngokuvamile iyalwe ngokulandelayo. Lokhu kuhlolwa kokuzala kungasetshenziselwa ukuqina kwesimo somlomo wesibeletho.
Kungenzeka ukuthi i-stenosis yesibeletho itholakale ngesikhathi sokwelashwa kokuzala. (Uma uzibuza ukuthi zingabanjwanga kanjani lapho kuhlolwa, kungenzeka ukuthi kulungiswe ukuqina kwesifo somlomo wesibeletho ngemuva kokulashwa).
Ngesikhathi se-IUI noma i-IVF, uma kunenkathazo ebeka i-catheter yokudlulisa isisu noma ukudluliswa kombungu, isifo somlomo wesibeletho singase sibe inkinga.
Izinketho zokwelapha
I-stenosis yomlomo wesibeletho ingelashwa, nakuba kunengozi ukuthi izicubu ezilulayo zizovala ukuvula. Kukhona izinketho zokunciphisa amathuba okunciphisa kabusha.
Enye indlela yokwelashwa ihilela ukusetshenziswa kwe-dilators. I-dilator ifika njengethimba lezintambo ezincane, ezikhula kancane kancane. Ngezinye izikhathi ngisho ne-dilator encane kunazo zonke kakhulu, lapho kwenzeka khona ucingo lungasetshenziswa.
Lokhu kungenziwa ehhovisi likadokotela. I-block paracervical isetshenziswa, okuyihlobo lomuthi wokubulala umzimba, ukunciphisa ubuhlungu ngesikhathi senqubo. Udokotela wakho uqala nge-thinnest ye-dilators, futhi ufaka ngokucophelela usayizi olandelayo, kuze kufike ukuvulwa okufunayo.
Ngesinye isikhathi, i-stent ifakwe ukugcina umlomo wesibeletho uvule futhi uvimbele izicubu ezincane ekushintsheni nasekuvala ukuvula. I-stent yinto efana ne-tube. I-stent izosuswa emva kwamasonto ambalwa.
Uma i-dilator ingaphumeleli noma ingafaneleki, ukushefa nge-hysterscoptic kuyindlela yokukhetha. Lena inqubo yokuhlinzwa egcwaliswe ngesikhathi se-hysteroscopy. Ukwelapha i-Laser-lapho izicubu ezibomvu ziqhutshwa khona nge-laser yezokwelapha-kungenye indlela ongakhetha ngayo.
Kulabo besifazane abazama ukukhulelwa, i-IUD ingabekwa ngemuva kokuphulukisa i-stenosis yomlomo wesibeletho. IUD ihloselwe ukuvimbela izicubu ezincane ekushintsheni. Uma ufuna ukukhulelwa esikhathini esizayo, i-IUD ingasuswa ngaleso sikhathi.
Kunezingozi ezingase zibe khona ekwelapheni kwesibeletho se-stenosis. Amathuba ayoxhomekeka kunoma iyiphi indlela yokwelapha esetshenziswayo, kodwa ezinye zalezi zingozi zihlanganisa:
- Ukugqunywa kwesisu
- Ukutheleleka
- Umlomo wesibeletho esingenasifo (ngesikhathi sokukhulelwa esizayo)
Ukuthola Ukwelashwa Okukhulelwe Ngokwemvelo Ngemuva Kokwelapha Kwe-Cervical Stenosis
Ngezinye izikhathi, i-stenosis yomlomo wesibeletho iyimbangela eyinhloko yokungasebenzi. Kulokhu, ungakwazi ukukhulelwa ngokwakho ngemuva kokwelashwa. Udokotela wakho uzophakamisa isikhathi sokuzama ukukhulelwa ngokwakho, cishe izinyanga ezingu-6. Uma ungakhulelwe, ukhetho olwengeziwe lokunakekelwa kokuzala lungacatshangelwa .
I-IVF ne-IUI Treatment
Uma i-stenosis yomlomo wesibeletho itholakele ngesikhathi ukwelashwa kwe-IUI futhi ivimbela inqubo, udokotela wakho angabeka isilwane esandulelwa ngaphambi kokuhlanza ngangokunokwenzeka kunokuba kube ngokomlomo. Ukuphumelela kokukhulelwa bekungeke kwenzeke ukuthi kwenzeke. Kodwa-ke, emva kokutholakala kwe-stenosis yomlomo wesibeletho, udokotela wakho kufanele akwazi ukuwuphatha futhi abuyele elinye i-IUI.
Nge-IVF, ngokufanele, udokotela wakho kufanele enze ukudluliswa kombungu ngaphambi kokuba umjikelezo wakho we-IVF. Lokhu kuzoveza izinkinga ezikhona, kuhlanganise nesimo somlomo wesibeletho.
Kwenzekani uma ukutholakala kwe-stenosis yomlomo kutholakala ngesikhathi sokujikeleza kwe-IVF, ekudluliseni kwangempela kwe-embryo? Udokotela wakho anganquma ukuzama ukuhlenga umlomo wesibeletho bese uqhubeka nokudluliswa. Ucwaningo luhlanganisiwe, noma ngabe lokhu kunciphisa amazinga okuphumelela kokukhulelwa noma cha.
Ukunciphisa Izingozi Zokukhulelwa
Njengoba kukhulunywe ngenhla, ukwelapha isifo somlomo wesibeletho kungandisa ingozi yengane yomlomo wesibeletho engakutholi noma ukubeletha ngaphambi kwesikhathi. Omunye ukwelashwa okungenzeka ukwehlisa ukunciphisa lo mngcipheko kuyaziwa ngokuthi i- cerclage . I-cerclage yilapho udokotela wakho ebeka umlomo wesibeletho uvaliwe ekuqaleni kokukhulelwa. I-sutures isuswe ngemuva kokuthi ufike emavikini angu-36, ngakho-ke ayiphazamisi ukuqhuma komlomo wesibeletho nokubeletha.
> Imithombo:
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> Lin YH1, Hwang JL, Huang LW, Seow KM, Chen HJ, Tzeng CR. "Ukusebenza kokuthengiswa komlomo wesibeletho ngenxa yesifo somlomo wesibeletho. "J Minim Gynecol Engavamile. 2013 Nov-Dec; 20 (6): 836-41. doi: 10.1016 / j.jmig.2013.04.026.
> Singh N1, Gupta P, Mittal S, Malhotra N. "Ukuhlanganiswa kobunzima bezobuchwepheshe ngesikhathi sokudluliswa kombungu nge > isilinganiso > sokukhulelwa komtholampilo. "J Hum uhlehlisiwe uSci. 2012 Sep; 5 (3): 258-61. doi: 10.4103 / 0974-1208.106337.
> Suen MWH1, Bougie O1, Singh SS2. "Ukuphathwa kwe-hysteroscopic yesifo somlomo we-stenotic. "Fertil Steril. 2017 Jun; 107 (6): e19. i-doi: 10.1016 / j.fertnstert.2017.03.027.