Izinketho ze-Tubal Ligation Options, Izingozi kunye nezinye iindlela
Ukuba ucinga ukufumana izibatho zakho ezibophelelwe-i-tubal ligation-Yintoni omele uyayiqonda? Ziziphi iindlela ezahlukileyo zokwenza inkqubo kwaye yiyiphi indlela enokuyilungele yona? Ziziphi iingozi ezinobungozi? Yaye yintoni enye indlela ekhoyo yokufumana ukuzalwa ngokusisigxina?
Ukuba nezibilini zakho ziboshwe
I-tubal ligation yindlela ehlala isigxina yokukhulelwa okanye ukulawula ukuzalwa.
Ukufumana ii-tubes eziboshweyo ngenye indlela yokuthi uye waba ne-tubal ligation. Le nkqubo inokuthi iphinde ihanjiswe njenge-stermilisation yabasetyhini okanye ukungabikho komntwana osisigxina.
Kungakhathaliseki ukuba isigama esetyenziswayo, ugulation of tubal ligation yinkqubo evala iingcambu zakho. Emva kokuba izibhabhu zakho zitywinwe, i-sperm ayiyi kukwazi ukudlula kwi-tube fallopian ukuze iqule iqanda-oko kuthetha ukuba awuyi kukwazi ukukhulelwa.
Le nkqubo ivame ukucetyiswa kwabasetyhini abadala abaqinisekileyo ukuba abafuni ukukhulelwa kwikamva. Kukho imibuzo enokuyiqwalasela xa ukhetha ukulawulwa kokuzalwa , kodwa kubafazi abenzileyo banabantwana, i-tubal ligation yinto ethandwa kakhulu ngenxa yokulungelelanisa kunye nokungabikho kwemiphumo emibi engenzeka ngeendlela zokulawula ixesha elifutshane.
Ngaba Amathubhu Am
Ngaba izibilini zakho ze-fallopian zibophelelwe ngokwenene xa une-tubal ligation?
Ingayiyo. Kukho iindlela ezininzi apho ugqirha wakho angasayinisa khona iibhubhu ezibandakanya:
- Ukuzibetha ngeesondo, izibambo, okanye iziqeshana
- Ukusika kunye nokuwafaka uphawu ngokuvalwa kombane (electrocautery)
- Ukubopha ama-tubes, ukuwasika, uze udibanise okanye ugqitywe ngombane
Ukucinga ngendlela iibhulo zakho eziza kutywinwa ngayo kungathi buhlungu, kodwa inkqubo iya kwenziwa phantsi kwe-anesthesia ukuze ungayi kuva nantoni na.
Izinketho zokuLungisa iT Tubal Ligation
Kukho iindlela ezininzi ezikhethiweyo zokukhetha ukususela xa kuziwa kwiinkqubo ze-tubal ligation, kwaye wena kunye nogqirha wakho unokuxoxa ngoluphi uhlobo olukhethekileyo kuwe. Ugqirha wakho uya kuqwalasela izinto ezinjengeyomzimba wakho kwaye nokuba awuzange wenze utyando lwangaphambili lomzimba. Ezi zilandelayo zikhetho ezahlukeneyo zokugonywa kwee-tubes ziboshwe:
1. I-Laparoscopy
Inzalo ye-laparoscopic enye yeendlela ezimbini eziqhelekileyo zokuba zikhombise izibhabhu kwaye zidlalwa phantsi kwe-anesthesia jikelele (uza kulala egumbini lokusebenza.) Ngaloo nkqubo, inkohlakalo encinane yenziwe kwinqakraza yakho yesisu i-laparoscope (into encinci, njenge-telescope ifana nekhanya) ukuba ifakwe. I-carbon dioxide igesi ijojowe ukwenzela ukuphakamisa udonga lwakho lwesisu esisuka kwizitho zakho zeplasvic, uvumele ugqirha wakho ukuba abone izibilini zakho. Udokotela ogqirha angayifaka enye idivaysi ngokusebenzisa i-laparoscope ukutywina izibilini zakho (okanye uya kudibanisa iibhubhu zakho ngezinye izinto ezincinci). Emva koko izigqibo zivaliwe. Inqubo ye-tubal laparoscopy inokuthatha kuphela malunga nemizuzu engama-30. Ngokuqhelekileyo kunqabile okukrakra, kwaye uya kubuyela ekhaya ngosuku olufanayo.
2. I-Mini-Laparotomy
I- mini-laparotomy (okanye i-mini-lap) i-tubal ligation yindlela enye eqhelekileyo yokuba nezibhanki zakho ziboshelwe. Uninzi lwabasetyhini luya kwenziwa le nqubo emva kokubeleka. Ngethuba le-postparusomy post-postparum, ugqirha wakho wenza intsimbi encinane ngaphantsi kweqhosha lakho lomzimba. Ngenxa yokuba isibeletho sakho sisandisiwe ukusuka ekukhulelweni, izibilini zakho ezikhohlakeleyo zilungele phezulu kwimbumba-efumaneka phantsi kweqhosha lakho lomzimba. Iibhulo zakho ezikhohlakeleyo zitshitshiswa zingena okanye ziphuma ngaphandle kwe-incision kwaye zivaliwe, zibuye zibuyisele endaweni, kwaye isicatshulwa sinqatshelwe.
3. I-Laparotomy (Vula i-Tubal Ligation)
Inqubo ye-laparotomy (eyaziwa nangokuthi i-tubal ligation evulekile) ithathwa njengophando olukhulu-ngoko lusetyenziswanga ngokuqhelekileyo njenge-laparoscopy kunye ne-laparotomy. Ugqirha uya kwenza i-incision enkulu (malunga neekhilomitha ezimbini ukuya ezintlanu ubude) kwisisu. Iibhulo zomgubo ziya kuthi zikhishwe ngaphakathi okanye zingaphandle kweso sakhiwo, zivaliwe / zivalelwe, zibuyisele endaweni. Isiza siya kugqitywa. I-tubal ligation evulekile idla ngokuqhutyelwa kwangaphambili okanye emva kohlobo oluthile lwe-operesheni esiswini esingasasebenziswanga, njengesiqendu seCesarea.
4. I-Culdoscopy kunye neColpotomy
I-Culdoscopy kunye ne- colpotomy zimbini iintlobo zezinto ezenziwe ngokusetyenziswa ngexesha leendlela zokutyalwa kwamanzi. Ukuba neethubhu zakho ziboshwe ngeendlela zangasese zakuba yindlela ekhethiweyo. Kodwa, ekubeni i-culdoscopy kunye ne-colpotomy inomngcipheko ophezulu, ukuhlinzwa okwenziwe nge-laparoscopic ngoku kuyindlela eqhelekileyo yokufumana izibhanki zakho ziboshelwe. Ugqirha wakho angakhetha ukwenza i-culdoscopy okanye i-colpotomy ukuba ukhuluphele (okanye ukhuluphele kakhulu) okanye ukuba une-uterus ekhunjulwayo (i-uterus eguqulweyo.) Zizi zombini zizinto ezincinci ezenziwe ngodongeni-kodwa kunokuba kunzima ukwenza kuba kufuneka ube kwindawo ye-lithotomy (imilenze ekhuphayo) ngelixa iphantsi kwe-anesthesia.
5. Hysterectomy
I- hysterectomy yinkqubo apho isisu sakho sisuswe kwaye kuthathwa njengophando olukhulu. I-hysterectomy ingeyona inkqubo ye-tubal ligation. Kodwa, emva kokuba isisu sakho sisuswe, akukho ndawo yeqanda yokumisela (ngoko awukwazi ukukhulelwa). I-hysterectomy ingenziwa ngokusebenzisa ubulili (u-hysterectomy wesisu) okanye isisu (hysterectomy esiswini). Kwixesha elidlulileyo, i-hysterectomy ngamanye amaxesha yenziwa njengenkqubo yonyango xa i-tubal ligation yayicingelwa njengezizathu zezenkolo.
Iinzuzo zokufumana izibilini zakho ziboshwe
Ukuba ugqirha unamathebhu akho adibeneyo, unokufumana inzuzo eyongezelelweyo yonyango. Uphando lubonisa ukuba ukuba ne-tubal ligation kunciphisa umngcipheko wakho kumhlaza wesi-ovariya kodwa ufike kuma-30 ekhulwini. Nangona isizathu esingaziwayo salokhu asiyazi, kukho iimbali ezimbini eziphambili ezi zinto zifunyenweyo:
- Xa unamathebhu akho adibeneyo, ukunikezelwa kwegazi kwi-ovaries yakho kuphazamisekile. Oku kunokutshintsha amazinga akho e-hormone, obangela umngcipheko omncinci womhlaza wesi-ovari.
- Ukuvalwa kwee-tublopian tubes, mhlawumbi, kukhusela ii-ovari kwiimpawu zendalo ezingabangela umdlavuza.
Enye inzuzo ye-tubal ligation kukuba ukuba nezibhanki zakho ezibophelelwe zinganciphisa amathuba akho ekuphuhliseni isifo se-pelvic (PID.) Nangona umngcipheko we-PID ungancitshiswa, nangona kunjalo, i-tubal ligation ayinikezeli naluphi na ukhuselo kwizifo ezithathelwana ngesondo .
Izingozi zeT Tubal Ligation
Njengoko nayiphi na inkqubo yokucubungula, i-tubal ligation inomngcipheko othile. Iingxaki ezinokuthi zinokuphulwa zibe zigaba ezintathu:
- Inkqubo ngenxa yenkqubo ekhoyo: Ezi zingabandakanya ukuvalwa okungaphelelanga kwezi-tubes (okubangelwa ukukhulelwa kwimiba engama-1 kwabangama-200 kwabasetyhini,) ukulimala kwizitho ezifuphi okanye izakhiwo ezibangelwa zizixhobo zokuvuthwa, kunye nomngcipheko okhulayo wokukhulelwa kwe-ectopic xa ukukhulelwa kwenzeka emva i-tubal ligation.
- Izingozi ezinxulumene nokusetyenziswa kwe-aneshesia: Uhlobo lwe-anesthesia olusetyenzisiweyo luxhomekeke kwindlela yokutyunjwa ekhethiweyo. I-Tubal ligation ingenziwa nge- consciousation (uhlobo lwe-anesthesia apho lona wesifazane evukile, kodwa ekhululekile kwaye elele) okanye i-sedation ejulile (i- anesthhetic ngokubanzi inikwa kwaye umfazi ulele.) I-Anesthesia ingaba yendawo, yesithili (umzimba unzima ukusuka kwintonga,) okanye jikelele (okubandakanya umzimba wonke,)
- Ingozi yokuhlinzwa ngokubanzi: Ingozi jikelele yokuhlinzwa iquka ukusuleleka kunye nokuphuma kwegazi.
Yintoni ongayilindela
Uninzi lwabasetyhini luya kuphinda lusebenze emva kweentsuku ezimbalwa emva kokuba lube ne-tubal ligation. Iyeza zonyango zinokukunceda ukukhulula nayiphi na into engeyiyo. Kunconywa ukuba abafazi bawuthintele ukuzivocavoca ngamandla kwiintsuku eziliqela. Ngokuqhelekileyo, abaninzi abafazi baziva bekulungele ukulala ngesibini kwiveki.
Uninzi lwabasetyhini luya kuvela kule nkqubo ngaphandle kweengxaki. Ngokungafani nokuzaliswa kwendoda (vasectomy), akukho mvavanyo efunekayo ukujonga ukuthotywa.
I-tubal ligation ayiyeki ukunciphisa ubulili bhinqa kwaye ayikuchaphazeli ubufazi bayo. Ekubeni akukho zigulane okanye izitho ezisuswe okanye zitshintshile kwaye zonke i-hormone ziya kuveliswa, i-tubal ligation ayinakuguqula ngokwesini okanye iphazamise ukusebenza komzimba wesini.
Iindleko
Ixabiso lexesha elilodwa le-tubal ligation, xa kuthelekiswa nezinye iindlela zokukhusela, kunokukugcina amakhulu emadola ngaphaya kwexesha. Iindleko zokuba ne-tubal ligation ingaba phakathi kwe-$ 1,000 ukuya kwi-3,000 zamawaka, kodwa ingaba phezulu xa unenxaki. Ibhinqa kufuneka lijonge umgaqo-nkqubo we-inshorensi yempilo njengoko uhlaselo lolawulo lokuzalwa luhluka. I-insicaid kunye ne-yinshorensi yempilo yabucala ingabandakanya iindleko ze-tubal ligation.
Impumelelo
I-tubal ligation ingaphezulu kwama-99 ekhulwini. Inqanaba elincinci lokungaphumeleli lwenzeka ngenxa yokuba ngamanye amaxesha izigubhu zengxowankulu zingakwazi ukuxhuma kwakhona. Ukuba ukukhulelwa kwenzeka emva kwe-tubal ligation, kukho ipesenti ezingama-33 ukuba kube nokukhulelwa kwe-ectopic. Nangona kunjalo, izinga lokukhulelwa liphantsi kakhulu, ukuba ithuba lomfazi lokuba nokukhulelwa kwe-ectopic liphantsi kakhulu kunokuba linikezelwe ukuba wayengenayo i-tubal ligation eyenziwe kwindawo yokuqala.
IT Tubal Ligation Reversal
Ibhinqa kufuneka liqwalasele ingqalelo ukuba ingaba i-tubal ligation (inzalisekiso engapheliyo) yindlela efanelekileyo kuyo. Nangona ngokuqwalaselwa ngenyameko, nangona kunjalo, abanye abafazi abane-tubal ligation bagcina bezisola ngesigqibo sabo kamva. Ibhinqa linokuzisola ukuba izibhabhu zakhe ziboshelwe ukuba:
- U selula
- Unabantwana abancinci okanye abangabikho
- Wakhetha le ndlela kungekhona ngenxa yokuba wayeyifuna kodwa ngenxa yokuba iqabane lakhe lalifuna ukuba lenziwe
- Wagqiba kwi-tubal ligation ngenxa yokuba wayekholelwa ukuba iza kulungisa iingxaki zemali okanye ukuba wayecinga ukuba inkqubo iya kunceda ukulungisa iingxaki zobudlelwane
I-tubal ligation ayifanele icingelwe nje ngexeshana. Ngamanye amaxesha ukuguqulwa kwe-tubal kuyenzeka ukuba umfazi kamva uthatha isigqibo sokuba ufuna ukukhulelwa. Nangona kunjalo, ukuguqulwa kwe-tubal yinkqubo ephambili yokuhlinzwa engasoloko ibangela ukukhulelwa. Amaphesenti angama-50 ukuya kuma-80 ekhulwini kwabasetyhini abanokuguqulwa kwe-tubal bangakhulelwa.
UkuNyulwa koPhuhliso olungapheliyo
I-tubal ligation ingaba yindlela ephezulu kakhulu yokulawulwa kokuzalwa ngokusisigxina, kunye nezinga eliphambili kakhulu lokuphumelela ukukhulelwa. Kwakhona kuneenzuzo ezongeziweyo zokunciphisa umngcipheko wakho wesifo somhlaza okanye i-pelvic inflammatory disease.
Oko kwathiwa, akusiyo wonke umntu onqwenela ukuhamba nale nkqubo kunye nento enxulumene nayo (nangona yincinci) yokuhlinzwa kunye ne-anesthesia jikelele.
Kukho iinkqubo ezininzi zokulawula ixesha lokuzalwa xa kunjalo. Kukho ezinye ezimbini ezibalulekileyo zokuhlala. Enye, i- vasectomy . Intloko efaniswayo nentloko, i-vasectomy inomngcipheko ongaphantsi kobungqina be-tubal ligation, kodwa abanye abantu abanomdla kule ndlela ngenxa yezizathu ezininzi.
Kulo mfazi, kukho enye indlela yokulawula ukuzalwa okusisigxina engapheliyo ebizwa ngokuba yi- Essure . Inkqubo yokuHlola (ebizwa ngokuba yindlela yokuthambisa inkunkuma) yindlela yokwenza iincinci ezincinci zifakwe emlonyeni wesibeleko kwaye zifike kwiibhulo zokuthi zifake. Inkqubo yeNkcazo sele ijikeleze ukususela ngo-2002, kodwa ayifumanekanga yonke indawo njengoko oogqirha badinga isatifikethi esikhethekileyo ukwenza inkqubo. Ukususela ngoNovemba ka-2016, i-Essure inesilumkiso esilungiselelwe ukuba kuqinisekiswe ukuba abantu bafundiswe malunga nobungozi benkqubo kunye nezinye iindlela.
Ukusetyenziswa ngokuthelekiswa kweendlela zeT Tubal Ligation
Akukho kubonakala ngathi akukho nomehluko omkhulu ekusebenzeni kwe-laparoscopy, lapartomy, okanye i-hysteroscopy ngokubhekiselele ekusebenzeni nangona imfuneko yokuphindaphinda inkqubo inokuba yinto enkulu kunabo abanenkqubo yokuHlola.
Ngaphantsi kweendlela zeT Tubal Ligation
Kukho iindlela ezahlukeneyo apho i-tubal ligation ingenziwa khona, kwaye ukhetho olulungileyo kuwe kuyinto ofuna kuyithetha ngayo ngokugqithiseleyo nodokotela wakho. Eyona nto ingcono iya kuxhomekeka kwiimeko ezininzi, njengokuba ukhulelwe njengamanje, uye wahlinzwa ngaphambili, xa ukhululeka kakhulu, okanye ukuba unesisu esilukileyo. Nangona i-tubal ligation ingaba nenzuzo yesibini, njengomngcipheko omncinci wesifo somhlaza we-ovari, kukho ezinye iindlela zokulawula ukuzalwa ngokusisigxina ezikhoyo.
> Imithombo:
> Antoun, L., Smith, P., Gupta, J., noT. Clark. Ubuchule, ukhuseleko, kunye nokusebenza kobuNcithakalo be-Hysteroscopic ngokumalunga ne-Laparoscopic Stterilization. I-American Journal ye-Obstetrics ne-Gynecology . 2017 Julayi 27. (Epub phambi kokuprintwa).
> Jokinen, E., Heino, A., Karipohia, T., Gissler, M., no R. Hurskainen. Ukhuseleko kunye nokuphumelela kwe-Tubal Sterilization yi-Hysteroscopy, i-Laparascopy, okanye iLaparotomy: I-Register Based Based Study. BJOG . 2017 Meyi 2. (Epub ngaphambi kokuprinta).
> Ilayisi, M., Murphy, M., kunye no-S. Tworoger. Tubal Ligation, Hysterectomy kunye ne-Ovarian Cancer: I-Meta-Analysis. Umbhalo woPhando lwe-Ovari . 2012. 5 (1): 13.
> Ulawulo lweZiko lokuTya kunye neDrug. IsiCwangciso soLawulo lokuLawula ngokusisigxina nge-Healthcare Bayer: Ukumenyezelwa kwe-FDA - Iinguqu zeeLikethi. 11/15/16. https://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm529241.htm