I-phalloplasty yindlela yokuvotela ipenis, okanye i-phallus. I-Phalloplasty ingaba yinkalo yokuguqulwa kwamadoda athile angama-transgender. (Amanye amadoda angama-transgender angakhetha ukuba ne-metodioplasty okanye angenayo inzala ekuzalweni komzimba.) I-Phalloplasty ingenziwa nakwabantu be- cisgender abazalelwa ngaphandle kwepenis okanye abalahlekelwa ipenisi ngengozi okanye izifo.
Ngokuqhelekileyo iqhutywe ngugqirha we-plastiki kunye / okanye i-urologist.
Phalloplasty Basics
Ngokusisiseko, ukudala ipenisi kubandakanya ukudala ityhubhu ngaphakathi kwiphubhu. I-tube yangaphakathi yi-urethra, isakhiwo apho amadoda axhoma khona. I-tube yangaphandle yintsimbi ye-penile. Esi sakhiwo, esaziwa ngokuthi i-neophallus ( neo - entsha), siqhotyoshelwe kwi-pelvis. I-urethra ye-neophallus ifakwe kwi-urethra ekhoyo. Imithambo yegazi kunye neentsholongwane ziyaqhotyoshelana nakwii-pelvis. Emva koko ingaphandle ye-neophallus icatshulwa ukuba ifane ne-penis shaft kunye nentloko.
Iintlobo zeFlap
Amacandelo enyama kunye nezinye izicubu ezisetyenziselwa iinkqubo zokuhlinzwa zaseplastiki ezifana ne-phalloplasty zibizwa ngokuba yi- flaps . Kukho iintlobo ezininzi zeefowuni ezingasetyenziselwa i-phalloplasty. EUnited States, uhlobo oluqhelekileyo lwe-flap elisetyenzisiweyo luyi-flaarm forearm, okanye i-RFF. Oku kubandakanya ukuvuna umxube omkhulu wesikhumba kwisinye sezigulane zesigulane.
Iinjongo eziphambili zeli phulo kukuba zikhulu kakhulu, kulula ukuvuna, kwaye zithintela ukuthintela. Iingxaki eziphambili kukuba umbala ungase uhluke kakhulu kwesikhumba somzimba kunye nokuba inkqubo iya kushiya inqabana ebonakalayo. Ubomvu buhluke kakhulu, ukuba abantu abajwayelene neRFF phalloplasty, ekuboneni kukubonisa ukuba umntu onobunzima uye wafumana lo msebenzi.
Oku kungabangela ingxaki kumadoda athile, abangafuni ukukhangisa abafumana iphalloplasty.
Enye ingozi ebalulekileyo kukuba i-forearm kufuneka ikhutshwe ngesikhumba esivela kwelinye lamathanga. Oku kushiya izikrakra kwiindawo ezimbini ezinokuba zibonakala zibonakala, kuxhomekeke kwindlela indoda egqoke ngayo. Ekugqibeleni, i-RFF ifuna ukuba ugqirha ube nekhono kwi-microsurgery, kuba i-flap isuswa ngokupheleleyo kwingalo kwaye kufuneka ibuye ixhunyelelwe kwiimbilini kunye nokunikezelwa kwegazi kufuphi ne-groin.
Ezinye iipopu ezisebenzisayo ngezinye izihlandlo ze-phalloplasty zivunwa kule mimandla elandelayo:
- Lattisimus dorsi
- Ummandla we-pubic
- Ikhuni
Iphulo lesigxina lesigxina linye i-flap esetyenziswa rhoqo kwi-phalloplasty e-United States. Ngokungafaniyo neengalo zengalo yomda, ezi ziphoso zihlala zixhunyaniswe nokunikezelwa kwegazi lokuqala. Oku kuthetha ukuba abafunanga ubuchwepheshe bokusebenza nge-microsurgery kwinxalenye yonyango owenza i-phalloplasty. Nangona kunjalo, ezi ziphoso ziyanzima ukusebenzisana nazo. Ubunqamle obuninzi beoli bubangela ukuba kube nzima ukuwafaka kwiphubhu ukuloba ipeni. Iipopu zentambo ehambayo zidibaniswa neerhafu eziphezulu zengxaki kunokugqithiswa kwe-forearm flaps. Kukho idatha encinane yokuthelekiswa kweziphumo zezinye iintlobo zefowuni ezisetyenziswe kwi-phalloplasty.
Prostheses yePenile
Akunabo bonke abantu abafuna i-phalloplasty banomdla wokuba nomsebenzi we-erectile ofanelekileyo wesini. Abanye baxhalabele ukukwazi ukuma ukuhamba okanye ukuhamba ngeendawo eziqhelekileyo ezifana namagumbi okupakisha. Nangona kunjalo, amadoda afuna ukukwazi ukulala nomlingane uya kufuna ukufakwa kweprothele. I-penile prosthesis iyaziwa nangokuthi i- penile implant .
Uninzi lwabagqirha lufake i-penile prostheses emva kokuba i-phalloplasty yokuqala ikwazi ukuphilisa, kodwa abanye baya kwenza inqanaba elilodwa. Kukho iinzuzo kunye nokungahambi kakuhle kokukhethwa kuzo zombini.
Ngokufanayo, kukho iinzuzo kunye neenzuzo kwiintlobo ezahlukeneyo zeeprothees ze-penile. I-penile prostheses ezithintekayo zisebenzise i-fluid pumped from a reservoir ukuze zomelele ipenisi. Kukho izimpembelelo ezinqamlekileyo okanye ezinokuthenjwa. Ezi zihlala zizinzileyo ngamaxesha onke kodwa ziyakwazi ukulungiswa okanye zilungiswe kwiimfuneko. Iifosheshe ezinokuxhatshazwayo zisetyenziselwa ngokuphindaphindiweyo, kuba azifuni umntu ukuba aqhele ukufumana ipeni elibi ngamaxesha onke. Nangona kunjalo, utyando olwenziwa ukuba lubekwe lulolu hlobo lunzima kunokuba lube lukhuni olungqongqo.
Iingxaki eziqhelekileyo zePhalloplasty
Iingxaki ze-uréthral yiyona nkxalabo eqhelekileyo ye-phalloplasty. Izigulane zingakhula i-fistula ehamba phambili, apho ibhubhu ephethe umchamo ivuleka kwesikhumba kwaye ibangela umchamo ukuvuza. Oku ngokuqhelekileyo kwenzeke apho i-urethra entsha ifakwe kwixesha elidala. Nangona kunjalo, kunokwenzeka naphi na kwi-neophallus.
Enye ingxaki yokuvuthwa kwe-urinary ye-phalloplasty yinkqubo yokunyusa. Yilapho inqanaba inqabile kakhulu ukuba ithwale umchamo. Enye, into engaphantsi kakhulu, iingxaki ze-phalloplasty ziquka ukulahleka okuthe ngqo okanye ukulahleka kwezinto kunye neengxaki zesikhumba. Izigulane ezifumana i-penile prostheses nazo zinokuba neengxaki ngalezo zixhobo. Enyanisweni, lolu hlobo lweengxaki aluqhelekanga, kokubili emva kokufakwa kwimihlaba kunye neminyaka emininzi. Iingxaki ezineepenesi ye-penile zingadinga ukususwa okanye ukutshintshwa kwe-implant.
Ulwahlulo lwe-Phalloplasty lwe-Transgender Men
Ngokuqhelekileyo, iinkqubo ze-phalloplasty zifana neentlobo ze-cisgender kunye ne-transgender amadoda. Nangona kunjalo, kukho ukungafani okumbalwa. Ukwahlukana kokuqala kubandakanya ukulondoloza ukuvakalelwa kwesondo. Kuba amadoda angama-transgender, iimbilini ze-phallus zixhomekeke kwii-clitoris okanye i-clitoris ifakwe kwisiseko sepenisi. Ngandlela-thile, injongo kukugcina isondo sezesondo kunye nomsebenzi we-orgasmic kwizitho zangasese, ngokuvumela ukuvuselelwa kwe-penile ukuvuselela iimbilini ze-clitoral.
Omnye umehluko omkhulu kukunyusa kwe-urrera. Kuba amadoda ase-cisgender, i-urethra ichanekile ngokufanelekileyo ukuxhamla kwi-body of penis. Nangona kunjalo, kumadoda angama-transgender, ukongezwa kufuneka kudalwe ukudibanisa i-urethra ekhoyo kwisiseko sepenisi. Oku kunokongeza ubunzima kutyando. Ukongezwa kwakhona kwenye indawo apho kunokubakho iingxaki zokuphilisa.
Ekugqibeleni, ngenxa yamadoda angama-transgender, ugqirha kufuneka ugqirha i-scrotum. Oku kudla ngokusetyenziswa ngesikhumba se-outer labia kubantu be-transgender. Kungokunokwenzeka ukufaka iifestile ze-testicular, ukuba isiguli sifuna. Ngokuxhomekeka kwintando yesigqirha, oku kungenziwa ngexesha lotyando okanye, ngokuphindaphindiweyo, emva kokuba utyando lokuqala lunexesha lokuphilisa.
Ukungaqhathaniswa noVimba lweeNqanaba eziManyeneyo
Isigaba esisodwa se-phalloplasty siquka ukwakhiwa kwangaphandle kwe-phallus kunye ne-urethra, kunye nokuxhuma kwe-urethra. Xa kubandakanyeka, kubandakanya ukuveliswa kwe-scrotum kunye nokufakelwa kwama-prostheses e-testicular. Konke oku kwenziwa njengenkqubo enye, nangona nayiphi iprothele i-prostheses ifakwa ngokutsha ngomhla ozayo.
I-multi-stage phalloplasty iphula ukuhlinzwa kwiindawo. Oku kuqhelekileyo, njengoko kuvumela ukulawulwa ngokubanzi kwecandelo ngalinye lotyando. Nangona kunjalo, amanye amaqela atyhutyayo enze amanyathelo athile. Oku kunokuba lula ngakumbi kwizigulane ezihamba umgama obalulekileyo wokuhlinzwa. Akucaci ukuba ngaba kukho ingozi eyongeziweyo yeengxaki kwiinkqubo ezizinye. Oko kwathiwa, abaninzi abantu abafumana i-phalloplasty baya kufuna omnye okanye ngaphezulu uphando, kungakhathaliseki ukuba inkqubo yayijoliswe ekuqaleni ukuba ibe yinto enye okanye ininzi.
> Imithombo:
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> Djordjevic ML, Stanojevic D, Bizic M, Kojovic V, Majstorovic M, Vujovic S, Milosevic A, Korac G, Perovic SV. I-Metodioplasty njengesifo esisodwa esisodwa sokuvuselelwa ngokwesini kwisini esithandana nabo besifazane: amava eBelgrade. J Sex Med. 2009 ngoMeyi; 6 (5): 1306-13. i-doi: 10.1111 / j.1743-6109.2008.01065.x
> Frey JD, uPoudrier G, Chiodo MV, Hazen A. Uhlolo oluhlelekile lweMetodioplasty kunye ne-Radial Forearm Flap iPhalloplasty kwi-Transgender Genital Reconstruction: Ngaba i-Neophallus "efanelekileyo" iyinjongo ephumelelayo? Faka i-Glove ye-Surger Open. 2016 NgoD 23; 4 (12): e1131. i-doi: 10.1097 / GOX.0000000000001131.
> Neuville P, Morel-Journel N, Maucourt-Boulch D, iDefffon A, Paparel P, Terrier JE. Iziphumo zophando ze-Erectile Implants Emva kwePhalloplasty: Ukuhlaziywa kwakhona kweeNkqubo ze-95. J Sex Med. 2016 Nov; 13 (11): 1758-1764. i-doi: 10.1016 / j.jsxm.2016.09.013.