Inqubo Yokuhlunga

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Inqubo Yokuhlunga

Inkambiso ye-Essure yindlela yokulawula yokuzalwa engavamile, yokugcina . Lolu hlobo lokuzalisa inzalo aludingi noma yikuphi ukucubungula futhi luqukethe ukufaka okulula, okuguquguqukayo (izimpande ze-coil) ezifakwe emathinini amathanga. Kungcono okunye okunye okunye okubhekiswe kulokho okuyi- tubal ligation ngoba zonke izinhlobo zezinzalo zezinsikazi zidinga ukufakwa (kukhona izinqubo zokuhlinza).

Inqubo ye-Essure ithatha ithatha imizuzu engaba ngu-10, ivame ukusebenza ehhovisi likadokotela, futhi ayidingi ukuhlala ubusuku bonke.

• Qinisekisa Ukulawulwa Kwokuzalwa
• Usizo! Ingabe Inqubo Yokwenza Usizo?

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Ukuxuba kwe-Cervix

Isinyathelo sokuqala ngenkathi Inqubo yokuhlunga i-cervix dilation. Udokotela wakho uzosebenzisa i-anesthesia yendawo ukuze anqande umlomo wesibeletho. Abanye odokotela bangase banikele ngemithi eyengeziwe engakusiza ukuba uphumule futhi / noma unciphise noma yikuphi ubuhlungu. Ukuze ufake ama-coil Essure, udokotela wakho uzodinga kancane kancane (noma avule) umlomo wesibeletho.

Ukunwetshwa kwe-cervix kungenzeka ngezindlela ezimbili:

1. Udokotela wakho angasebenzisa i- speculum ukuthi ivule isisu. Lona idivaysi efana nensimbi yensimbi. Insimbi ifakwa ngaphakathi kwesifazane, futhi ama-blade ayo ahlukeneyo ahlukaniswa futhi avuliwe. Udokotela wakho uzobe efaka induku encane, enesibhakabhaka yentambo ngobumnene emgodini bese efika ekuvuleni okuncane komlomo wesibeletho. Induku ishiywe isikhashana endaweni, isuswe, futhi ishintshwe ngenduku encane kakhulu. Le nqubo iphindwe kuze kube yilapho umlomo wesibeletho ubanzi ngokwanele ukuvumela ukuthi izimpande zibekwe endaweni. Lokhu kuthatha imizuzu engaba ngu-10, futhi ungase uzwe ukucindezeleka nokungahambi kahle kubangelwa ukwehlukaniswa kwemisipha yomlomo wesibeletho ukuze ubambe induku ngayinye.

Enye indlela yokunciphisa umlomo wesibeletho kungenxa yokusebenzisa i- osmotic dilator , idivaysi ethatha umswakama ovela emathisini azungeze umlomo wesibeletho futhi ihamba kancane kancane. Ukwandiswa kwe-dilator kuvula kancane kancane umlomo wesibeletho futhi kuvame ukubangela ukungathandeki okuncane. Kunezinhlobo ezimbili ezivamile ze-osmotic dilator:

• I-Laminaria iyishubhu encane eyenziwe ngamanwe omisiwe omhlaba afakwe emgodini wesibeletho 8 kuya ku-24 ngaphambi kokuba inqubo ye-tubal ligation; ngokuvamile kudinga owesifazane ukuba eze ngosuku ngaphambi kwenkambiso yakhe yokufaka lokhu. Iningi le-dilation yomlomo wesibeletho lenzeke phakathi kwamahora ayisithupha okuqala, ngokukhuphuka okukhulu okwenzeka kumahora angu-12 kuya kwangu-24 ngemuva kokufakwa.
• I-Dilapan (i-synthetic dilator) iyisiponji esomile, esinyumba esifakwa emgodini wesibeletho amahora ambalwa ngaphambi kwenqubo ye-Essure. I-dilator ye-synthetic yenza kube lula ukufaka nokuvula umlomo wesibeletho ngesikhathi esingaphansi kunendlela ye-laminaria.

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Inqubo Yokuhlunga

Ngenkambiso ye - Essure , uzobe ubeke imilenze yakho evulekile futhi evulekile, efana nokuthi uzoba kanjani ukuhlolwa kwe-pelvic. Udokotela wakho uzofaka i-catheter kanye nensimbi encane, efana nethubhu (i-hysteroscope) emgodini, ngomlomo wesibeletho, kuze kube sesikhungweni. Ikhamera ekupheleni kwesilinganiso ivumela udokotela wakho ukuba angene esibelethweni. Ingeniso ye-Essure ifakwe ku-catheter futhi ifakwe ekuvuleni kwe-tube fallopian. Ukufakelwa kwesibili kufakwa kwenye i-tube fallopian ngendlela efanayo. Ungase ube nokuya esikhathini-njengokwenqamula ngesikhathi nangemva kwalokhu. Uma lokhu sekuqedile, i-x-ray ingathathwa ukuze kuqinisekiswe ukuthi izimpande zekhoyili zikhona. Yonke inqubo ithatha cishe imizuzu engu-10-30.

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Yini Ongayilindela Ngemuva Kwendlela Yokuhlunga

Abesifazane bavame ukubuyela ekhaya kungakapheli imizuzu engama-45 emva kwenqubo ye - Essure , futhi abesifazane abaningi abasebenza baphinde baqala ukusebenza kungakapheli amahora angu-24 noma ngaphansi. Abaningi besifazane babuyela emisebenzini evamile ezinsukwini ezi-1 kuya kwezingu-2, kodwa abesifazane abaningi babika ukuthi bakwazi ukuqhuba imisebenzi evamile ngokomzimba ngosuku olufanayo njengenqubo.

Ngemuva kokuba nenqubo yokuHlola, abesifazane baye babika ukuthi babhekene nalokhu:

• Ukusuka kwamagciwane okubangelwa ukuhamba kwesibeletho ngesikhathi senqubo.
• Ukunciphisa ubuhlungu kanye / noma ukucindezela izinsuku ezimbalwa ngemuva kwenqubo.
• Izinguquko zesikhashana emigqeni yazo yokuya esikhathini (ezilukhuni noma ezide kunezikhathi ezijwayelekile, ukuphuma noma ukuphawula phakathi kwezikhathi).
• Ubuhlungu be-pelvic, kwesisu, kanye / noma emuva.
• Ukuzisola ngesinqumo sabo.

Ungaqala ukulala ngokocansi ngokushesha uma uzizwa, futhi akubanga ubuhlungu. Kwabesifazane abaningi, lokhu kuthatha cishe isonto elilodwa ngemuva kokuhlinzwa. Kubalulekile ukuthi usebenzise indlela yokulawulwa kokuzalwa kokuzalwa kwezinyanga ezintathu zokuqala ngemuva kokufakwa kwe-Essure. Kuthatha mayelana nalesi sikhathi isikhathi sokuba izicubu ezibomvu zakha nxazonke zamakhoyili, ngaleyo ndlela zivimbela amashubhu we-fallopian. Kuze kuqinisekiswe ukuthi amashubhu avinjelwe, enye indlela yokukhulelwa kumele isetshenziswe.

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Ukuhlola kwe-Hysterosalpingogram (HSG)

Isivivinyo esibizwa ngokuthi i-hysterosalpingogram (HSG) senziwa izinyanga ezintathu emva kwenqubo yakho Yokuhlunga ukuqinisekisa ukuthi ngabe ama-tublopian tubes avinjelwe noma cha. Lokhu kuhlola kufanele kuhlelwe ngesonto ngemuva kwenkathi yakho ukuqinisekisa ukuthi awukhulelwe. Uzobe usudinga ukusayina ifomu lokuvuma futhi.

I-HSG izokwenziwa emnyangweni we-radiology isebenzisa itafula elinomshini we-x-ray ngaphezulu. Yilungele ukulala etafuleni bese ubeka izinyawo zakho, njengoba wenza ngesikhathi sokuhlolwa kwe-pelvic. Ngalesi sikhathi, idayi izokujova ngomlomo wesibeletho sakho kanye nesisu ngenxa yesikhala esincane. Khona-ke, i-x-ray ithathwa ukuveza izithombe zezibeletho zesisu nesigqila. I-HSG izokwethula ukuthi ngabe ukufakelwa kwama-coil kusesimeni esifanele bese ubonisa ukuthi ngabe amashubhu avinjiwe ngempumelelo. Uma kunjalo, ngeke usayisebenzisa enye indlela yokulawula ukuzalwa. Nakulokhu, ukukhulelwa okungeziwe kufanele kusetshenziswe kuze kube yilapho isivivinyo se-HSG sigcizelela ukuthi amashubhu we-fallopian avinjelwe ngokugcwele izicubu ezibomvu.

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Izinzuzo ze-Tuber Ligation yama-Hysteroscopic

Indlela yokuhlunga i- hysteroscopic yokusebenzisa izimila ze-tubal inikeza izinzuzo ezithile uma kuqhathaniswa nezindlela zendabuko, zokuhlinzeka nge-tubal ligation .

Akulona nje kuphela okuphephile, azikho izibazi, futhi abesifazane ngokuvamile babika ukungakhululeki kancane.

Amaphesenti angu-99% abaye abhekana nenqubo ye-Essure balinganise induduzo yabo yesikhathi eside njengento emihle kakhulu futhi abesifazane abangama-95% bathi bazoyincoma kumngane.

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Izinkinga ze-Hysteroscopic Tubal Ligation

Enye yezinsalela zenqubo ye- Tubid ligation ligation isidingo sokusebenzisa enye indlela yokulawula ukubeletha izinyanga ezintathu kuze kuphele amafomu amancane futhi uvimbela ama-tubes.

Ukwengeza, inqubo yokwenza inzalo ye-Esster hysteroscopic ayibuyiswa. Ngenxa yokuthi izicubu ze-tublopian tube kanye nama-coil implants zikhula ndawonye ukuze zenze ivesi elivaliwe, ukungena okuncane kungakwazi ukukhishwa ngaphandle kokulimaza amashubhu.

Ukufakelwa kwe-tubal kungase kube nzima ukufaka, ngakho-ke inqubo yesibili ngezinye izikhathi kudingekile ukuvimbela ngokuphelele zombili izilimo eziyizigaxa. Emiphakathini yezokwelapha, cishe owesifazane kwabayisishiyagalolunye kwabayisishiyagalombili abakwazanga ukufaka izimpande zombili izigubhu ze-fallopian ngesikhathi sokuqala kokubekwa.

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Hlola Izinhlekelele Zendlela

Njengombiko wezokuphepha we-FDA ka-2014, inqubo ye- Essure ayibonakali ibangela imiphumela emibi yesikhathi eside. Njenganoma yiluphi uhlobo lwe-tubal ligation, ngaso sonke isikhathi kukhona ithuba elincane lokuthi kungenzeka ukukhulelwa kwe-ectopic.

Ngokusho kwe-Planned Parenthood, izifundo zokulandelela ezenziwa abesifazane eminyakeni emibili emva kwenqubo ye-Essure ibonisa lezi zingozi ezingenzeka:

• Ukufakelwa okuncane okungenzeka kukhishwe kuma-tubespian tubes.
• Ukufakela kwama-coil kungenzeka ukuthi kufakwe kude kakhulu, noma hhayi okwanele, kungena emathinini we-fallopian.
• Ukufakelwa okuncane kungase kuqhutshwe ngaphakathi kwesibeletho noma udonga lwama-tube (perforation). Uma kwenzeka lokhu, ukuhlinzwa kungadingeka ukuze kulungiswe isimo.
• Ukufakwa kwe-coil kungonakaliswa ngenye indlela yezokwelapha, njenge-endopriyamu biopsy, ukuhlenga, nokukhishwa (D & C), noma izinqubo ezidinga ukusetshenziswa kwemvamisa yomsakazo.

Izinkinga ezengeziwe ezingase zenzeke ngenkathi kufakwa izimpande ze-Essure zifaka:

• Ubuhlungu obukhulu ukulinganisela
• I-nausea kanye / noma ukuhlanza
• Ukuphoqa emva kwenqubo
• Ukutheleleka
• Ukukhulelwa okungaziwa

Abesifazane abanenqubo enziwe phakathi nenxenye yesibili yokujikeleza kokuya esikhathini (emva kokuvuthwa kwe-ovulation) basengozini yokwanda kokungazi ngokukhulelwa ngenkathi yenqubo. Kunconywa ukuthi inqubo ye-Essure yenzeka phakathi nengxenye yokuqala yomjikelezo wokuya esikhathini ngaphambi kokuba kuvele ukuvunguza.

Kungenzeka ingxenye yengeniso ukuze ihlukane noma owesifazane abone ukukhishwa ngokweqile kwamanzi, nakuba lezi zinkinga zihamba phambili kunezinye ezibalwe. Kube khona imibiko yesikhala esiphukile esibangela ubuhlungu noma izinkinga ekuvimbeleni ukukhulelwa. Ukunwetshwa kwamanzi amaningi kungabangela ukuphefumula noma isidingo semithi yokuqeda uketshezi oludlulele. Lokhu kumele kuphathwe ngokushesha ukuvimbela izinkinga ezinkulu, kufaka phakathi ukufa.

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Hlola ukusebenza

Ukucwaninga kusikisela inqubo yokubangela inzalo ebizwa ngokuthi i- Essure hysteroscopic inqubo ephumelela kakhulu ye- tubal ligation , kanti odokotela abaningi manje sebashintsha kule ndlela.

Ucwaningo lubonise ukuthi abesifazane abangaphansi kuka-1.7 kwabangu-1000 baphela bekhulelwe eminyakeni emihlanu emva kwenqubo (99.83% ephumelelayo).

Ukuhlolwa kwe-Hysterosalpingogram (HSG) yezinyanga ezintathu zokulandela:

• Cishe i-1% yabesifazane ingaba neyodwa yezimpilishi zekhoyili ezingekho.
• Amaphesenti angama-96% ama-tubes fallopian abesifazane azobe avinjelwe ngempumelelo.

Ezinyangeni eziyisithupha emva kwenqubo, abesifazane abayi-100% kufanele babe nezibhamu zombili zivaliwe ngokuphelele.

Ukucutshungulwa Okungeziwe Mayelana Nesisindo:

Amaphesenti angamashumi ayisishiyagalolunye nesithupha abafazi bakwazi ukubeka amakhoyili ngokuphumelelayo kuzo zombili izigubhu emva kwenqubo eyodwa ye-Essure, kodwa abesifazane abangamaphesenti angu-10 namanje abakwazi ukufakwa ngamakhoyili abo ngempumelelo ngemva kwezinqubo ezimbili. Okokugcina, abesifazane abangu-3% abanokubekwa ngokuphumelela kokufakwa kwe-Essure abakwazi ukuqhubeka nokusebenzisa lokhu njengendlela yabo yokukhulelwa ngenxa yezizathu ezithile.

_Izinkomba:

_{(1990). Amagciwane okuvuthwa komlomo wesibeletho - I-dilator ye-synthetic eyenziwe nge-polyacrylonitrile hydrogel, i-Dilapan. I-American Family Physician, 42 (3), 775-776.}

_{Hlola Iwebhusayithi. (nd). Imibuzo evamile.}

_{U-Knowles, J. (2005). I-Tubal Inzalo . Umzali Ohleliwe.}