Izinketho zokuLungiswa kweT Tubal, Izingozi, Nezinye izindlela
Uma ucabangela ukuthola amashubhu akho ahlanganiswe-a-tubal ligation-yini okufanele wazi? Yiziphi izindlela ezahlukene zokwenza inqubo nokuthi iyiphi inketho engase ibe ngcono kuwe? Yiziphi izingozi ezingase zibe khona? Futhi yiziphi ezinye izindlela ezitholakalayo ezitholakalayo zokulawulwa kokuzalwa okungapheli?
Ukuba nezibilini zakho ziboshelwe
I-tubal ligation yindlela ehlala njalo yokuvimbela ukukhulelwa noma ukulawula ukubeletha.
Ukuthola amashubhu akho aboshwe yenye indlela yokusho ukuthi uke waba ne-tubal ligation. Le nqubo ingabuye ibhekiswe ngokuthi inzalo yesifazane noma ukungabi namuntu okuhlala njalo.
Kungakhathaliseki ukuthi amagama asetshenzisiwe yini, i-tubal ligation yokuhlinzwa iyinkqubo evimbela amashubhu akho. Uma izibhubhu zakho zivaliwe, isidoda ngeke sikwazi ukudlula i-tube fallopian ukutshala iqanda-okusho ukuthi ngeke ukwazi ukukhulelwa.
Le nqubo ivame ukuphakanyiswa kwabesifazane abadala abadala ukuthi abafuni ukukhulelwa esikhathini esizayo. Kunemibuzo eminingi okufanele uyihlole lapho ukhetha ukulawulwa kokuzalwa , kodwa kwabesifazane abenziwa ukuba nezingane, i-tubal ligation iyisinqumo esithandwa kakhulu ngenxa yokuthi kulula futhi ukungabi nemiphumela emibi okungenzeka ngezindlela zokulawula okwesikhashana.
Ingabe Izibilini Zami Ziboshwe Ngempela?
Ingabe amashubhu akho angama-fallopian ahlangene ngempela uma une-tubal ligation?
Kungenzeka. Kukhona ngempela izindlela eziningana lapho udokotela wakho angagcina khona amashubhu akho kufaka phakathi:
- Ukuzibopha ngezindandatho, izikhalazo, noma iziqeshana
- Ukuzisika nokuwafaka uphawu ngokuvala ugesi (electrocautery)
- Ukubopha ama-tubes akho, ukuwasika, bese ubhala noma ukuwafaka uphawu kagesi
Ukucabanga ukuthi amashubhu akho azobekwa uphawu kungase kube buhlungu kanjani, kodwa inqubo yenziwa ngaphansi kwe-anesthesia ngakho ngeke uzwe lutho.
Izinketho zokuLuba ze-Tubal zokuhlinzeka
Kunezinketho eziningi ezihlukahlukene ongakhetha kuzo uma kuziwa ezinkambisweni zethubal ligation, futhi wena nodokotela wakho ungaxoxa ukuthi iyiphi inketho engcono kuwe. Udokotela wakho uzocabangela izici ezifana nesisindo somzimba wakho nokuthi ngabe uke wahlinzwa ngokubeletha kwangaphambili noma cha. Okulandelayo yizinketho ezahlukene zokuhlinzwa zokuba nezibhamu zakho ziboshelwe:
1. I-laparoscopy
Inzalo ye-laparoscopic ingenye yezindlela ezimbili ezivame kakhulu zokuba nezilimo eziyizigaxa zakho ziboshwe futhi kuvame ukwenza ngaphansi kwe-anesthesia ejwayelekile (uzolala egumbini lokusebenzela.) Phakathi nale nqubo, ukufakwa okuncane kuyenziwe ngaphakathi noma eduze kwenkinobho yakho yesisu ukuvumela i-laparoscope (ithuluzi elincane, elithambile-telescope elinokukhanya) okufanele lifakwe. I-carbon dioxide gas ijojowe ukuze kuphakanyiswe udonga lwakho lwesisu esisuka ezithombeni zakho zomzimba, kuvumela udokotela wakho ohlinzayo ukuba abone amashubhu akho angama-fallopian. Udokotela ohlinzayo angase afake enye idivaysi ngokusebenzisa i-laparoscope ukufaka amashubhu akho (noma uzobopha amashubhu akho ngenye indlela encane). Khona-ke ukucubungula kuvaliwe. Inqubo ye-tubal laparoscopy ithatha cishe imizuzu engama-30. Ngokuvamile kuvame ukulimala, kanti cishe uzobuyela ekhaya ngosuku olufanayo.
2. I-Mini-Laparotomy
I- mini-laparotomy (noma i-mini-lap) i-tubal ligation yindlela ejwayelekile kunazo zonke yokuba nezibhamu zakho ziboshelwe. Abaningi besifazane bazoba nale nqubo eyenziwa ngemuva kokubeletha. Phakathi ne-postpartum mini-laparotomy, udokotela wakho ohlinzayo wenza ukuchofoza okuncane ngaphansi kwesibhamu sakho esiswini. Ngenxa yokuthi isibeletho sakho sisakhula kusukela ekukhulelweni, amashubhu akho angamahloni aphezulu phezulu kwesibeletho-esitholakala ngaphansi kwesibhamu sakho esiswini. Ama-tubes akho angama-fallopian abese ekhishwa ngaphakathi noma aphume ngaphandle kwe-incision futhi avaliwe, bese ubuyela emuva, futhi ukuchotshozwa kugcizelelwe.
3. I-laparotomy (Open Tubal Ligation)
Inqubo ye-laparotomy (eyaziwa nangokuthi i-tubal ligation evulekile) ibhekwa njengokuhlinzwa okukhulu-ngakho ayisetshenzisiwe njengalapha njenge-laparoscopy ne-mini-laparotomy. Udokotela ohlinzayo uzokwenza ukucubungula okukhulu (cishe ngamasentimitha amabili kuya kwezinhlanu ubude) esiswini. Ama-tubes wesigqila ayobe esedluliselwa ngaphakathi noma angaphandle kwe-incision, avaliwe / avaliwe, futhi abuyise endaweni. Ukuchotshozwa kuzobe sekukhishwa kuvaliwe. I-tubal ligation evulekile ivame ukuqhutshwa ngaphambi noma emva kwenye uhlobo lokuhlinzwa okungavumelani kwesisu, njengesigaba seCesarea.
4. I-Culdoscopy ne-Colpotomy
I-Culdoscopy ne- colpotomy yizinhlobo ezimbili zokucubungula okusetshenziselwa izindlela zokwelapha izibeletho . Ukuba nezilimo eziyizigaxa zakho eziboshwe ngendlela yesisindo kwaba yindlela ekhethwayo. Kodwa, njengoba i-culdoscopy ne-colpotomy inezingozi eziphakeme, ukuhlinzeka kwe-laparoscopic manje kuyindlela evamile yokuthola amashubhu akho ahlanganiswe. Udokotela wakho angakhetha ukwenza i-culdoscopy noma i-colpotomy uma ukhuluphele (noma ukhuluphele ngokweqile) noma uma unesibindi esiphundukile (isibeletho esihlotshisiwe). Zombili lezi ziyizingcingo ezincane ezenziwe ngodonga lwama-vagin-kodwa kungase kube nzima ukwenza ngoba kufanele ube yi-lithotomy isikhundla (imilenze ehamba phambili) ngenkathi ngaphansi kwe-anesthesia.
5. Hysterectomy
I- hysterectomy yinkqubo lapho isisu sakho sisusiwe khona futhi kubhekwa njengukuhlinzwa okukhulu. I-hysterectomy ayiyona inqubo ye-tubal ligation. Kodwa, uma isisu sakho sisusiwe, akusikho indawo yeqanda ongayifaka (ngakho awukwazi ukukhulelwa). I-hysterectomy ingenziwa nge-vaginal (hysterectomy yesisu) noma esiswini (hysterectomy esiswini). Esikhathini esedlule, i-hysterectomy ngezinye izikhathi yenziwa njengendlela yokwelapha lapho umuthi we-tubal ucatshangelwa ngezizathu zenkolo.
Izinzuzo zokuthola izibilini zakho ziboshwe
Uma uhlinzekwa ukuthi izibopho zakho ziboshelwe, kungenzeka ukuthi uthole inzuzo eyengeziwe yokwelapha. Ukucwaninga kusikisela ukuthi ukutholakala kwe-tubal ligation kunciphisa ingozi yakho yomdlavuza we- ovarian kodwa kube ngamaphesenti angama-30. Nakuba isizathu esiqondile salokhu akungaziwa, kunezinkolelo ezimbili eziyinhloko zalokhu okutholayo:
- Uma unezilimo eziyizigaxa zakho eziboshiwe, igazi elihlinzeka ngama-ovari akho liphazanyiswa. Lokhu kungashintsha amazinga akho e-hormone, okuholela engozini encishisiwe yomdlavuza we-ovarian.
- Ukuvalwa kwama-tubespial tubespies, mhlawumbe, kuvikela ama-ovari avela kuma-agent angokwemvelo angabangela umdlavuza.
Kodwa enye inzuzo ye-tubal ligation yukuthi ukuba nezibhamu zakho ziboshwe zinganciphisa amathuba akho okuthuthukisa isifo sokuvuvukala kwe-pelvic (PID.) Ngenkathi ingozi ye-PID ingancishiswa, noma kunjalo, ukuxilongwa kwe-tubal akuhlinzeki noma yikuphi ukuvikelwa kwezifo ezithathelwana ngocansi .
Izingozi ze-Tubal Ligation
Njenganoma iyiphi inqubo yokuhlinza, i-tubal ligation inengozi ethile. Izinkinga ezingenzeka kungenzeka zihlukaniswe zibe izigaba ezintathu:
- Izingozi ngenxa yenqubo yangempela: Lokhu kungabandakanya ukuvalwa okungaphelele kwamatayipi (okuholela ekukhulelweni cishe kwabangu-1 kwabangu-200 besifazane,) ukulimala ezithombeni eziseduze noma izakhiwo ezibangelwa izinsimbi zokuhlinzeka, kanye nengozi eyengeziwe yokukhulelwa kwe-ectopic uma ukukhulelwa kwenzeka ngemva i-tubal ligation.
- Izingozi ezihlobene nokusetshenziswa kwe-anesthesia: Uhlobo lwe-anesthesia elisetshenziswa lusekelwe endleleni yokuhlinzwa ekhethiwe. I-tubal ligation ingenziwa nge- sedation (i-anesthesia lapho owesifazane ephapheme khona, kodwa ekhululekile futhi elele) noma e-sedation ejulile (i- anesthetic ejwayelekile inikezwa futhi owesifazane ulele.) I-anesthesia ingaba yendawo, isifunda (umzimba iyinqwaba kusukela enkabayeni phansi,) noma jikelele (okubandakanya wonke umzimba,)
- Izingozi zokuhlinzwa ngokujwayelekile: Izingozi ezijwayelekile zokuhlinzwa zifaka ukutheleleka nokuphuma kwegazi.
Okufanele Ukulindele
Abaningi besifazane bangabuyela emsebenzini emasontweni ambalwa emva kokuba banesibindi. Imithi yokwelapha ingasiza ekunciphiseni noma yikuphi ukungakhululeki. Kunconywa ukuthi abesifazane bagweme ukuzivocavoca okunzima izinsuku ezimbalwa. Ngokuvamile, iningi labesifazane bazizwa belungele ukulala ocansini phakathi nesonto.
Abaningi besifazane baphulukiswa kule nqubo ngaphandle kwezinkinga. Ngokungafani nenzalo yesilisa (vasectomy), akukho ukuhlolwa okudingekayo ukuze kuhlolwe ubumpofu.
I-tubal ligation ayinciphisi injabulo yobulili yowesifazane futhi ayikuthinti ubufazi bayo. Njengoba kungekho izigulane noma izitho ezisusiwe noma zishintshiwe futhi wonke ama-hormone azokwenziwa akhiqizwe, i-tubal ligation akufanele ishintshe ubulili noma iphazamise ukusebenza komzimba wesifazane wesifazane.
Izindleko
Izindleko zesikhathi esisodwa ze-tubal ligation, uma kuqhathaniswa nezinye izindlela zokukhulelwa, zingakusindisa amakhulu ezinkulungwane zamahora ngaphezulu kwesikhathi. Izindleko zokuba ne-tubal ligation zingaba phakathi kuka-$ 1,000 kuya ku-3,000, kodwa zingase zibe ngaphezulu uma unenkinga. Owesifazane kufanele ahlole inqubomgomo yomshuwalense wezempilo njengoba ukuhlolwa kokulawulwa kokuzalwa kuhluka. Umshuwalense wezempilo kanye nempilo yangasese ingase ihlanganise izindleko ze-tubal ligation.
Ukuphumelela
I-tubal ligation ingaphumelela engamaphesenti angu-99. Izinga elincane lokuhluleka livela ngoba ngezikhathi ezithile ama-tubespian tubes angase aphinde aphinde aqokelele. Uma ukukhulelwa kwenzeka ngemuva kwesigqoko se-tubal, kunamaphesenti angu-33 amathuba okuba i-ectopic pregnancy. Kodwa-ke, izinga jikelele lokukhulelwa liphansi kangangokuthi ithuba lomama lokuba nokukhulelwa kwe-ectopic liphansi kakhulu kunokuba lingahlinzekwa ukuthi akanalo ukuqhutshwa kwe-tubal kwenziwa kuqala.
Ukuguqulwa kweT Tubal Ligation
Owesifazane kufanele ahlole ngokucophelela ukuthi noma yini i-tubal ligation (inzalo engapheliyo) iyindlela engcono kakhulu kuye. Ngisho nangokucabangela ngokucophelela, noma kunjalo, abanye besifazane abane-tubal ligation bagcina sebezisola ngesinqumo sabo kamuva. Owesifazane cishe uzodabuka ngokuthi izibhamu zakhe ziboshelwe uma:
- Usemncane
- Unabantwana abancane noma abangekho
- Wakhetha le ndlela hhayi ngenxa yokuthi wayeyifuna kodwa ngoba umlingani wakhe wayefuna ukuthi kwenziwe
- Wakhetha enkundleni ye-tubal ngoba wayekholelwa ukuthi uzoxazulula izinkinga zemali noma ngabe ucabanga ukuthi le nqubo izosiza ukulungisa izinkinga zobudlelwane
I-ligal ligation akufanele icatshangwe njengesikhashana. Ngezinye izikhathi ukuguqulwa kwe-tubal kungenzeka uma owesifazane kamuva ekhetha ukuthi ufuna ukukhulelwa. Kodwa-ke, ukuguqulwa kwe-tubal kuyindlela enkulu yokuhlinzwa engahlali njalo ekukhulelweni. Amaphesenti angaba ngu-50 kuya kwabangu-80 wamaphesenti abesifazane abathintekayo nge-tubal bangakhulelwa.
Ukwelashwa Okuqhubekayo Okungapheli
I-tubal ligation ingaba uhlobo oluhle kakhulu lokulawulwa kokuzalwa okungapheli, ngesilinganiso esihle kakhulu sokuphumelela ekuvimbeleni ukukhulelwa. Ibuye inezinzuzo ezengeziwe zokunciphisa ingozi yakho yomdlavuza we-ovari noma izifo ezivuvukala.
Lokho kusho ukuthi akuwona wonke umuntu ofisa ukusebenzisa le nqubo kanye nezinkinga ezihlobene (nakuba ezincane) zokuhlinzeka nokuhlinzekwa kwe-anesthesia jikelele.
Kunezinketho eziningi zokulawula ukubeletha okwesikhashana uma kunjalo. Kunezindlela ezimbili ezinkulu ezihlala njalo. Enye, i- vasectomy . Uma kuqhathaniswa ikhanda kuya ekhanda, i-vasectomy inomngcipheko omkhulu kunokuba i-tubal ligation, kodwa amanye amadoda awanandaba nale ndlela ngezizathu eziningana.
Kwabesifazane, kunomunye ongakhetha ukulawula ukuzalwa okungahleliwe okungapheli okubizwa ngokuthi i- Essure . Inqubo ye- Essure (ebizwa nangokuthi inzalo ebizwa ngokuthi i-hysteroscopic inzalo) yindlela yokwenza izinsimbi ezincane zifakwe emgodini wesibeletho futhi zingene emathanjeni wokuwabulala ukuze ziwafake . Inqubo ye-Essure ibilokhu ikhona kusukela ngo-2002, kodwa ayitholakali yonke indawo njengoba odokotela badinga isitifiketi esikhethekile sokwenza inqubo. Kusukela ngoNovemba 2016, i-Essure inesixwayiso sebhokisi esenzelwe ukuqinisekisa ukuthi abantu bafundiswa ngezingozi ezingase zibe khona zenqubo kanye nezinye izindlela.
Ukuqhathanisa ukusebenza kweT Tubal Ligation Izindlela
Akukho kubonakala sengathi kukhona umehluko omkhulu ekusebenzeni kwe-laparoscopy, i-lapartomy, noma i-hysteroscopy ngokuqondene nokusebenza kahle nakuba isidingo senqubo yokuphindaphinda singase sibe sikhulu kakhulu kulabo abaneNqubo yokuHlola.
Ngaphansi ngezindlela zeT Tubal Ligation
Kunezindlela ezihlukahlukene lapho kungenziwa khona i-tubal ligation, futhi okukhethile okufanele ukwenze ukuxoxa ngokucophelela nodokotela wakho. Okukhethwa kukho okuzotholakala kuncike ezintweni eziningi, njengokuthi ukhulelwe njengamanje, uye wahlinzwa ngaphambilini, uma ukhuluphele ngokweqile, noma uma unesibeletho esihlotshisiwe. Ngenkathi i-tubal ligation ingaba nenzuzo yesibili, njengengozi enciphise yomdlavuza we-ovarian, kunezinye izinketho zokulawulwa kokuzalwa okungapheli ezitholakalayo.
> Imithombo:
> Antoun, L., Smith, P., Gupta, J., noT. Clark. Ukutholakala, Ukuphepha, Nokusebenza Kwezinzalo Ze-Hysteroscopic Uma kuqhathaniswa ne-Laparoscopic Stterilization. Journal American of Obstetrics and Gynecology . 2017 July 27. (Epub ngaphambi kokuphrinta).
> Jokinen, E., Heino, A., Karipohia, T., Gissler, M., no R. Hurskainen. Ukuphepha nokusebenza kwe-Tubal Stterilization nge-Hysteroscopy, i-Laparascopy, noma i-Laparotomy: I-Register Based Based Study. I-BJOG . 2017 Meyi 2. (Epub ngaphambi kokuphrinta).
> Ilayisi, M., Murphy, M., noS S. Tworoger. Tubal Ligation, Hysterectomy kanye ne-Ovarian Cancer: A Meta-Analysis. I-Journal ye-Ovarian Research . 2012. 5 (1): 13.
> Ukuphathwa Kwezokudla Nezidakamizwa zase-US. Hlola uhlelo lokulawula ukubeletha okungapheli nge-Bayer Healthcare: Ukumenyezelwa kwe-FDA - Izinguquko zelebula. 11/15/16. https://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm529241.htm