I-phalloplasty yilapho ukwakhiwa kwe-penis, noma i-phallus. I-phalloplasty ingaba yingxenye yokuhlinzeka ngokuhlinzwa kwamanye amadoda angama-transgender. (Amanye amadoda angama-transgender angase akhethe ukuba ne-metoidioplasty noma angenaso isithakazelo ekuhlinzekeni ngokocansi.) Amadoda angama- cisgender angazalwa ngaphandle kwepenisi noma alahlekelwa ipenisi ngengozi noma ngezifo.
Ngokuvamile kwenziwa ngumhlinzeki wezinambuzane epulasitiki kanye / noma i-urologist.
Phalloplasty Basics
Ngokuyisisekelo, ukudala ipenisi kuhilela ukwakha ithubhu ngaphakathi kwebhubhisi. I-tube yangaphakathi yi-urethra, isakhiwo abantu abavuthwa ngayo. I-tube yangaphandle yi-shaft penile. Lesi sakhiwo, esaziwa ngokuthi i-neophallus ( neo - entsha), sihlinzekwa ngokugcwele ngesikhumba. I-urethra ye-neophallus ixhunywe ku-urethra ekhona. Izindwangu zegazi nezishukela zinamathele kulabo bekhanda. Khona-ke ingaphandle yangaphandle ye-neophallus icatshangelwa ukuba ifane ne-shaft shaft nekhanda.
Izinhlobo ze-Flap
Izigaba zesikhumba nezinye izicubu ezisetshenziselwa izinqubo zokuhlinzwa epulasitiki ezifana ne-phalloplasty ziyaziwa ngokuthi yi- flaps . Kunezinhlobo eziningana ze-flap ezingasetshenziswa phalloplasty. E-United States, uhlobo oluvame kakhulu lwe-flap elisetshenziswe yi-flap ye-frontal flap, noma i- RFF. Lokhu kuhilela ukuvunwa umugqa omkhulu wesikhumba kwesinye sezibeletho zesiguli.
Izinzuzo eziyinhloko zalesi sigqoko yilokuthi lukhulu kakhulu, kulula ukuvuna, futhi luzwela ukuthinta. Izinkinga eziyinhloko ukuthi umbala ungase uhluke kakhulu esikhunjeni sobulili nokuthi leyo nqubo ishiya isibazi esiphezulu kakhulu esibonakalayo. Ubuchopho buhluke kakhulu, ukuthi kubantu abajwayele i-RFF phalloplasty, ukubona lokhu kuyisibonakaliso sokuthi lo muntu obomvu uthola lokhu kuhlinzwa.
Lokhu kungaba inkinga kwamanye amadoda, angafuni ukukhangisa athole i-phalloplasty.
Enye ingozi ebalulekile ukuthi i-forearm kumele ihlanganiswe ngesikhumba sesikhumba esisuka kwelinye lamathanga. Lokhu kushiya izibazi ezindaweni ezimbili ezingase zibonakale, kuye ngokuthi umuntu ugqoke kanjani. Okokugcina, i-RFF ivuliwe idinga ukuthi udokotela ohlinzayo abe nolwazi lwe-microsurgery, ngoba i-flap isuswe ngokugcwele engalweni futhi idinga ukuxhunyaniswa kabusha nasezikhungweni zegazi eduze ne-groin.
Amanye ama-flaps athile asetshenziselwa i-phalloplasty avunwa ezindaweni ezilandelayo:
- Lattisimus dorsi
- Isifunda sesishicilelo esiphezulu
- Ithanga
Iziphazamiso zethanga ezenziwe ngamapulangwe yizona ezinye iziphambano ezivame ukusetshenziselwa i-phalloplasty e-United States. Ngokungafani nama-flaps angama-radial, lezi ziphazamiso zihlala zixhunyaniswe nokunikezwa kwegazi kwangempela. Lokhu kusho ukuthi akudingi ubuchwepheshe bokusebenza kwamakhamzimba engxenyeni yokuhlinza eyenza i-phalloplasty. Noma kunjalo, lezi ziphazamiso zisebenza kanzima kakhulu. Ungqimba lwamanqamu okhudlwana lukwenza kube nzima ukuwafaka emgodini ukuze ubumbe ipeni. Iziphazamiso zethanga ezenziwe ngamapulangwe nazo zihlotshaniswa nezinga eliphezulu lezinkinga zokuncintisana kunezingqimba zomsindo. Kukhona idatha encane yokuqhathanisa yemiphumela yamanye ama-flap asetshenziswe ku-phalloplasty.
Amaphrotheni asePenile
Akubona bonke abantu abafuna i-phalloplasty banesifiso sokwenza umsebenzi we-erectile ofanelekayo ocansini lokungena. Abanye ngokuyinhloko bakhathazeke ngokukwazi ukuma ukuchama noma ukuhamba ngezindawo ezivamile njengamakamelo okuzulazula. Kodwa-ke, amadoda afuna ukukwazi ukulala nomngani wakho kuzodinga ukufakwa kwe-penile prosthesis. I-penile prosthesis nayo yaziwa nangokuthi i- penile implant .
Odokotela abaningi abahlinzayo bafaka i-penile prostheses ngemuva kokuba i-phalloplasty yokuqala ikwazi ukuphulukisa, kodwa abanye bayokwenza inqubo eyodwa. Kukhona izinzuzo nokungalungi kokubili okukhethwa kukho.
Ngokufanayo, kunezinzuzo nezinzuzo ezinhlobonhlobo ze-prostenies ye-penile. I-infleable penile prostheses isebenzisa i-fluid pumped kusuka emgodini ukuze igxile ipeni. Kukhona nezimpande eziqinile noma ezinokuthenjelwa. Lezi zigcina zinzima ngaso sonke isikhathi kodwa zingagujwa noma ziqondiswe ngezidingo. I-prostheses ene-inflatable isetshenziswa kangcono kakhulu, ngoba ayidingi indoda ukuba isetshenziswe ukuba ne-penis kanzima ngaso sonke isikhathi. Kodwa-ke, ukuhlinzekwa ukuyibeka kuyinkimbinkimbi kakhudlwana kunokuba kube nokutshala okuqinile.
Izinkinga ezivamile ze-Phalloplasty
Izinkinga ze-urethral yizixazululo ezivamile kakhulu ze-phalloplasty. Iziguli zingase zihlakulele i-fistula ye-urethral, lapho i-tube ethwala umchamo ivuleka esikhumbeni futhi ibangele umchamo ukuba uvuza. Lokhu ngokuvamile kwenzeka lapho i-urethra entsha ijoyine khona endala. Noma kunjalo, kungenzeka noma kuphi ku-neophallus.
Okunye okukhona okungahle kwenzeke emcimbini we-phalloplasty kuyinkinga yokukhohlisa. Yilapho ukuhamba kuyoba mncane kakhulu ukuphatha umchamo. Okunye, okungavamile kakhulu, izinkinga ze-phalloplasty zifaka ukulahlekelwa okungafani noma okuphelele kwephutha kanye nezindaba ne-graft yesikhumba. Iziguli ezithola i-penile prostheses nazo zingase zibe nezinkinga ngalawo madivayisi. Eqinisweni, lolu hlobo lwezinkinga aluvamile, kokubili ngemuva kokufakelwa kabusha kanye neminyaka eminingana. Izinkinga ezine-penile prosthesis zingadinga ukususwa noma ukufakwa esikhundleni sokufakelwa.
Ukwahlukana Kwe-Phalloplasty Kwabesilisa Be-Transgender
Ngokuvamile, izinqubo ze-phalloplasty zifana namadoda ase-cisgender namadoda angama-transgender. Noma kunjalo, kunemibono embalwa ebalulekile. Umehluko wokuqala uhilela ukulondoloza ukuzwa kwesondo. Kwabesilisa abahlukumezayo, izinzwa ze-phallus zixhunywe kulabo be-clitoris noma i-clitoris ifakwe ngaphansi kwesipenisi. Kungakhathaliseki ukuthi yikuphi, umgomo ukuvikela isisindo socansi kanye nomsebenzi we-orgasmic ezithombeni zobulili, ngokuvumela ukugqugquzelwa kwe-penile ukuvuselela izinzwa ze-clitoral.
Omunye umehluko omkhulu ukukhuliswa kwe-urethra. Kwabesilisa be-cisgender, i-urethra isendaweni efanele yokuxhuma emzimbeni wepenisi. Kodwa-ke, ngenxa yamadoda angama-transgender, kufanele kwenziwe isandiso sokuxhumanisa i-urethra ekhona ngaphansi kwesipenisi. Lokhu kungafaka ubunzima obunzima ekuhlinzekeni. Lesi sandiso senye indawo lapho kungaba khona izinkinga ekuphulukisweni.
Okokugcina, ngenxa yamadoda angama-transgender, udokotela ohlinzayo kumele ahlinzekele ngokudala i-scrotum. Lokhu kuvame ukukwenziwa ngokusebenzisa isikhumba sabantu abangaphandle bezintambo. Ngakho-ke kungenzeka ukufaka ama-testicular prostheses, uma isiguli sifuna. Kuye okuthandwayo kwalowo ohlinzayo, lokhu kungenziwa ngesikhathi sokuhlinzwa noma, ngokuphindaphindiwe, ngemuva kokuhlinzwa kokuqala sekuyisikhathi sokuphulukisa.
Okungahambisani nama-Multi Stage Surgeries
Isiteji esisodwa se-phalloplasty sihilela ukwakhiwa kwesinye isikhathi se-phallus ne-urethra, kanye nokuxhuma kwe-urethra. Uma kudingekile, kuhilela nokudalwa kwe-scrotum nokufakwa kwe-testicular prostheses. Konke lokhu kwenziwa njengendlela eyodwa, yize noma yiziphi izidakamizwa ze-penile ngokuvamile ezifakwa ngosuku oluthile.
I-phalloplasty yesigaba esiningi iphula ukuhlinzwa kube yizingxenye. Lokhu kuvame kakhulu, njengoba kuvumela ukuphathwa okuningiliziwe kwengxenye ngayinye yokuhlinzwa. Kodwa-ke, amanye amaqembu okuhlinzeka enza izinqubo ezilodwa zesiteji. Lokhu kungaba lula kakhulu iziguli okufanele zihambe ibanga elikhulu lokuhlinzwa. Akucaci ukuthi kukhona yini ingozi eyengeziwe yokubhekana nezinkinga ezikodwa. Lokho kusho ukuthi abantu abaningi abazobhekana ne-phalloplasty bazodinga ukuhlinzekwa okukodwa noma ngaphezulu kokubuyekeza, kungakhathaliseki ukuthi inqubo ekuqaleni yayihloselwe ukuba yodwa noma isigaba esiningi.
> Imithombo:
> Ascha M, Massie JP, Morrison SD, Crane CN, Chen ML. Imiphumela yeSisiteli esisodwa se-Phalloplasty nge-Pedicled Anterolateral Thigh Flap ngokumelene ne-Radial Forearm Free Flap ngoGender Ukuqinisekisa Ukuhlinzwa. J Urol. 2017 Jul 29. pii: S0022-5347 (17) 77248-5. doi: 10.1016 / j.juro.2017.07.084.
> ML Djordjevic, Stanojevic D, Bizic M, Kojovic V, Majstorovic M, Vujovic S, Milosevic A, Korac G, Perovic SV. I-Metoidioplasty njengokwenziwa kwesinye isikhathi sokuhlinzwa kwezesondo zocansi kuma-transsexual abesifazane: isipiliyoni saseBelgrade. I-J Med Med. 2009 Meyi; 6 (5): 1306-13. i-doi: 10.1111 / j.1743-6109.2008.01065.x
> Frey JD, Poudrier G, Chiodo MV, Hazen A. Ukubukezwa Okuhlelekile Kwe-Metoidioplasty ne-Radial Forearm Flap Phalloplasty ku-Transgender Genital Reconstruction: Ingabe i-"Ideal" Neophallus iyinjongo efinyelelekayo? I-Plast Reconstr Surg Glob Vula. 2016 Dec 23; 4 (12): e1131. i-doi: 10.1097 / GOX.0000000000001131.
> Neuville P, Morel-Journel N, Maucourt-Boulch D, i-Ruffion A, i-Paparel P, i-Terrier JE. Imiphumela Yokuhlinza Yemihlahlandlela Erectile Ngemuva kwePhalloplasty: Ukuhlaziywa Okubukeziwe Kwezinqubo ezingu-95. I-J Med Med. 2016 Nov; 13 (11): 1758-1764. i-doi: 10.1016 / j.jsxm.2016.09.013.