Uvuyo oluvayo njengomzali xa ujonge usana olusandul’ ukuzalwa alunakuchazwa. Kodwa ngamanye amaxesha, xa ugqirha ehlola umntwana aze akuxelele ukuba kukho into engalunganga emzimbeni wakhe, ungaziva usoyika kwaye ukhathazekile. Namhlanje, sithetha ngesiphene esingaqhelekanga, kodwa esibalulekileyo sokuzalwa. Oku kubizwa ngokuba yi-Urogenital Sinus.
Yintoni le Urogenital Sinus?
Ngamafutshane, esi siphene sokuzalwa esichaphazela amantombazana kuphela . Khawucinge nje, intombazana idla ngokuba nezimbobo ezintathu emzimbeni wayo ongezantsi.
1. Ukuvulwa kwendlela yomchamo (urethra) apho umchamo uphuma khona.
2. Ukuvulwa kwesisu (isitho sangasese sowesifazane).
3. Umngxuma okwi-rectum (i-anus) apho kuphuma khona ilindle.
Nangona kunjalo, umntwana one-Urogenital Sinus unemingxuma emibini. Omnye uvula indawo yokuphuma kwendle. Omnye uvula indawo eqhelekileyo eyenzeka ngokudibana kwe-urethra kunye ne-vagina. Oku kuthetha ukuba zombini i-urethra kunye ne-vagina zidibene nale mingxuma inye.
Kutheni oku kusenzeka?
Ukuze sikuqonde oku, kufuneka sibuyele kwizigaba zokuqala zokukhula komntwana esibelekweni. Xa umntwana esakhula njengomntwana ongekazalwa, ezi nkqubo zintathu sizikhankanyileyo (inkqubo yamathumbu, inkqubo yomchamo, kunye nenkqubo yokuzala) ziqala zihlangane kwaye zivuleke kwigumbi eliqhelekileyo. Oku kubizwa ngokuba yi-"cloaca". Njengoko umntwana ekhula esibelekweni, ezi nkqubo zintathu ziyahlukana kancinci kancinci kwaye zenze imingxuma emithathu eyahlukeneyo. Kodwa ngamanye amaxesha, ngesizathu esithile, inkqubo yomchamo kunye nelungu lobufazi azihlukani kakuhle. Kulapho zidibana khona kwaye zenze imeko ebizwa ngokuba yi-"Urogenital Sinus."
Ngaba kukho iintlobo eziphambili ze-Urogenital Sinus?
Ewe, le meko inokwahlulwa ibe ziintlobo ezimbini eziphambili, kuxhomekeke ekubeni indlela eqhelekileyo ingakanani na kwaye idibana phi emzimbeni.
| Uhlobo | Ingcaciso elula |
|---|---|
| I-confluence edibeneyo/edibeneyo engaphantsi | Kolu hlobo, i-urethra kunye ne-vagina zidibana kufutshane kakhulu nomnyango wangaphandle womzimba. Ke ngoko, indlela eqhelekileyo imfutshane kakhulu . I-urethra kunye ne-vagina zinokuba nobukhulu obuqhelekileyo kunye nendawo eqhelekileyo. Le yimeko engembi kangako. |
| Idibaniso ephezulu / ephezulu | Apha, ezi ndlela zimbini zidibana ngaphakathi emzimbeni, kude nomnyango wangaphandle. Ke ngoko, indlela eqhelekileyo inde kakhulu . Oku kuthathwa njengemeko enzulu ngakumbi . Kuba inxulunyaniswa nomngcipheko ophezulu wezinye iingxaki. |
Le yimeko engaqhelekanga kakhulu. Idla ngokuvela ngaphantsi komnye kubantwana abazalwayo abayi-10,000. Ngoko ke musani ukothuka yile ndaba.
Zithini iimpawu zoku?
Iimpawu zingahluka ngokuxhomekeke kubukhali bemeko. Ezi zidla ngokubonakala xa ugqirha ehlola umntwana emva kokuzalwa.
- Eyona nto iphambili kukuba, njengoko besitshilo ngaphambili , kukho imingxuma emibini kuphela : enye yendle kwaye enye ingumngxuma oqhelekileyo we-urethra kunye ne-vaginal.
- Umchamo uqokelelana ngaphakathi kwilungu lobufazi, nto leyo ebangela ukuba ilungu lobufazi lidumbe. Oku kuthiwa yi-``hydrocolpos``` ngokwezonyango.
- Ngamanye amaxesha isini sisenokungakhuli ngokupheleleyo.
- Usenokubona amalungu angaphakathi afana nesibeleko, ama-ovari, okanye iityhubhu ze-fallopian zingakhuli kakuhle.
Kutheni oku kusenzeka? Zithini izizathu?
Kudla ngokuba nzima ukukhomba unobangela othile, kodwa kukho izizathu ezimbalwa eziphambili ezichongiweyo ngoogqirha.
- I-Congenital Adrenal Hyperplasia (CAH): Le yimeko yemfuza. Kule meko, amadlala e-adrenal omntwana awavelisi i-enzyme efunekayo ukuvelisa iihomoni. Oku kunokubangela ukungalingani kweehomoni kunye nophuhliso olungaqhelekanga lwezitho zangasese, ingakumbi kumantombazana.
- Ukukhula kwe-Virilization: Ngamafutshane, kukwanda kwee-hormone zamadoda (androgens) kwimveku ekhulelweyo. Oku kunokuchaphazela nophuhliso lwezitho zangasese.
Oogqirha bayixilonga njani le meko?
Ukuchonga le meko ngokuchanekileyo kubaluleke kakhulu ekucwangciseni unyango. Ngamanye amaxesha inokubonwa ngexesha le-ultrasound scans yokukhulelwa. Kodwa uninzi lwexesha, ugqirha uqaphela olu tshintsho ngexesha lovavanyo lokuqala lomzimba emva kokuba umntwana ezelwe . Emva koko, kuyalelwa ezinye iimvavanyo ezininzi ukuqinisekisa imeko kunye nokufumanisa ubukhali bayo.
| Uvavanyo | Ngamafutshane, wenza ntoni ngayo? |
|---|---|
| Iskena se-Ultrasound | Oku kunceda ukubona imeko yezitho zangaphakathi zomntwana, ezifana nezintso, isinyi, i-vagina, kunye ne-rectum. Kungajonga nokudumba kwe-hydrocolpos (i-vagina). |
| I-Retrograde Genitogram | Olu luvavanyo olukhethekileyo lwe-X-ray. Ugqirha ufaka idayi ekhethekileyo kwindawo evulekileyo aze athathe imifanekiso ye-X-ray. Oku kuvumela ukuba imo, ubungakanani, kunye nendawo yezitho ezingaphakathi zibonakale ngokucacileyo. |
| Iskeni yeMRI | Oku kuvumela imifanekiso ecacileyo neneenkcukacha zangaphakathi lomzimba. Kungabonisa nendawo echanekileyo ekuyo i-Urogenital Sinus kunye nezinye iingxaki ezinokubakho, njengomqolo ojikelezileyo. |
| I-Endoscopy | Le ndlela isebenzisa ityhubhu encinci (i-endoscope) exhotyiswe ngekhamera kunye nokukhanya ukuze kufakwe ngaphakathi kwi-orifice eqhelekileyo kwaye kubonwe ngaphakathi ngqo kwisikrini. |
Iphathwa njani?
Eyona ndlela yokunyanga le meko kukwahlula i-vagina kunye ne-urethra ngotyando .
Esi sisigqibo esinzima kakhulu. Ngaphambi kotyando, uya kuba nengxoxo ende neqela lezonyango lomntwana wakho. Eli qela lidla ngokuquka ugqirha ogxile kwiinkqubo zomchamo nezokuzala (i-'Urologist') kunye nogqirha ogxile kwiihomoni (i-'Endocrinologist').
Olu tyando ludla ngokwenziwa kunyaka wokuqala wobomi bomntwana . Uhlobo lotyando oluqhutywayo luxhomekeke ekubeni imeko `ijoyintiwe `okanye `ijoyintiwe `, esixoxe ngayo ngaphambili.
- Kwimo edibeneyo esezantsi:Inkqubo yotyando ebizwa ngokuba yi-'flap vaginoplasty' idla ngokwenziwa. Kule nkqubo, ugqirha usebenzisa inxalenye yesithuba esiqhelekileyo ukwenza izithuba ezimbini ezahlukeneyo zesini kunye ne-urethra.
- Kwiimeko ezinamaqhina aphezulu: Kufuneka utyando olunzima ngakumbi, olufana ne-'pull-through vaginoplasty'. Apha, i-vagina yahlulwe kwindawo eqhelekileyo kwaye kwenziwe umngxuma owahlukileyo kuyo.
Abanye abantwana banokufuna utyando, olufana ne-'clitoroplasty' okanye 'labiaplasty', ukuze kubuyiselwe imo ye-clitoris okanye ye-labia kwisimo esiqhelekileyo.
Ngaba oku kuya kuyichaphazela ikamva lomntwana wam?
Lo ngumbuzo omkhulu kumzali ngamnye. Injongo ephambili yolu tyando kukuvumela umntwana ukuba enze imisebenzi yomzimba eqhelekileyo nokubuyisela ukubonakala kwezitho zangasese kwimeko eqhelekileyo.
- Ukuchama: Emva kotyando, uninzi lwabantwana luyakwazi ukuchama ngendlela eqhelekileyo ngaphandle kweengxaki .
- Umjikelo wenyanga: Oku akuyi kuchaphazela umjikelo wenyanga oqhelekileyo emva kokuba umntwana ekhulile.
- Ubomi bokwabelana ngesondo: Ngamanye amaxesha, njengoko umntwana ekhula, isini singancipha okanye sibe mfutshane (i-vaginal stenosis). Oku kunokubangela ubunzima ngexesha lokwabelana ngesondo kwixesha elizayo. Ungathetha nogqirha wakho ngale nto kwaye ufumane unyango oluyimfuneko.
- Ukukhulelwa: Ukuba nale meko akuthethi ukuba umntwana akayi kukwazi ukukhulelwa kwixesha elizayo. Nangona kunjalo, ukuba utyando lunzima kakhulu, oogqirha banokucebisa ukuba umntwana abelekwe ngotyando (C-section) xa umntwana ezalwa.
Ezi zinto zinokwahluka ngokuxhomekeke kwimeko yomntwana wakho, ngoko ke kungcono ukuxoxa ngayo yonke into ngokukhululekileyo nogqirha wakho.
Imibuzo yokubuza ugqirha
Buza ugqirha wakho ngayo yonke imibuzo yakho kunye noloyiko lwakho. Umzekelo, ungabuza imibuzo efana nale:
- Luhlobo luni lweSinus ye-Urogenital umntwana wam anayo?
- Luhlobo luni lotyando olucetywayo? Uneminyaka emingaphi engcono ukuba lwenziwe?
- Ngaba umntwana wam usentlungwini ngoku?
- Ngaba kuza kufuneka utyando olongezelelekileyo njengoko umntwana ekhula?
- Ngaba oku kuya kuyichaphazela indlela umntwana aqala ngayo ukuya exesheni?
- Ngaba oku kuya kuyichaphazela into yokuba umntwana amkelwe nguwe kwixesha elizayo?
Umyalezo Wokuya Ekhaya
- I-Urogenital sinus sisifo esingaqhelekanga sokuzalwa kwamantombazana, apho i-urethra kunye ne-vagina zidibana nomngxuma omnye oqhelekileyo.
- Le meko idla ngokufunyaniswa ngexesha lokuhlolwa ngugqirha emva nje kokuba umntwana ezelwe.
- Unyango olulodwa loku kukwahlula iindlela ezimbini ngotyando. Esi sisigqibo esibalulekileyo abazali kunye neqela lezonyango abasenza kunye.
- Emva kotyando olufanelekileyo, uninzi lwabantwana lunokuphila ubomi obuqhelekileyo. Bayakwazi ukuchama ngendlela eqhelekileyo.
- Thetha ngokukhululekileyo nogqirha womntwana wakho malunga namathandabuzo okanye uloyiko onalo. Baza kukunika ulwalathiso olungcono kakhulu.
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