Wake wezwa ngento efana nale ngemva kokuhlinzwa? (Isthmocele / Cesarean Scar Defect)

Uyazi, uma sikhuluma ngokuhlinzwa ngokuhlinzwa kokubeletha, asivamile ukukhuluma ngezinkinga ezingaba khona ngemva kwalokho. Ngokufanayo, abanye abantu bangase babe nenkinga encane ngemva kokuhlinzwa ngokuhlinzwa kokubeletha uma ukusikwa kwesibeletho kungapholi kahle. Lokhu yilokho odokotela abakubiza ngokuthi i-Isthmocele noma i-Cesarean Scar Defect. Ungakhathazeki, lokhu akwenzeki kuwo wonke umuntu, kodwa kubalulekile ukuqaphela lokhu, ikakhulukazi uma uke wahlinzwa ngokuhlinzwa kokubeletha noma uhlela ukukwenza esikhathini esizayo.

Ngakho-ke, iyini le isthmocele?

Kalula nje, i-isthmus iyisikhinjana esincane noma umgodi odongeni lwesibeletho sakho lapho wabelethwa khona ngokuhlinzwa. Ukuze kube sobala, kwenzeka odongeni lwesibeletho. Lokhu 'kugoba kwesibeletho' kwenzeka lapho ukusikwa okwenziwe ngesikhathi sokuhlinzwa kungapholi ngokuphelele. Lokhu ngezinye izikhathi kungaholela enkingeni yokukhulelwa (ukungazali), izinkinga ngesikhathi sokukhulelwa esikhathini esizayo, kanye nezinye izinkinga eziningi.

Ubani osengozini enkulu yokuba ne-isthmus defect (Cesarean Scar Defect)?

Nakuba lesi simo singaba khona kunoma ubani ohlinzwa ngokuhlinzwa, abanye abantu basengozini enkulu kancane. Ake sibheke ukuthi bangobani:

• Uma ukhuluphele kakhulu /ukhuluphele ngaphambi noma ngesikhathi sokukhulelwa.
• Uma unezinkinga zempilo eziphazamisa ukuphola kwenxeba.
• Ukuhlinzwa kwenziwa njengesinqumo esiphuthumayo, isikhathi eside ngemuva kokubeletha (ukuhlinzwa okungahleliwe kwaze kwaba sekwephuzile enkambisweni yokubeletha).
• Uma unesifo sikashukela noma uma unesifo sikashukela ngesikhathi sokukhulelwa (isifo sikashukela sokukhulelwa).
• Uma uke wabelethwa ngokuhlinzwa izikhathi eziningi .
• Uma ubhema noma usebenzisa eminye imikhiqizo kagwayi .

Uma okukodwa noma ngaphezulu kwalokhu kusebenza kuwe, kungumqondo omuhle ukuqaphela kancane. Kodwa khumbula, ngisho noma kunalezi zici eziyingozi, akuwona wonke umuntu ozokuthola.

Sivame kangakanani lesi simo se-isthmus?

Ngokusho kwemibiko yocwaningo, phakathi kuka-24% no-70% wabesifazane abaye babelethwa okungenani ngokuhlinzwa bahlakulela lesi simo. Njengoba inani lokubeletha ngokuhlinzwa landa emhlabeni wonke, lesi simo manje sesivame kakhulu. Isibonelo, cishe u-30% wezingane ezizalwa e-United States zibelethwa ngokuhlinzwa. Ngakho-ke kubalulekile ukuqaphela lesi simo.

Kungani kwenzeka lesi sici sesibazi sokuhlinzwa (i-Isthmocele)?

Cabanga nje, ngesikhathi sokuhlinzwa, kwenziwa izimbobo ezimbili. Owodwa esiswini, kanti omunye esibelethweni. Uma isimbobo esibelethweni singapholi kahle,Kulungile, noma mhlawumbe uma usika kaningi endaweni efanayo, izicubu ezikuleyo ndawo zingaba zincane. Yilapho kwakheka indawo efana nesikhwama, njengaleyo oyishilo, bese iqala ukugcwala uketshezi negazi.

Ngezinye izikhathi, indawo lapho kunqunywe khona ngesikhathi sokuhlinzwa kungathinta nalokhu. Uma ukuhlinzwa kwenziwa phansi kakhulu esibelethweni, kunethuba elikhulu lokuba nesilonda esikhulu. Ngokuvamile, lolu hlobo lokuhlinzwa oluphansi lwenziwa lapho kwenziwa ukuhlinzwa isikhathi eside ngemva kokuzalwa. Kuthiwa futhi uma kusetshenziswa ungqimba olulodwa kuphela lwezithungo lapho kuvalwa ukuhlinzwa kwesibeletho esikhundleni sezimbili , ingozi yokwakheka kwe-isthmus inganda.

Ingabe isibazi sokuhlinzwa singadala ukungazali?

Yebo, ngezinye izikhathi lesi sibazi sokuhlinzwa singadala ukungazali . Kodwa izindaba ezinhle ukuthi ngokwelashwa okufanele, abantu abaningi bangaqhubeka nokukhulelwa okunempilo futhi. Uma uzizwa sengathi unezimpawu ze-isthmus, noma uma ubulokhu uzama ukukhulelwa unyaka wonke (noma izinyanga eziyisithupha uma uneminyaka engaphezu kwengu-35) futhi ungakakwazi ukukhulelwa, qiniseka ukuthi ubona udokotela wakho futhi ukhulume ngakho.

Ziyini izimpawu zalesi simo se-isthmus?

Nakuba kungebona bonke abantu abangase babe nezimpawu, abanye abantu bangase babe nalokhu okulandelayo:

• Ukuya esikhathini okungavamile .
• Ukuya esikhathini okubuhlungu (i-Dysmenorrhea).
• Ubuhlungu ngesikhathi socansi (i-Dyspareunia).
• Ubuhlungu be-pelvic .
• Ukopha okuvela esithweni sangasese sowesifazane noma esibelethweni phakathi kwemijikelezo emibili yokuya esikhathini.
• Ukuphuma koketshezi olungavamile esithweni sangasese sowesifazane .

Uma uqhubeka nokuba nesinye noma ngaphezulu salezi zimpawu, kungcono ukukhuluma nodokotela ngakho.

Yiziphi izinkinga ezingaba khona ze-isthmus cyst?

Uma lesi simo singelashwa kahle, kungase kube nezinkinga ezithile. Lezi zinkinga zifaka:

• Ingozi eyengeziwe yezinkinga ngesikhathi sezinqubo zezifo zabesifazane.
• I-placenta accreta ( i-placenta enamathela kakhulu odongeni lwesibeletho ).
• I-Placenta previa.
• Ukukhulelwa kwezibazi - Lolu futhi uhlobo lokukhulelwa kwe-ectopic, lapho iqanda elivundisiwe lifaka khona isibazi esibelethweni.
• Ukungazali kwesibili - Lokhu kusho ukungakwazi ukukhulelwa futhi ngemva kokukhulelwa okuphumelelayo kwangaphambilini.
• Ukuphuma kwesibeletho ( ukuklebhuka noma ukuklebhuka kwesibeletho endaweni yesibazi sesibeletho ).

Lezi zinkinga zingase zesabe ukuzwa ngazo. Kodwa khumbula, azenzeki kuwo wonke umuntu. Ukuxilongwa kusenesikhathi kanye nokwelashwa kunganciphisa kakhulu lezi zingozi.

Uyibona kanjani le nkinga ye-isthmus?

Thola i-IsthmusUkuhlolwa kwezithombe ezikhethekile kuphumelela kakhulu. Isikhathi esingcono kakhulu sokwenza lokhu kuhlolwa kungemuva nje kokuphela komjikelezo wakho wokuya esikhathini. Lokhu kungenxa yokuthi indawo engezansi ingase igcwale igazi ngaleso sikhathi, okwenza kube lula ukubona esivivinyweni.

Udokotela wakho angase asikisele ukuhlolwa okufana nalokhu:

• I-Hysteroscopy: Lokhu kuhilela udokotela ukufaka ipayipi elincane, elikhanyayo ngesitho sakho sangasese sowesifazane bese ehlola ingaphakathi lomlomo wesibeletho sakho kanye nesibeletho. Lokhu kungahlola noma yiziphi izibazi, izicubu ezingavamile, noma ezinye izinkinga.
• I-sonohysterography yokufakwa kwe-saline: Lokhu kunikeza imininingwane eminingi kune-ultrasound ejwayelekile ye-transvaginal. Lapha, udokotela ugcwalisa isibeletho sakho nge-saline (amanzi anosawoti ahlanziwe) bese enza i-ultrasound. Njengoba 'isikhwama' sigcwele amanzi, izinto ezifana nosayizi waso kanye nobukhulu bodonga zingabonakala ngokucacile ezithombeni.
• I-ultrasound edluliselwa esithweni sangasese sowesifazane: Lokhu kuhilela ukufaka i-ultrasound probe ngesitho sangasese sowesifazane ukuze kubhekwe isibazi kanye 'nendawo' esibelethweni. Kungahlola nobukhulu besibazi.

Izibazi zokuhlinzwa ziphathwa kanjani?

Kunezindlela eziningana zokwelapha ama-cyst e-isthmus. Udokotela wakho uzonquma ukuthi yikuphi ukwelashwa okungcono kakhulu kuwe ngokusekelwe esimweni sakho, ubukhali bezimpawu zakho, nokuthi uyafuna yini ukuba nabantwana futhi.

• Izithibela-nzalo eziphuzwa ngomlomo: Lawa amaphilisi okuvimbela inzalo. Anikeza imithamo ephansi yama-hormone. Lawa ma-hormone angalawula umjikelezo wakho wokuya esikhathini futhi anciphise ukuphuma kwegazi esikhathini. Ngezinye izikhathi lokhu kwelashwa kunganciphisa ubukhulu 'bendawo' kangangokuthi ukuhlinzwa akudingeki.
• Ukususwa kwe-Hysteroscopic (HR): Ngesikhathi se-hysteroscopy, udokotela angasusa izicubu zesilonda esibelethweni. Angavula nezinhlangothi 'ze-niche' ukuze kuphume igazi noketshezi. Lokhu akudingi noma yikuphi ukusikwa esiswini.
• Ukulungiswa kwe-Laparoscopic: Kule nqubo, udokotela wenza ukusikwa okukodwa noma ngaphezulu okuncane esiswini sakho bese efaka ipayipi elincane, elikhanyayo (i-laparoscope) ngalo ukuze abheke ngaphakathi kwesibeletho sakho. Izicubu zesibazi kanye nezicubu ezengeziwe ezizungeze 'indawo' ziyasuswa. Lokhu kuyindlela encane yokuhlinzwa yezibazi zokuhlinzwa. Lokhu kungakusiza ukuthi ululame ngokushesha futhi uzizwe ubuhlungu obuncane.
• Ukususwa kwesibeletho:Lokhu kusho ukususa sonke isibeletho. Lokhu kuvame ukwenziwa kubantu abanezimpawu ze-isthmus ezinzima kakhulu futhi abangafuni ukuphinda babe nabantwana. Ungase ukwazi ukuhlinzwa nge-laparoscopic hysterectomy. Lena futhi inqubo engavamile, okusho ukuthi ungalulama ngokushesha futhi ube nobuhlungu obuncane ngaphandle kokwenza imivimbo emikhulu.

Sikuvimbela kanjani ukwakheka kweziqhingi?

Eqinisweni, okuwukuphela kwendlela yokuvimbela ngokuphelele i-isthmus ukugwema ukuhlinzwa ngokuhlinzwa. Kodwa akuwona wonke umuntu ongakwenza lokho. Uma ukhulelwe futhi uhlela ukuhlinzwa ngokuhlinzwa, khuluma nodokotela wakho ngengozi yakho yokuthola isibazi sokuhlinzwa (isthmus). Unganciphisa ingozi yakho ngokwenza okulandelayo:

• Gcina isisindo esinempilo ngaphambi nangesikhathi sokukhulelwa.
• Ukulawula isifo sikashukela .
• Ukugwema ukubhema nokusebenzisa eminye imikhiqizo kagwayi .

Sinjani isimo sempilo sabantu abanezibazi zokuhlinzwa?

Izindaba ezinhle ukuthi isibazi sokuhlinzwa (isthmus) yisimo esingelapheka. Abantu abaningi bayakwazi ukukhulelwa futhi ngemva kokwelashwa, ngakho ungalilahli ithemba.

Kufanele ngimbone nini udokotela?

Uma une-isthmus ngesikhathi sokukhulelwa, usengozini yokuqhekeka kwesibeletho . Lesi yisimo esiphuthumayo sezokwelapha . Lokhu kwenzeka lapho isibazi sesibeletho sihlukana futhi isibeletho sidabuka. Lokhu kungaba yingozi enkulu empilweni yakho nakumntwana wakho.

Uma uzwa ubuhlungu obukhulu be-pelvic, ubuhlungu lapho kwakukhona khona isibazi sakho sokuhlinzwa, noma ukopha okukhulu kwesitho sangasese sowesifazane , lokhu kungaba izimpawu zokuqhekeka kwesibeletho. Uma lokhu kwenzeka, funa iseluleko sezokwelapha ngokushesha.

I-isthmus iyisikhwanyana esincane, noma 'i-niche,' esakheka odongeni lwesibeletho sakho. Ibangelwa ukusikwa kokuhlinzwa kokubeletha okungaphili kahle. Lokhu kungabangela ukopha okungajwayelekile kwesitho sangasese sowesifazane, ubuhlungu be-pelvic, nezinkinga zokuya esikhathini. Kungabangela futhi ukungazali noma izinkinga ngokukhulelwa kwesikhathi esizayo. Ukwelashwa okuvamile kakhulu ukuhlinzwa okuncane okungafuneki ukuze kususwe izicubu zesilonda esengeziwe futhi kudale 'i-niche.' Iningi labantu lingaba nokukhulelwa okunempilo ngemva kokwelashwa.

Khumbula into ebaluleke kakhulu (Umyalezo Wokuya Ekhaya)

• I-isthmocele 'isikhwama' esincane esakheka lapho ukusikwa kwesibeletho kungapholi kahle ngemva kokuhlinzwa.
• Nakuba kungebona bonke abantu ababhekana nalokhu, abanye abantu bangase babe nokungabi nabantwana, izinkinga zokuya esikhathini, kanye nezinkinga ngesikhathi sokukhulelwa esikhathini esizayo.
• Uma unezimpawu ezifana nokopha okungajwayelekile noma ubuhlungu be-pelvic, bona udokotela.
• Lesi simo singatholakala futhi selashwe . Ezimweni eziningi, ukukhulelwa okuphumelelayo kungatholakala ngemva kokwelashwa.
• Uma uke wabelethwa ngokuhlinzwa, kubaluleke kakhulu ukuqaphela lokhu. Akukho okufanele ukwesabe, khuluma nodokotela wakho ngaso sonke isikhathi ngalokhu.

Uma uneminye imibuzo mayelana nalokhu, ungesabi ukubuza udokotela wakho wezifo zabesifazane. Bazokusiza.

I- Isthmocele, Isici Esibi Sokuhlinzwa, Ukuhlinzwa Kwesibeletho, Isibeletho, Impilo Yabesifazane, Ukungazali, Ukuhlinzwa Kwesibeletho