Agenesis Huina
Nānaina
ʻO ka agenesis vaginal (a-JEN-uh-sis) he maʻi maʻamau ʻole ia kahi ʻaʻole e ulu ai ka pepeiao wahine, a e ulu hapa wale paha ka ʻōpū (uterus) a i ʻole ʻaʻole loa. Aia kēia kūlana ma mua o ka hānau ʻana a pili paha i nā pilikia o ka puʻupaʻa a i ʻole nā iwi.
Ua ʻike ʻia hoʻi kēia kūlana ma ke ʻano he agenesis mullerian, aplasia mullerian a i ʻole Mayer-Rokitansky-Kuster-Hauser syndrome.
Hoʻomaopopo pinepine ʻia ka agenesis vaginal i ka wā o ka pulapula ke hoʻomaka ʻole ka wahine e kahe. Hoʻohana pinepine ʻia kahi dilator vaginal, kahi mea hana like me ka paipa e hiki ke hoʻolōʻihi i ka pepeiao wahine i ka hoʻohana ʻana i ka manawa lōʻihi, e kūleʻa i ka hana ʻana i kahi pepeiao wahine. I kekahi mau hihia, pono paha ka ʻoki kino. Hana ka mālama ʻana i ka hiki ke moe kolo.
Nā hōʻailona
Hoʻomau pinepine ʻia ka agenesis vaginal me ka ʻike ʻole ʻia a hiki i ka wā ʻōpiopio o nā wahine, akā ʻaʻole e hele mai ka menstruation (amenorrhea). Hoʻomau pinepine nā hōʻailona ʻē aʻe o ka puberty e like me ka hoʻomohala maʻamau o ka wahine. Hiki i ka agenesis vaginal ke loaʻa kēia mau hiʻohiʻona: E like ka ʻano o nā genital me ka wahine maʻamau. Hiki ke pōkole ka vagina me ka ʻole o ka cervix ma ka hopena, a i ʻole ʻaʻohe a hōʻailona wale ʻia e kahi indentation iki kahi e loaʻa ai ka wehe ʻana o ka vagina maʻamau. Hiki paha ʻaʻohe uterus a i ʻole kekahi i hoʻomohala ʻia wale nō. Inā loaʻa kahi pūnaewele e uhi ana i ka uterus (endometrium), hiki ke loaʻa ka cramping mahina a i ʻole ka ʻeha ʻōpū mau loa. Hoʻomohala maʻamau nā ovaries a hana, akā hiki iā lākou ke loaʻa i kahi wahi maʻamau ʻole i loko o ka ʻōpū. I kekahi manawa, ʻaʻohe o nā paipa ʻelua e hele ai nā hua mai nā ovaries a i ka uterus (fallopian tubes) a i ʻole ʻaʻole hoʻomohala maʻamau. Hiki nō hoʻi ke pili ka agenesis vaginal i nā pilikia ʻē aʻe, e like me: Nā pilikia me ka hoʻomohala ʻana o nā puʻupaʻa a me ka urinary tract Nā loli hoʻomohala i nā iwi o ke kua, nā iwi ʻaoʻao a me nā lima Nā pilikia lohe Nā kūlana congenital ʻē aʻe e pili ana i ka naʻau, ka gastrointestinal tract a me ka ulu ʻana o nā lālā Inā ʻaʻohe ou menstruation ma ka makahiki 15, e ʻike i kāu mea lawelawe ola.
ʻO ka manawa hea e ʻike ai i ke kauka
Inā ʻaʻohe o kāu manawa mahina i ka makahiki 15, e ʻike i kāu mea lawelawe ola.
Nā kumu
ʻAʻole maopopo ka mea e hoʻokumu ai i ka agenesis vaginal, akā i kekahi manawa i loko o nā hebedoma 20 mua o ka hāpai ʻana, ʻaʻole i ulu pono nā paipu i kapa ʻia ʻo nā ducts mullerian.
Ma ke ʻano maʻamau, ʻo ka ʻāpana haʻahaʻa o kēia mau ducts e ulu ai i ka uterus a me ka vagina, a ʻo ka ʻāpana kiʻekiʻe e lilo i nā fallopian tubes. ʻO ka underdevelopment o nā ducts mullerian e hopena ai i ka vagina i nele a i ʻāpana paha i pani ʻia, uterus i nele a i ʻāpana paha, a i ʻole nā ʻelua.
Nā pilikia
Hiki i ka agenesis vaginal ke hoʻopilikia i kāu mau pilina moekolohe, akā ma hope o ka mālama ʻana, e hana maʻamau kāu vagina no ka hana moekolohe.
ʻAʻole hiki i nā wahine me ka uterus nele a i ʻole hapa wale nō ke hapai. Inā olakino kou mau ovaries, eia naʻe, hiki paha ke loaʻa iā ʻoe ke keiki ma o ka fertilization in vitro. Hiki ke kanu ʻia ka embryo i loko o ka uterus o kekahi kanaka e hāpai i ka pēpē (gestational carrier). E kūkākūkā i nā koho hānau keiki me kāu mea lawelawe ola.
ʻImi ʻike
E kuhikuhi ana kāu kauka kamaliʻi a i ʻole kāu kauka wahine i ka agenesis vaginal ma muli o kāu moʻolelo lapaʻau a me kahi hoʻokolokolo kino.
Hoʻomaopopo pinepine ʻia ka agenesis vaginal i ka wā o ka pubescence ke hoʻomaka ʻole kāu mau manawa, ʻoiai ma hope o ka ulu ʻana o kou mau umauma a loaʻa iā ʻoe ka lauoho ma lalo o kou mau ʻūhā a me kou pubic. I kekahi manawa, hiki ke ʻike ʻia ka agenesis vaginal i kahi makahiki ʻōpio i ka wā o ka loiloi ʻana no nā pilikia ʻē aʻe a i ʻole ke ʻike nā mākua a i ʻole ke kauka i kahi pēpē ʻaʻohe puka vaginal.
Hiki i kāu mea lawelawe ola ke ʻōlelo aku i ka hoʻokolohua, me:
- Nā hoʻokolohua koko. Hiki i nā hoʻokolohua koko e loiloi i kāu mau chromosomes a ana i kāu mau pae hormone ke hōʻoia i kāu kuhi a kāpae i nā kūlana ʻē aʻe.
- Ultrasound. Hōʻike nā kiʻi ultrasound i kāu mea lawelawe ola inā loaʻa iā ʻoe kahi uterus a me nā ovaries a ʻike inā he mau pilikia me kou mau puʻupaʻa.
- Magnetic resonance imaging (MRI). Hāʻawi ka MRI i kāu mea lawelawe ola i kahi kiʻi kikoʻī o kāu ʻōnaehana hanau a me nā puʻupaʻa.
- Nā hoʻokolohua ʻē aʻe. Hiki i kāu mea lawelawe ola ke kauoha aku i nā hoʻokolohua ʻē aʻe e nānā i kou lohe, naʻau a me nā iwi.
Ka mālama ʻana
Hoʻomaka pinepine ka lāʻau lapaʻau no ka agenesis vaginal i nā makahiki hope o nā makahiki ʻōpio a i ʻole nā makahiki mua o 20, akā hiki iā ʻoe ke kali a hiki i kou wā ʻelemakule a ʻike ʻoe ua hoʻoikaika a mākaukau e komo i ka lāʻau lapaʻau.
Hiki iā ʻoe a me kāu mea lawelawe ola ke kūkākūkā i nā koho lāʻau lapaʻau. Ma muli o kou kūlana pilikino, hiki i nā koho ke komo i ka lāʻau lapaʻau ʻole a i ʻole ka hana ʻana i kahi vagina ma ke kaʻina hoʻonui iho a i ʻole ka ʻoki kino.
Hoʻomaopopo pinepine ʻia ka hoʻonui iho ma ke ʻano he koho mua. Hiki i ka hoʻonui iho ke ʻae iā ʻoe ke hana i kahi vagina me ka ʻole o ka ʻoki kino. ʻO ka pahuhopu, ʻo ia ka hoʻolōʻihi ʻana i ka vagina i ka nui e ʻoluʻolu ai no ka moekolohe.
E kūkākūkā i ke kaʻina hana o ka hoʻonui iho me kāu mea lawelawe ola i ʻike ʻoe i nā mea e hana ai a e kamaʻilio e pili ana i nā koho dilator e ʻike i ka mea kūpono loa no ʻoe. Pono ka hoʻohana ʻana i ka hoʻonui iho ma nā manawa i ʻōlelo ʻia e kāu mea lawelawe ola a i ʻole ka moekolohe pinepine ma luna o ka manawa e mālama ai i ka lōʻihi o kāu vagina.
Ua hōʻike kekahi mau mea maʻi i nā pilikia me ka urination a me ke koko vaginal a me ka ʻeha, ʻoi aku hoʻi i ka hoʻomaka. Hiki ke kōkua ka lubrication artificial a me ka ho'āʻo ʻana i kahi ʻano dilator ʻē aʻe. Hoʻolōʻihi maʻalahi kāu ʻili ma hope o ka ʻauʻau mahana, no laila hiki i kēlā ke manawa kūpono no ka dilation.
ʻO ka dilation vaginal ma o ka moekolohe pinepine he koho ia no ka hoʻonui iho no nā wāhine he mau hoa hana makemake. Inā makemake ʻoe e ho'āʻo i kēia ʻano, e kamaʻilio me kāu mea lawelawe ola e pili ana i ke ala maikaʻi loa e hoʻomau ai.
Inā ʻaʻole hana ka hoʻonui iho, hiki i ka ʻoki kino e hana i kahi vagina hana (vaginoplasty) ke lilo i koho. ʻO nā ʻano o ka ʻoki kino vaginoplasty e komo pū me:
-
Ke hoʻohana nei i kahi graft tissue. Hiki i kāu kauka ke koho mai nā ʻano graft e hoʻohana ana i kāu mau pūnaewele ponoʻī e hana i kahi vagina. ʻO nā kumu hiki ke komo pū me ka ʻili mai ka ʻūhā waho, nā puʻupuʻu a i ʻole ka ʻōpū haʻahaʻa.
Hana kāu kauka i kahi incision e hana i ka wehe ʻana o ka vagina, waiho i ka graft tissue ma luna o kahi mold e hana i ka vagina a waiho i loko o ke kahawai i hana hou ʻia. Noho ka mold ma kahi o hoʻokahi pule.
Ma ke ʻano laulā, ma hope o ka ʻoki kino, mālama ʻoe i ka mold a i ʻole kahi dilator vaginal ma kahi akā hiki ke wehe iā ia ke hoʻohana ʻoe i ka lumipaku a i ʻole ka moekolohe. Ma hope o ka manawa mua i ʻōlelo ʻia e kāu kauka, e hoʻohana ʻoe i ka dilator i ka pō wale nō. Kūkulu ka moekolohe me ka lubrication artificial a me ka dilation manawa pinepine iā ʻoe e mālama i kahi vagina hana.
-
Ke hoʻokomo nei i kahi hāmeʻa traction lapaʻau. Waiho kāu kauka i kahi hāmeʻa ʻoliva-ʻano (ka hana ʻana o Vecchietti) a i ʻole kahi hāmeʻa balloon (balloon vaginoplasty) ma kāu wehe ʻana o ka vagina. Ke hoʻohana nei i kahi mea nānā māmā lahilahi, kukui (laparoscope) ma ke ʻano he alakaʻi, hoʻohui ka kauka i ka hāmeʻa i kahi hāmeʻa traction kaʻawale ma kāu ʻōpū haʻahaʻa a i ʻole ma o kāu navel.
E hoʻopaʻa ʻoe i ka hāmeʻa traction i kēlā me kēia lā, e huki mālie i ka hāmeʻa i loko e hana i kahi kahawai vaginal ma luna o kahi pule. Ma hope o ka wehe ʻana o ka hāmeʻa, e hoʻohana ʻoe i kahi mold o nā nui like ʻole no kahi o ʻekolu mahina. Ma hope o ʻekolu mahina, hiki iā ʻoe ke hoʻohana hou i ka hoʻonui iho a i ʻole ka moekolohe maʻamau e mālama i kahi vagina hana. E pono paha ka lubrication artificial no ka moekolohe.
-
Ke hoʻohana nei i kahi ʻāpana o kāu colon (bowel vaginoplasty). I loko o ka bowel vaginoplasty, hoʻoneʻe ka kauka i kahi ʻāpana o kāu colon i kahi wehe ʻana ma kāu wahi genital, e hana ana i kahi vagina hou. A laila hoʻohui hou kāu kauka i kāu colon i koe. ʻAʻole pono ʻoe e hoʻohana i kahi dilator vaginal i kēlā me kēia lā ma hope o kēia ʻoki kino, a emi ka nui o kou pono no ka lubrication artificial no ka moekolohe.
Ke hoʻohana nei i kahi graft tissue. Hiki i kāu kauka ke koho mai nā ʻano graft e hoʻohana ana i kāu mau pūnaewele ponoʻī e hana i kahi vagina. ʻO nā kumu hiki ke komo pū me ka ʻili mai ka ʻūhā waho, nā puʻupuʻu a i ʻole ka ʻōpū haʻahaʻa.
Hana kāu kauka i kahi incision e hana i ka wehe ʻana o ka vagina, waiho i ka graft tissue ma luna o kahi mold e hana i ka vagina a waiho i loko o ke kahawai i hana hou ʻia. Noho ka mold ma kahi o hoʻokahi pule.
Ma ke ʻano laulā, ma hope o ka ʻoki kino, mālama ʻoe i ka mold a i ʻole kahi dilator vaginal ma kahi akā hiki ke wehe iā ia ke hoʻohana ʻoe i ka lumipaku a i ʻole ka moekolohe. Ma hope o ka manawa mua i ʻōlelo ʻia e kāu kauka, e hoʻohana ʻoe i ka dilator i ka pō wale nō. Kūkulu ka moekolohe me ka lubrication artificial a me ka dilation manawa pinepine iā ʻoe e mālama i kahi vagina hana.
Ke hoʻokomo nei i kahi hāmeʻa traction lapaʻau. Waiho kāu kauka i kahi hāmeʻa ʻoliva-ʻano (ka hana ʻana o Vecchietti) a i ʻole kahi hāmeʻa balloon (balloon vaginoplasty) ma kāu wehe ʻana o ka vagina. Ke hoʻohana nei i kahi mea nānā māmā lahilahi, kukui (laparoscope) ma ke ʻano he alakaʻi, hoʻohui ka kauka i ka hāmeʻa i kahi hāmeʻa traction kaʻawale ma kāu ʻōpū haʻahaʻa a i ʻole ma o kāu navel.
E hoʻopaʻa ʻoe i ka hāmeʻa traction i kēlā me kēia lā, e huki mālie i ka hāmeʻa i loko e hana i kahi kahawai vaginal ma luna o kahi pule. Ma hope o ka wehe ʻana o ka hāmeʻa, e hoʻohana ʻoe i kahi mold o nā nui like ʻole no kahi o ʻekolu mahina. Ma hope o ʻekolu mahina, hiki iā ʻoe ke hoʻohana hou i ka hoʻonui iho a i ʻole ka moekolohe maʻamau e mālama i kahi vagina hana. E pono paha ka lubrication artificial no ka moekolohe.
Ma hope o ka ʻoki kino, pono ka hoʻohana ʻana i kahi mold, dilation a i ʻole ka moekolohe pinepine e mālama i kahi vagina hana. Hoʻokaʻulua pinepine nā mea lawelawe ola i nā lāʻau lapaʻau ʻoki kino a hiki i kou mākaukau a hiki ke mālama i ka hoʻonui iho. Me ka ʻole o ka dilation maʻamau, hiki i ke kahawai vaginal i hana hou ʻia ke hoʻoemi koke a pōkole, no laila he mea nui loa ka makua ʻana i ka manaʻo a me ka mākaukau e hoʻokō i ka mālama ma hope.
E kamaʻilio me kāu mea lawelawe ola e pili ana i ke koho ʻoki kino maikaʻi loa e hoʻokō i kāu mau pono, a me nā pilikia a me ka mālama pono ma hope o ka ʻoki kino.
Hiki ke paʻakikī ke aʻo ʻoe i ka agenesis vaginal. ʻO ia ke kumu e ʻōlelo ai kāu mea lawelawe ola e lilo kahi psychologist a i ʻole kahi limahana pilikanaka i ʻāpana o kāu hui lāʻau lapaʻau. Hiki i kēia mau mea lawelawe olakino noʻonoʻo ke pane i kāu mau nīnau a kōkua iā ʻoe e mālama i kekahi o nā ʻaoʻao paʻakikī o ka loaʻa ʻana o ka agenesis vaginal, e like me ka infertility hiki.
Hiki iā ʻoe ke makemake e hoʻohui me kahi hui kākoʻo o nā wahine e hele nei i ka mea like. Hiki paha iā ʻoe ke loaʻa kahi hui kākoʻo ma ka pūnaewele, a i ʻole hiki iā ʻoe ke noi i kāu mea lawelawe ola inā ʻike ʻo ia i kahi hui.
Hōʻole: He kahua ʻike olakino ʻo ʻAukake a ʻaʻole hōʻike kāna mau pane i ka ʻōlelo aʻoaʻo lapaʻau. E kūkākūkā mau me kahi ʻoihana lapaʻau laikini kokoke iā ʻoe ma mua o ka hana ʻana i nā hoʻololi.
Hana ʻia i India, no ka honua