Ukuqala Kwe-Vagina? Izimpawu, Izimbangela, Nokwelashwa

Ukuqala kwe-vagina kuyisimo esingavamile lapho uzalwa ungenayo i-vagina noma une-vagina engathuthukiswanga kahle. Lokhu kwenzeka lapho izitho zokuzala zingakhi kahle ngesikhathi sokuthuthukiswa kwesisu, kuchaphazela cishe umuntu omunye kwaba-4,000 kuya ku-5,000 abamiswe njengabesifazane ekuzalweni.

Nakuba lokhu kungase kuzwakale kukhulu, kubalulekile ukwazi ukuthi lesi simo singelashwa. Abantu abaningi abane-vaginal agenesis baqhubeka benobudlelwano obukhulu obuseduze kanye nokuphila okuhle ngenxa yokunakekelwa kwemithi efanele kanye nokwesekwa.

Iyini i-vaginal agenesis?

I-vaginal agenesis isho ukuthi i-vaginal canal yakho ayizange ithuthuke kahle ngaphambi kokuzalwa. Ezimweni eziningi, uzalwa une-genitalia yangaphandle evamile, kodwa ukuvulwa kwe-vagina kuholela e-canal emfushane kakhulu noma akukho canal nhlobo.

Lesi simo singxenye yeqembu elibizwa nge-Müllerian agenesis noma i-MRKH syndrome (i-Mayer-Rokitansky-Küster-Hauser syndrome). Ama-ovari akho avame ukuthuthuka kahle, okusho ukuthi amazinga akho e-hormone avame ukuba nempilo futhi uzobona ukuthuthuka okuvamile kwamabele namanye amaphuzu e-puberty.

I-uterus nayo ingase ingekho noma ingathuthukiswanga kahle ezimweni eziningi. Noma kunjalo, njengoba ama-ovari akho esebenza kahle, uzoqhubeka ukhiqiza ama-hormone adala i-menstrual cycle yakho yemvelo, ngisho noma ungenayo isikhathi.

Ziyini izimpawu ze-vaginal agenesis?

Uphawu olukhulu ongalubona ukungabikho kwesikhathi se-menstrual ngaphambi kweminyaka engu-16, ngisho noma ezinye izici ze-puberty ziqhubeke kahle. Lokhu kungase kuzwakale kukungabaza lapho umzimba wakho ubonakala uthuthuka njengoba kulindelekile ngezindlela eziningi.

Nazi izimpawu ezibalulekile okufanele uzazi:

• Awekho ama-menstrual periods naphezu kokuthuthuka okuvamile kwamabele nokukhula kwezinwele ze-pubic
• Ubunzima noma ukungakwazi ukufaka ama-tampons
• Ubuhlungu noma ukungakwazi ngesikhathi sokuzama ukungena ngocansi
• Ukuvulwa kwe-vagina okujulile kakhulu noma i-dimple lapho ukungena kwe-vagina kufanele kube khona
• I-genitalia yangaphandle evamile ebonakala iyavamile ngokuphelele
• Ukushintsha okuvamile kwe-hormone njengokuguquguquka kwesimo sengqondo noma ubuhlungu bebele, ngisho noma kungekho ama-periods

Lezi zimpawu zivame ukubonakala ngesikhathi seminyaka yakho yobusha lapho ama-periods eqala khona. Kuvamile ukukhathazeka noma ukudideka uma uhlangabezana nalezi zimpawu.

Yini ebangela i-vaginal agenesis?

I-vaginal agenesis iyenzeka ngenxa yokushintsha kokuthuthuka phakathi kwezinyanga ezimbalwa zokuqala zokukhulelwa. Izakhiwo ezivame ukwakha i-vagina ne-uterus, ebizwa nge-Müllerian ducts, azithuthuki njengoba kulindelekile.

Imbangela eqondile ayiqondakali ngokuphelele, kodwa abacwaningi bakholelwa ukuthi ihilela ukuxubana kwezinto zofuzo nezimo zangaphandle. Ezimweni eziningi, kwenzeka ngokungahleliwe ngesikhathi sokuthuthukiswa kwesisu kunokuba kuzuzwe kubazali.

Ngezinye izikhathi, ukuguquguquka kwezinto zofuzo kungadlala indima. Ngokungavamile, kungase kuhlotshaniswe nezinye izimo zofuzo, kodwa kubantu abaningi, kwenzeka njengokuhlukana kokuthuthuka okungekho umlando wentsapho ocacile.

Ziyini izinhlobo ze-vaginal agenesis?

Kunezinhlobo ezimbili eziyinhloko ze-vaginal agenesis, nokuqonda ukuthi yiluphi uhlobo olukhona kusiza ukuqondisa izinketho zokwelapha. Ukwahlukaniswa kuncike ekutheni ezinye izakhiwo zokuzala zithinteka yini.

Uhlobo 1 lwe-vaginal agenesis luhilela nje i-vagina engabikho noma engathuthukiswanga kahle. I-uterus yakho nama-fallopian tubes athuthuka kahle, okusho ukuthi ungase uhlangabezane nobuhlungu be-pelvic njengoba umzimba wakho uqhubeka ne-menstrual cycles ngaphandle kwendlela yokuba igazi le-menstrual liphume.

Uhlobo 2 lwe-vaginal agenesis, oluvamile kakhulu, luhilela kokubili i-vagina ne-uterus engabikho noma engathuthukiswanga kahle. Lokhu kuvame ukuba yingxenye ye-MRKH syndrome. Ngeke uhlangabezane nama-menstrual periods noma ukubamba okubangelwa yilokho njengoba akukho uterine lining yokuyilahla.

Nini okufanele ubone udokotela nge-vaginal agenesis?

Kufanele ukhulume nodokotela uma ungaqalanga isikhathi sakho ngaphambi kweminyaka engu-16, ikakhulukazi uma ezinye izimpawu ze-puberty njengokuthuthuka kwamabele seziqale kahle. Ukubheka kusenesikhathi kungakunika izimpendulo nokuthula kwengqondo.

Kubalulekile futhi ukufuna iseluleko sezokwelapha uma uhlangabezana nobuhlungu ngesikhathi sokuzama ukufaka i-tampon noma umsebenzi wobulili. Lezi zimo zingase zibe nzima ukukhuluma ngazo, kodwa abahlinzeki bezempilo bayeqeqeshwe ukusingatha lezi zingxoxo ngokuqonda nobuchwepheshe.

Ungaliqedi ukufuna usizo uma uzizwa ukhathazekile noma ucindezelekile ngalezi zimpawu. Ukuba nokuxilongwa okucacile kukuvumela ukuthi uhlole izinketho zokwelapha futhi uxhumane nemithombo yokwesekwa engase yenze umehluko omkhulu ekuphileni kwakho.

Ziyini izinto ezingase zikubeke engozini ye-vaginal agenesis?

I-vaginal agenesis iyenzeka ngokungahleliwe ezimweni eziningi, okusho ukuthi azikho izinto ezingase zikubeke engozini ongaziqondisa noma uzazi.

Kodwa-ke, ezinye izimo zofuzo ezingavamile zingase zikhulise amathuba e-vaginal agenesis. Lokhu kuhlanganisa ukuguquguquka okuthile kwe-chromosome noma ama-syndromes ezinto zofuzo athinta izinhlelo eziningi zomzimba, nakuba lokhu kuhlanganisa izingxenye ezincane nje zezimangalo.

Ukuba nomlando wentsapho wezinto ezihlukile zendlela yokuzala kungase kukhulise kancane ingozi, kodwa lokhu akuvamile. Abantu abaningi abane-vaginal agenesis abanalo umlando wentsapho wezimo ezifanayo, okwenza kube nzima ukubikezela.

Ziyini izinhlanganisela ezingase zenzeke nge-vaginal agenesis?

Izinhlanganisela eziyinhloko zihilela ukugeleza kwe-menstrual nobudlelwano obuseduze, kodwa lezi zingaphathwa ngokwelashwa okufanele. Ukuqonda izinhlanganisela ezingase zenzeke kukusiza ukwenza izinqumo ezifanele mayelana nokunakekelwa kwakho.

Uma une-Type 1 vaginal agenesis ene-uterus esebenzayo, igazi le-menstrual lingase libuthene njalo ngenyanga, libangele ubuhlungu obukhulu be-pelvic ebizwa nge-hematocolpos. Lokhu kudinga ukunakekelwa kwemithi ngokushesha ukuvimbela izinhlanganisela ezingeziwe njengokuqunjelwa noma ukonakala kwezitho ezizungezile.

Ukwehluka kwezinkimbinkimbi zezinso ne-urinary tract kwenzeka cishe ku-25-30% yabantu abane-vaginal agenesis. Lokhu kungase kuhlanganise ukuba nesinye isinso, ukuguquguquka kwesimo sesinso, noma ukwehluka kwendawo ye-urinary tract okuvame ukungabangeli izimpawu kodwa kufanele kulandelelwe.

Imiphumela yengqondo kanye neyezingqondo ingaba khulu, ikakhulukazi ngokuphathelene nesithombe somzimba, ubudlelwano, nokukhathazeka ngokuzala. Abantu abaningi bahlangabezana nokukhathazeka, ukucindezeleka, noma izinselele zobudlelwano, kungakho ukwesekwa kwengqondo kuyisigaba esibalulekile sokunakekelwa okuphelele.

I-vaginal agenesis ixilongwa kanjani?

Ukuxilongwa kuvame ukuqala ngokuhlolwa komzimba kanye nezingxoxo zomlando wezokwelapha nodokotela wakho. Bazohlola i-genitalia yakho yangaphandle futhi bangase bazama ngobumnene ukuthola ukuvulwa kwe-vagina ukuhlola ukujula kwayo.

I-MRI scan inikeza izithombe eziningiliziwe zezitho zakho zokuzala ezingaphakathi. Lokhu kusiza ukuqonda ukuthi i-uterus yakho nama-ovari akho akhona yini nokuthi abekwe kanjani, okuqondisa izinqumo zokwelapha.

Izivivinyo zegazi ziqala amazinga akho e-hormone ukuqinisekisa ukuthi ama-ovari akho asebenza kahle. Lezi zivivinyo ngokuvamile zibonisa izindlela eziqondile ze-hormone yesifazane, okusiza ukwahlukanisa i-vaginal agenesis kwezinye izimo ezingase zibangele ukungabikho kwama-periods.

Ngezinye izikhathi, i-ultrasound ingase isetshenziswe njengokuhlolwa kokuqala kwezithombe. Noma kunjalo, i-MRI ngokuvamile inikeza ulwazi olunemininingwane ngezakhiwo ezingaphakathi futhi kubhekwa njengendlela engcono kakhulu yokuxilonga.

Iyini impilo ye-vaginal agenesis?

Ukwelashwa kugxile ekwakheni i-vagina esebenzayo evumela ubudlelwano obuseduze obukhululekile. Kunezindlela zokwelapha zokucutshungulwa kanye nezingelona ubuhlungu, futhi ukukhetha okuhle kuncike esimweni sakho somuntu siqu kanye nezifiso zakho.

Ukwelashwa okungelona ubuhlungu kuhilela ukwandisa i-vagina, lapho uqala kancane ukwelula insimbi ye-vagina usebenzisa ama-dilators aklanywe ngokukhethekile. Le nqubo idinga ukuzimisela futhi ngokuvamile ithatha izinyanga eziningi, kodwa ingase ikhiqize i-vagina esebenzayo ngaphandle kokuhlinzwa.

Izinketho zokucutshungulwa zihlanganisa izindlela ezihlukene zokwakha i-vaginal canal. I-McIndoe procedure isebenzisa ama-skin grafts, kuyilapho i-intestinal vaginoplasty isebenzisa ingxenye yomathumbu ukwakha i-vaginal lining. Udokotela wakho uzoxoxa ngendlela engase isebenze kangcono emzimbeni wakho.

Isikhathi sokwelashwa kubalulekile futhi kufanele sihambisane nokulungela kwakho ubudlelwano obuseduze. Ochwepheshe abaningi bancoma ukulinda kuze kube yilapho ulungile ngokomzwelo futhi uneqabane elisekela, njengoba lokhu kuthuthukisa amazinga ompumelelo wokwelashwa.

Ungayiphatha kanjani i-vaginal agenesis ekhaya?

Uma usebenzisa ama-vaginal dilators njengengxenye yokwelashwa kwakho, ukuzinza kuyisihluthulelo sempumelelo. Landela isimiso sika dokotela wakho ngokucophelela, njengoba ukusetshenziswa okuvamile kusiza ukugcina nokukhulisa kancane ukujula kwe-vagina.

Dala indawo ekhululekile, eyimfihlo yezifundo zokwandisa. Sebenzisa ama-lubricants afanele njengoba kunconywe yiqembu lakho lezokwelapha, futhi thatha isikhathi sakho ukuze ugweme ubuhlungu noma ukulimala.

Ukunakekelwa komzwelo kubalulekile ngokulinganayo ngesikhathi sokwelashwa. Cabanga ngokujoyina amaqembu okwesekwa, ku-inthanethi noma ngokomuntu siqu, lapho ungaxhumana khona nabanye abaqonda isipiliyoni sakho. Abantu abaningi bathola induduzo enkulu kulezi zikhungo.

Gcina ukuxhumana okuvulekile neqembu lakho lezokwelapha mayelana nanoma yikuphi ukukhathazeka noma izinselele ozibhekana nazo. Bangase balungise uhlelo lwakho lokwelashwa noma banikeze ezinye izinto zokwesekwa ukuze basekele intuthuko yakho.

Kufanele ulungiselele kanjani i-appointment yakho yokuhlangana nodokotela?

Bhala zonke izimpawu zakho nokuthi zaqala nini, kuhlanganise imininingwane mayelana nomlando wakho we-menstrual nanoma yiluphi ubuhlungu noma ukungakhululeki obuhlangabezane nakho. Lolu lwazi lusiza udokotela wakho ukuqonda isimo sakho ngokuphelele.

Lungisa uhlu lwemibuzo ofuna ukuyibuza. Imibuzo evamile ihlanganisa izinketho zokwelapha, amazinga ompumelelo, isikhathi sokuthuthuka, nokuthi isimo singase lithinte kanjani ubudlelwano bakho besikhathi esizayo noma ukuhlela kwakho komndeni.

Cabanga ngokuletha umngane othembekile noma ilungu lomndeni ukuze likusize, ikakhulukazi uma uzizwa ukhathazekile nge-appointment. Ukuba nomuntu lapho kungakusiza ukukhumbula ulwazi olubalulekile futhi kunikeze induduzo yomzwelo.

Lungela ukuxoxa ngemininingwane yomsebenzi wobulili ngomzimba wakho nobudlelwano. Khumbula ukuthi abahlinzeki bezempilo bangochwepheshe abaphatha lezi zingxoxo njalo ngaphandle kokwahlulela.

Iyini into ebalulekile mayelana ne-vaginal agenesis?

I-vaginal agenesis iyisimo esingelashwa esingadingi ukulinganisela ikhono lakho lokuba nobudlelwano obuseduze obukhulu noma ukuphila okujabulisayo. Ngokunakekelwa kwemithi efanele nokwesekwa, abantu abaningi bafinyelela imiphumela emihle.

Ukuxilongwa kusenesikhathi kanye nohlelo lokwelashwa kukunika imiphumela engcono kakhulu futhi kusiza ukubhekana nanoma yikuphi ukukhathazeka komzwelo ongabe unakho. Ukusebenza nabahlinzeki bezempilo abanolwazi abakhethekile kulesi simo kuqinisekisa ukuthi uthola ukunakekelwa okufanele.

Khumbula ukuthi lesi simo sithinta abantu abaningi, futhi awuwedwa kulesi sipiliyoni. Amaqembu okwesekwa, ukwelashwa, kanye nokwelashwa kwemithi konke kungadlala indima ebalulekile ekusikweni ukuhamba ngale ndlela ngempumelelo.

Imibuzo evamile mayelana ne-vaginal agenesis

Ngingakhulelwa yini uma ngine-vaginal agenesis?

Ukukhulelwa kuncike ekutheni une-uterus nama-ovari asebenza yini. Uma ama-ovari akho evamile kodwa i-uterus yakho ingekho (Uhlobo 2), awukwazi ukuthwala ukukhulelwa ngokwemvelo, kodwa ama-eggs akho angase asebenziselwe i-surrogacy. Uma une-uterus (Uhlobo 1), ukukhulelwa kungase kube nokwenzeka ngemuva kokwelashwa okwenza i-vaginal canal.

Ukwelashwa kwe-vaginal agenesis kuzosebenza yini ekuhlangabezaneni ngokobulili?

Abantu abaningi abaqeda ukwelashwa ngempumelelo babika ubudlelwano obuseduze obukhululekile. Kokubili ukwelashwa kokucutshungulwa kanye nokungelona ubuhlungu kungase kwakha i-vagina esebenza kahle emsebenzini wobulili. Isici esibalulekile ukulandela ukwelashwa ngokuphelele nokugcina imiphumela njengoba kunconywe yiqembu lakho lezokwelapha.

Ukwelashwa kuthatha isikhathi esingakanani ukusebenza?

Ukukhulisa okungelona ubuhlungu ngokuvamile kuthatha izinyanga eziyi-3-6 zesifundo samasonto onke ukuze kufinyelelwe ukujula okwanele. Izindlela zokucutshungulwa zidinga isikhathi sokuphulukisa sezinyanga eziyi-6-8, okulandelelwa ukugcinwa okuqhubekayo. Udokotela wakho uzokunikeza izikhathi ezithile ezincike endleleni yokwelapha oyikhethile.

Ingabe i-vaginal agenesis iyefa?

Ezimweni eziningi, i-vaginal agenesis iyenzeka ngokungahleliwe futhi ayitholakali kubazali. Nakuba ezinye izimo zofuzo ezingavamile zingase zikhulise ingozi, iningi lezimangalo liyenzeka ngaphandle komlando wentsapho. Ukuba nalesi simo akukhuli ngokukhulu ingozi kubantwana bakho besikhathi esizayo.

Ngingase ngidinga ukunakekelwa kwemithi okuphila kwami konke ngalesi simo?

Ngemuva kokwelashwa okuphumelelayo, uzodinga ukuhlangana njalo ukuqinisekisa ukuthi konke kuqhubeka kusebenza kahle. Uma ukhetha ukukhulisa, uzodinga ukugcina isimiso ukuze ugcine ukujula kwe-vagina. Abantu abaningi ekugcineni badinga kuphela ukuhlolwa minyaka yonke, okufana nokunakekelwa okuvamile kwe-gynecological.