Tubal ligation - kuyini, izinkomba, contraindications, side effects

I-Tubal ligation ibhekwa njengenqubo yezokwelapha ephephile, ukuqaliswa okungafanele kusongele impilo nokuphila kowesifazane. Ukukhethwa kwale ndlela kuwukukhulula owesifazane ezingozini ezihlobene nezinye izinto zokuvimbela inzalo, njengemiphumela engemihle yamahomoni omlomo, ukukhohlisa okungaholela ekulimaleni kwesitho sokuzala lapho efaka i-IUD, izindandatho zesitho sangasese sowesifazane, noma izindleko ezihlobene nokuvamile. ukuvakasha. ukubhala imiyalelo. I-Tubal ligation iyinqubo ethandwa kakhulu emazweni athuthuke kakhulu.

1. Yini i-tubal ligation?

I-Tubal ligation iyindlela ephumelela kakhulu yokuvimbela ukukhulelwa. I-Tubal ligation iyinqubo yokuhlinzwa lapho amashubhu esikwa futhi aboshwe. Kuyayihlanekezela i-patency ye-fallopian tubeslapho iqanda elivundisiwe lingasakwazi ukungena esibelethweni. I-Tubal ligation iphumelele - inkomba yePearl ingu-0,5. Ngezinye izikhathi amashubhu e-fallopian avuleka ngokuzenzakalelayo, kodwa lezi yizimo ezizimele. Ukuhlinzwa kwenziwa nge-laparotomy noma i-laparoscopy ngaphansi kwe-anesthesia yendawo noma evamile.

I-tubal ligation ivame ukwenzeka ngesikhathi sokuhlinzwa. Owesifazane angaqala umsebenzi wocansi kuphela ngemva kokuba izilonda sezipholile, okuthatha cishe izinyanga ezi-3. Mayelana nokusetshenziswa kwalolu hlobo izindlela zokuvimbela inzalo owesifazane kufanele enze isinqumo ngokubonisana nomlingani wakhe, futhi imvume yenqubo kufanele inikezwe ngokubhaliwe. Ezimweni eziningi, lesi yisixazululo esingenakuhlehliswa. lolu hlobo ukuvimbela inzalo eyenziwa emazweni athuthuke kakhulu.

EPoland, inqubo enjalo ayikho emthethweni. Ngaphansi kwe-Criminal Code, ukuphuca umuntu ikhono lokuzala izingane kujeziswa ngokuvalelwa ejele iminyaka engu-1 kuya kweyi-10. Lesi sijeziso sinikezwa udokotela owenza inqubo, hhayi kowesifazane okhetha ukuyenza.

I-Tubal ligation ivunyelwe uma kuyingxenye yokwelashwa noma uma ukukhulelwa okulandelayo kungalimaza kakhulu impilo yowesifazane noma kubeke ukuphila kwakhe engozini.

Lokhu kuyamukeleka futhi esimweni lapho inzalo elandelayo izoba nesifo esibi kakhulu sofuzo. Kwezinye izimo, udokotela akakwazi ukwenza inqubo ngisho nangesicelo esiqondile sesiguli.

2. Ukuvala inzalo ngaleso sikhathi futhi manje

Ukuvala inzalo kunomlando omude kakhulu emhlabeni. Ngeshwa, lezi zinqubo zazivame ukwenziwa ngokungemthetho, zephula inkululeko yomuntu siqu yabesifazane, zibalimaze.

Okwakuvamile kwakuwukuvalwa inzalo kwabesifazane abampofu nabamnyama, okwathi uma bephikiswa, basala bengenalo noma yiluphi usizo lwezokwelapha kanye nosizo lwempahla. Emlandweni wempucuko yethu kukhona nezimo zokuvala inzalo ngenkani kwabagula ngengqondo, iziboshwa kanye nabamele izinhlanga ezincane ukuze kuqedwe. Babehlukumeza amalungelo abantu.

Njengamanje, njengoba kushiwo ngenhla, ukusebenza okunjalo ePoland akwamukeleki ngokomthetho, futhi ukuqaliswa kwayo akukho emthethweni futhi kujeziswe ngokuboshwa. Nokho, e-USA nasemazweni amaningi aseNtshonalanga Yurophu (Austria, Denmark, Finland, Norway, Sweden, Great Britain), le nqubo yenziwa ngesicelo sesiguli.

3. Nquma ukuthi kufanele yini ube ne-tubal ligation.

Isinqumo sokuhlinzwa i-tubal ligation ngesinye sezinqumo ezinzima kakhulu empilweni yowesifazane. Kunemiphumela embalwa impela, ngoba iphesenti elikhulu lenqubo alihlehliseki. Owesifazane kufanele alinganise ngokuthula nangokufanele zonke izinzuzo nezingozi, aqaphele ngokugcwele ukuthi esikhathini esizayo ngeke akwazi ukukhulelwa izingane ngokwemvelo. Kufanele acabangele izimo ezihlukahlukene zokuphila angase azithole ekuzo, njengokushintsha komlingani kanye nesifiso sokuthola abantwana kuye, ukushona kwengane. Kufanele futhi acabangele ezinye izindlela, njengokusebenzisa ezinye izinto zokuvimbela inzalo ezihlehliswayo.

Izizathu ezivame kakhulu zokuthi kungani abesifazane benquma ukwenza inzalo yilezi:

• ukungafuni ukuba nezingane eziningi lapho kungenakwenzeka ukusebenzisa ezinye izindlela zokuvimbela inzalo,
• izinkinga zempilo ezingaba zimbi kakhulu ngesikhathi sokukhulelwa futhi zisongele impilo kamama,
• ukuphazamiseka kofuzo.

Nakuba abesifazane bezama ukucabangisisa kahle ngaphambi kokwenza isinqumo esingujuqu mayelana nenqubo, cishe u-14-25% uyazisola ngesinqumo sabo. Lokhu kuyiqiniso ikakhulukazi kwabesifazane abanquma ukuvalwa inzalo besebancane kakhulu (abaneminyaka engu-18-24 ubudala) - cishe u-40% bayazisola ngesinqumo sabo. Ngakho-ke, kwamanye amazwe kuneziphakamiso zokuthi kungenzeka ukuvala inzalo ngemva kweminyaka engu-30 kwabesifazane asebevele benezingane.

Kunezikhungo emhlabeni jikelele ezisebenza ngokukhethekile ekubuyiseleni amandla obunikazi be-fallopian tubes, kodwa lezi ziyizinqubo eziyinkimbinkimbi kakhulu futhi ezibizayo, ukuphumelela kwazo okungenakuqinisekiswa. Yingakho kubaluleke kakhulu ukwazisa ngokucophelela owesifazane mayelana nayo yonke imiphumela engenzeka ye-tubal ligation.

4. Izinkomba zokuhlinzwa kwe-tubal ligation.

Ngaphezu kokuvala inzalo ngokuzithandela, kukhona futhi izinkomba ezinquma ukuthi yibaphi abesifazane okufanele bangene kule nqubo ye-tubal ligation. Zingahlukaniswa ngamaqembu amaningana amakhulu:

• izinkomba zezokwelapha - zihlanganisa yonke inqwaba yezifo zangaphakathi kanye ne-oncological ezingaholela ezinkingeni ezinkulu zempilo noma ngisho nezimo ezisongela ukuphila lapho owesifazane ekhulelwa. Ngesikhathi senqubo, lesi sifo kufanele sixolelwe noma silawulwe kahle, futhi isimo sesiguli kufanele sizinze,
• izinkomba zofuzo - lapho owesifazane ephethe isici sofuzo futhi ukuzalwa kwengane enempilo kuye akunakwenzeka ngokwezokwelapha,
• ngokusho kwezinkomba zengqondo, lokhu ukuvimbela okukhulu kokukhulelwa kwabesifazane abasesimweni esinzima, esingenakwenzeka ukuthuthukisa isimo sezezimali.

Kubaluleke kakhulu ukuthi isiguli sazi kahle ngenqubo ye-tubal ligation, izinzuzo, izinkomba, ukuphikisana kanye nezinkinga ezingenzeka ngemva kwenqubo ngaphambi kokuba yenziwe ngesikhathi sokuvakashela udokotela.

5. Imiphumela ye-tubal ligation

Imiphumela ye-tubal ligation ubunyumba unomphela. Ngakho-ke, ngaphambi kokuba owesifazane anqume ngale nqubo, kufanele acabangele ukuthi uyaqiniseka yini ukuthi akafuni ukuba nabantwana. Ukusebenza kwe-tubal ligation enkulu. Inqubo, ebuyisela i-patency yamashubhu e-fallopian, isebenza ngama-30% kuphela.

Kodwa-ke, qaphela ukuthi uma ukhulelwa ngaphambi kwenqubo, kunengozi enkulu yokukhulelwa kwe-ectopic. Kwenzeka ngokwezibalo kaningi kwabesifazane abasebasha abenze inqubo, kanye nakulabo abaye bahlinzwa besebenzisa indlela ye-electrocoagulation yamashubhu e-fallopian. Ngaphambi kwenqubo, kufanele usebenzise izindlela ezithile zokuvimbela inzalo, nge-Pearl index ephezulu (sikweluleka ukuthi ungasebenzisi indlela yekhalenda, kungcono ukusebenzisa amakhondomu noma ukuyeka ucansi okwesikhashana).

Abanye besifazane baphinde babike izifo eziningi zesinye ngemva kokuhlinzwa.

Kunezinganekwane eziningi ezingenasisekelo mayelana nemiphumela emibi ye-salpingectomy. Abesifazane besaba ukulahlekelwa "ubufazi" ngemva kwenqubo, ukunciphisa i-libido, ukuthola isisindo somzimba. Akukho ukubhekwa okuqinisekise lezi zinkolelo-mbono, ngokuphambene nalokho, njengoba abantu abaningi abangamaphesenti angu-80 babika ukuxhumana okuthuthukisiwe nabalingani babo.

6. Izinkinga ngemva kwe-tubal ligation

I-Tubal ligation iyindlela ephephile. Njengoba ubona, imiphumela emibi yesikhathi eside ayiselona usongo. Imiphumela eminingi engemihle ivela ngokuphathelene nenqubo ngokwayo. Phakathi kwabesifazane abangu-4 no-12 kwabangu-100 be-salpingectomies eyenziwa emazweni asathuthuka bayafa (ukopha, izinkinga zokubulala izinzwa).

Izimbangela ezivame kakhulu zezinkinga yilezi:

• Izimbangela ze-anesthesia: ukungezwani nezidakamizwa ezijovwe, ukuphazamiseka kokujikeleza kwegazi nokuphefumula (ukusetshenziswa kwezinzwa zesifunda kunciphisa kakhulu ingozi yalezi zinkinga),
• izimbangela zokuhlinzwa: ukulimala kwemikhumbi emikhulu kanye nokopha okuhambisanayo okudinga ukuvuleka kabusha komgodi wesisu, ukulimala kwezinye izitho, izifo kanye namathumba amanxeba.

Inkinga eyingozi kakhulu ehambisana ne-laparoscopy, usongo olukhulu empilweni, ukulimala kwemikhumbi emikhulu:

• i-aorta,
• i-vena cava ephansi,
• izitsha zesifazane noma zezinso.

6.1. I-Minilaparotomy

I-mini parotomy iyinqubo lapho udokotela enza khona ukusika odongeni lwesisu ngenhla nje kwe-pubic symphysis. Le nqubo ithwala ingozi enkulu yobuhlungu, ukopha, nokulimala kwesinye uma kuqhathaniswa ne-laparoscopy.

Ngemuva kokuhlinzwa kanye ne-anesthesia ehlotshaniswa nayo, sonke isiguli sinelungelo lokuzwa ubuthakathaka, isicanucanu nobuhlungu ngaphansi kwesisu. Nokho, lezi zimpawu zidlula ngokushesha okukhulu futhi ukululama okuphelele kwenzeka ezinsukwini ezimbalwa nje.

6.2. Izinkinga ngemva kokusebenzisa indlela ye-ESSURE

Ukusetshenziswa kwale ndlela yesimanje nakho kuhlanganisa nezingozi ezithile. Lokhu kungase kusebenze inqubo ngokwayo - umonakalo esithweni sokuzala lapho ufaka ukufakwa ku-fallopian tube, ukopha. Ezinye izinkinga ngemva kokusebenzisa indlela ye-Essure zihlanganisa:

• ukopha emgudwini wesitho sangasese,
• ukukhulelwa
• ingozi yokukhulelwa kwe-ectopic,
• ubuhlungu,
• ukudlikizela,
• izikhathi ezinde ngezikhathi ezithile, ikakhulukazi phakathi nemijikelezo emi-2 yokuqala,
• isicanucanu,
• hlanza,
• ukuquleka
• ukungezwani komzimba nezinto.

7. Ukuxhunywa kwama-ovari kanye nomthetho

zalolu hlobo ukuvimbela inzalo eyenziwa emazweni athuthuke kakhulu. EPoland kuvunyelwe uma kuyingxenye yokwelashwa noma uma ukukhulelwa okulandelayo kungalimaza kakhulu impilo yowesifazane noma kufaka ukuphila kwakhe engozini.

Ngokwenza, i-tubal ligation yenziwa lapho okunye ukukhulelwa kubangela usongo empilweni noma empilweni yowesifazane, futhi nalapho kwaziwa ukuthi inzalo elandelayo izoba nesifo esibi kakhulu sofuzo. Kwesinye isimo, udokotela akakwazi ukwenza inqubo ngisho nangesicelo esiqondile sesiguli.

Ungalindi ukubona udokotela. Thatha ithuba lokubonisana nochwepheshe abavela kulo lonke elasePoland namuhla kwa-abcZdrowie Thola udokotela.