Ukungachumi

Ukungachumi kuthetha ukuba awukwazi ukukhulelwa (ukukhulelwa).

Zimbini iintlobo zokungachumi:

• Ukungachumi kwasekuqaleni kubhekisa kwizibini ezingakhange zikhulelwe emva kweminyaka eli-1 zilala ngaphandle kokusebenzisa iindlela zokulawula ukuzalwa.
• Ukungafumani bantwana kubhekisa kwizibini ezikwazileyo ukukhulelwa kube kanye, kodwa ngoku azikwazi.

Izinto ezininzi zomzimba kunye neemvakalelo zinokubangela ukungachumi. Isenokuba ngenxa yeengxaki kumfazi, indoda, okanye zombini.

UKUNGAKHOLELWA KWABASetyhini

Ukungachumi kwabasetyhini kunokwenzeka xa:

• Iqanda elichumileyo okanye umbungu awusaphili wakuba unamathele kuludwe lwesibeleko (isibeleko).
• Iqanda elichumileyo alincamathelisi kuludwe lwesibeleko.
• Amaqanda awanako ukusuka kwizibeleko ukuya esibelekweni.
• Amaqanda aneengxaki zokuvelisa amaqanda.

Ukungachumi kwabasetyhini kunokubangelwa:

• Ukuphazamiseka komzimba, njenge-antiphospholipid syndrome (APS)
• Iziphene zokuzalwa ezichaphazela indawo yokuzala
• Umhlaza okanye ithumba
• Ukuphazamiseka kokuvala
• Seswekile
• Ukusela kakhulu utywala
• Ukuzivocavoca kakhulu
• Ukuphazamiseka kwindlela yokutya okanye ukungondleki
• Ukukhula (njenge-fibroids okanye iipolyps) kwisibeleko kunye nomlomo wesibeleko
• Amayeza anje ngamachiza e-chemotherapy
• Ukungalingani kweHormone
• Ukutyeba kakhulu okanye ukutyeba kakhulu
• Ukwaluphala
• Ii-cysts ze-Ovarian kunye ne-polycystic ovary syndrome (i-PCOS)
• Usulelo lwe-pelvic olubangelwa kukuqhaqha okanye ukuvuvukala kwemibhobho ye-fallopian (i-hydrosalpinx) okanye isifo se-pelvic (PID)
• Ukuqhekeka kosulelo olusasazeka ngesondo, utyando lwesisu okanye i-endometriosis
• Ukutshaya
• Ugqirha ukuthintela ukukhulelwa (i-tubal ligation) okanye ukusilela ukubuyela umva kwe-tubal ligation (reanastomosis)
• Isifo se-thyroid

UKUNGALAMBI KWAMANDLA

Ukungachumi kwamadoda kunokuba ngenxa:

• Ukwehla kwenani lesidoda
• Ukuvaleka kuthintela ukuba isidoda singakhululwa
• Ukusilela kwisidoda

Ukungachumi kwamadoda kunokubangelwa:

• Iziphene zokuzalwa
• Unyango lomhlaza, kubandakanya ichemotherapy kunye nemitha
• Ukubonakaliswa kukushisa okuphezulu ixesha elide
• Ukusela kakhulu utywala, intsangu, okanye icocaine
• Ukungalingani kweHormone
• Ukungabi namandla
• Usulelo
• Amayeza afana ne-cimetidine, spironolactone, kunye ne-nitrofurantoin
• Ukutyeba kakhulu
• Ukwaluphala
• Ukubuyisela kwakhona i-ejaculation
• Ukuqhekeka kwizifo ezosulela ngokwabelana ngesondo (STIs), ukulimala, okanye utyando
• Ukutshaya
• Iityhefu kwindalo esingqongileyo
• IVasectomy okanye ukusilela kokutshintsha kwe-vasectomy
• Imbali yosulelo kumatyhalarha

Izibini ezisempilweni ezingaphantsi kweminyaka engama-30 ezabelana ngesondo rhoqo ziya kuba nama-20% ngenyanga amathuba okuba ukhulelwe inyanga nenyanga.

Umntu obhinqileyo uchuma kakhulu kwiminyaka yakhe yama-20. Ithuba lokuba umfazi afumane ukukhulelwa kwehle kakhulu emva kweminyaka engama-35 (kwaye ngakumbi emva kweminyaka engama-40). Ubudala apho ukuchuma kuqala ukwehla kuyahluka ukusuka kumfazi ukuya kowasetyhini.

Iingxaki zokungachumi kunye nokuphuma kwesisu kunyuka ngokubonakalayo emva kweminyaka engama-35 ubudala. Kukho ngoku iindlela zokubuyisa amaqanda kwangoko kunye nokugcinwa kwabasetyhini abakwi-20 yabo. Oku kuyakunceda ekuqinisekiseni ukukhulelwa okunempumelelo ukuba ukuzala kulibazisekile kude kube semva kweminyaka engama-35. Olu khetho lubiza kakhulu. Nangona kunjalo, abasetyhini abaziyo ukuba baya kudinga ukulibaziseka ekuzaleni komntwana banokukuqwalasela.

Ukuthatha isigqibo sokuba uza kunyangwa nini ukungachumi kuxhomekeke kubudala bakho. Ababoneleli ngononophelo lwempilo bacebisa ukuba abasetyhini abangaphantsi kwama-30 bazame ukukhulelwa bodwa unyaka omnye ngaphambi kokuvavanywa.

Abasetyhini abangaphezulu kweminyaka engama-35 kufuneka bazame ukukhulelwa iinyanga ezi-6. Ukuba ayenzeki ngelo xesha, kuya kufuneka bathethe nomboneleli wabo.

Ukuvavanywa kokungachumi kubandakanya imbali yezonyango kunye novavanyo lomzimba kuwo omabini amaqabane.

Uvavanyo lwegazi kunye nomfanekiso ngoyena kufunekayo. Kubafazi, oku kunokubandakanya:

• Uvavanyo lwegazi ukujonga amanqanaba ehomoni, kubandakanya iprogesterone kunye ne-follicle evuselelayo yehomoni (FSH)
• Iikiti zokufumanisa i-ovulation ekhaya
• Ukulinganisa ubushushu bomzimba rhoqo kusasa ukubona ukuba ii-ovari ziyawakhupha na amaqanda
• I-FSH kunye novavanyo lomngeni we-clomid
• Uvavanyo lwehomoni ye-Antimullerian (AMH)
• IHysterosalpingography (HSG)
• Iipelvic ultrasound
• Laparoscopy
• Uvavanyo lomsebenzi we-thyroid

Uvavanyo kumadoda lunokubandakanya:

• Uvavanyo lwesidoda
• Uvavanyo lwee-testes kunye ne-penis
• I-Ultrasound yamalungu esini obudoda (ngamanye amaxesha enziwe)
• Uvavanyo lwegazi ukujonga amanqanaba ehomoni
• I-biopsy testicular (enqabile ukwenziwa)

Unyango luxhomekeke kwisizathu sokungachumi. Inokubandakanya:

• Imfundo kunye neengcebiso malunga nemeko
• Unyango lokuchuma olunjenge-intrauterine insemination (IUI) kunye ne-vitro fertilization (IVF)
• Amayeza okunyanga usulelo kunye nokuphazamiseka kwengxaki
• Amayeza anceda ukukhula kunye nokukhululwa kwamaqanda kwii-ovari

Amaqabane anokunyusa amathuba okuba ukhulelwe inyanga nganye ngokulala ngesondo ubuncinci rhoqo kwiintsuku ezimbini ngaphambi nangexesha lokuvuthwa.

I-Ovulation yenzeka malunga neeveki ezi-2 ngaphambi kokuqala kokuya esikhathini. Ke ngoko, ukuba owasetyhini ufumana ixesha lakhe rhoqo kwiintsuku ezingama-28 esi sibini kufuneka sabelana ngesondo ubuncinci rhoqo kwiintsuku ezi-2 phakathi komhla we-10 nowe-18 emva kokuqala kwexesha lakhe.

Ukwabelana ngesondo ngaphambi kokuba i-ovulation yenzeke ngakumbi kuluncedo.

• Isidoda sinokuhlala ngaphakathi komzimba womfazi ubuncinci iintsuku ezi-2.
• Nangona kunjalo, iqanda lomfazi linokuchunyiswa kuphela lidlozi ngaphakathi kweeyure ezili-12 ukuya kwezingama-24 emva kokuba likhutshiwe.

Abasetyhini abangaphantsi okanye abatyebe kakhulu banokuthi bandise amathuba abo okuba bakhulelwe ngokufumana ubunzima obunempilo.

Abantu abaninzi bakufumanisa kuluncedo ukuthatha inxaxheba kumaqela enkxaso kubantu abaneengxaki ezifanayo. Unokucela umboneleli wakho ukuba acebise amaqela endawo.

Uninzi lwezibini ezi-1 kwizibalo ezi-5 ezifunyenwe zinengxaki yokungachumi ekugqibeleni ziyakhulelwa ngaphandle konyango.

Uninzi lwezibini ezinokungachumi ziyakhulelwa emva konyango.

Shayela umnikezeli wakho ukuba awukwazi ukukhulelwa.

Ukuthintela ii-STIs, ezinjenge-gonorrhea kunye ne-chlamydia, kunokunciphisa umngcipheko wokungachumi.

Ukugcina ukutya okunempilo, ubunzima, kunye nendlela yokuphila kunokunyusa amathuba okuba ukhulelwe kwaye ukhulelwe ngendlela esempilweni.

Ukuphepha ukusebenzisa izinto zokuthambisa ngexesha lokwabelana ngesondo kunokunceda ukuphucula ukusebenza kwesidoda.

Ukungakwazi ukukhulelwa; Ayikwazi ukukhulelwa

• Iiparvic laparoscopy
• I-anatomy yokuzala yabasetyhini
• I-anatomy yokuzala eyindoda
• Ukungachumi kwaseprayimari
• Isidoda

UBharak S, uGordon Baker HW. Ulawulo lweklinikhi lokungazali kwabesilisa. Ku: Jameson JL, De Groot LJ, de Kretser DM, et al, ii-eds. Endocrinology: Abantu abadala kunye nabantwana. Umhla wesi-7. IPhiladelphia, PA: Elsevier Saunders; I-2016: isahluko 141.

I-Broekmans FJ, iFauser BCJM. Ukungachumi kwabasetyhini: uvavanyo kunye nolawulo. Ku: Jameson JL, De Groot LJ, de Kretser DM, et al, ii-eds. Endocrinology: Abantu abadala kunye nabantwana. Umhla wesi-7. IPhiladelphia, PA: Elsevier Saunders; I-2016: isahluko 132.

UCatherino WH. Ukuzala i-endocrinology kunye nokungachumi. Ku: Goldman L, Schafer AI, eds. Amayeza eGoldman-Cecil. Ngomhla wama-26. IPhiladelphia, PA: Elsevier; 2020: isahluko 223.

Lobo RA. Ukungachumi: i-etiology, uvavanyo lokuqonda isifo, ulawulo, isifo. Ku: Lobo RA, Gershenson DM, Lentz GM, Valea FA, ii-eds. Gynecology egqibeleleyo. Umhla wesi-7. IPhiladelphia, PA: Elsevier; Ngo-2017: isahluko 42.

Ikomiti yokuziqhelanisa noMbutho waseMelika woNyango lokuZala. Ukuvavanywa kovavanyo lokuqonda kwabasetyhini abangazaliyo: umbono wekomiti. Ukuchuma okuchumileyo. 2015; 103 (6): e44-e50. IINKCUKACHA: 25936238 www.ncbi.nlm.nih.gov/pubmed/25936238.

Ikomiti yokuziqhelanisa noMbutho waseMelika woNyango lokuZala. Ukuvavanywa kovavanyo lwendoda engafumani bantwana: umbono wekomiti. Ukuchuma okuchumileyo. 2015; 103 (3): e18-e25. IINKCUKACHA: 25597249 www.ncbi.nlm.nih.gov/pubmed/25597249.