Ukuphazamiseka kokukhula kwinqanaba lesini labasetyhini

Ukuphazamiseka kokukhula kwinqanaba lokuzala labasetyhini ziingxaki kumalungu okuzala wentombazana. Zenzeka ngelixa ekhula esibelekweni sikanina.

Izitho zokuzala zabasetyhini zibandakanya ubufazi, amaqanda, isibeleko kunye nomlomo wesibeleko.

Usana luqala ukukhulisa amalungu alo okuzala phakathi kweveki yesi-4 neye-5 yokukhulelwa. Oku kuyaqhubeka kwiveki ye-20 yokukhulelwa.

Uphuhliso yinkqubo entsonkothileyo. Izinto ezininzi zinokuchaphazela le nkqubo. Ingxaki yengxaki yosana lwakho ixhomekeke ekubeni ukuphazamiseka kwenzeke nini. Ngokubanzi, ukuba iingxaki zivela kwangoko esibelekweni, iziphumo ziya kuthi gabalala.Iingxaki kuphuhliso lwamalungu okuzala amantombazana kunokubangelwa:

• Imfuza eyaphukileyo okanye elahlekileyo (iziphene zemfuza)
• Ukusetyenziswa kwamachiza athile ngexesha lokukhulelwa

Abanye abantwana banokuba nesiphene kwimfuza yabo ethintela imizimba yabo ekuveliseni i-enzyme ebizwa ngokuba yi-21-hydroxylase. I-adrenal gland ifuna le enzyme ukwenza iihormone ezinje ngecortisol kunye nealdosterone. Le meko ibizwa ngokuba yi-congenital adrenal hyperplasia. Ukuba umntwana oyintombazana okhulayo akanayo le enzyme, uya kuzalwa enesibeleko, amaqanda, kunye nemibhobho. Nangona kunjalo, amalungu akhe esini angaphandle aya kufana nalawo afunyenwe kumakhwenkwe.

Amayeza athile athathwa ngumama anokugqitha egazini losana kwaye aphazamisane nokukhula komzimba. Elinye iyeza elaziwa ngokwenza le diethylstilbestrol (DES). Ababoneleli ngononophelo lwempilo bakube bemisele eli yeza kubafazi abakhulelweyo ukunqanda ukukhulelwa kwesisu kunye nokusebenza kwangethuba. Nangona kunjalo, izazinzulu ziye zafumanisa ukuba abantwana abangamantombazana abazelwe ngabafazi abathatha eli yeza banesibeleko esimile ngokungaqhelekanga. Iyeza lonyusa amathuba eentombi zokuphuhlisa uhlobo olunqabileyo lomhlaza welungu lobufazi.

Ngamanye amaxesha, isifo sokukhula sinokubonwa kwakamsinya emva kokuba umntwana ezelwe. Ingabangela iimeko ezisongela ubomi kwiintsana. Ngamanye amaxesha, imeko ayifumaneki de ibe indala intombazana.

Ukuzala kukhula kufutshane nomchamo kunye nezintso. Ikhula kwangaxeshanye namanye amalungu amaninzi. Ngenxa yoko, iingxaki zophuhliso kwindlela yokuzala yabasetyhini ngamanye amaxesha zenzeka ngeengxaki kwezinye iindawo. Ezi ndawo zinokubandakanya indawo yokuchama, izintso, amathumbu kunye nomqolo osezantsi.

Ukuphazamiseka kuphuhliso lwendlela yokuzala yabasetyhini kubandakanya:

• I-Intersex
• Isini esingaqondakaliyo

Ezinye iingxaki zokukhula kwendlela yokuzala yabasetyhini zibandakanya:

• Ukungaqheleki kweCloacal: I-cloaca sisakhiwo esifana netyhubhu. Kumanqanaba okuqala ophuhliso, i-urinary tract, i-rectum, kunye nelungu lobufazi konke kungenanto kule tube enye. Emva kwexesha, iindawo ezi-3 zahlukene kwaye zinokuvula kwazo. Ukuba i-cloaca iyaqhubeka njengoko umntwana oyintombazana ekhula esibelekweni, zonke iindawo ezivulekileyo azenzi kwaye zahlukane. Umzekelo, umntwana unokuzalwa enovulo olunye kuphela emazantsi omzimba kufutshane nendawo engasemva. Umchamo kunye nelindle azinakho ukuphuma emzimbeni. Oku kunokubangela ukudumba kwesisu. Ezinye izinto ezingaqhelekanga ezinokubangela ukuba umntwana oyintombazana abonakale ngathi unelungu lobudoda. Ezi ziphene zokuzalwa zinqabile.
• Iingxaki ngezitho zangasese zangaphandle: Iingxaki zophuhliso zinokukhokelela kwi-clitoris edumbileyo okanye kwi-labia edibeneyo. Ilebia edibeneyo yimeko apho izihlunu zethishu ezijikeleze ukuvulwa kwelungu lobufazi zihlangene. Uninzi lwezinye iingxaki zesini sangaphandle zinxulumene ne-intersex kunye ne-genitalia engacacanga.
• Indawo yokungafani kakuhle: I-hymen sisicwili esibhityileyo esigubungela ngokuyivula kwelungu lobufazi. I-hymen engafakwanga ibhloka ngokupheleleyo ekuvuleni kwilungu lobufazi. Oku kuhlala kukhokelela kudumba olubuhlungu lobufazi. Ngamanye amaxesha, i-hymen inovulo oluncinci kakhulu okanye imingxunya emincinci emincinci. Le ngxaki ayinakufunyanwa kude kube kufikisa. Abanye abantwana abangamantombazana bazalwa bengenayo i-hymen. Oku akuthathwa njengokungaqhelekanga.
• Iingxaki ze-Ovarian: Intombazana encinci ingaba ne-ovary eyongezelelweyo, izicubu ezongezelelweyo eziqhotyoshelwe kwi-ovary, okanye izakhiwo ezibizwa ngokuba yi-ovotestes ezinezicubu zesilisa kunye nabasetyhini.
• Iingxaki zesibeleko kunye nomlomo wesibeleko: Intombazana encinci ingazalwa inesibeleko esongezelelweyo kunye nesibeleko, isibeleko esenziwe ngesiqingatha, okanye ukuvalwa kwesibeleko. Ngokwesiqhelo, amantombazana azelwe enesiqingatha sesibeleko kunye nesiqingatha selungu lobufazi alahleka kwizintso kwicala elinye lomzimba. Ngokuqhelekileyo, isibeleko singenza "udonga" oluphakathi okanye i-septum kwinxalenye ephezulu yesibeleko. Umahluko kwesi siphene uvela xa isiguli sizalwa sinomlomo wesibeleko esinye kodwa izibeleko ezimbini. Isibeleko esingaphezulu ngamanye amaxesha asithethi nomlomo wesibeleko. Oku kukhokelela ekudumbeni kunye neentlungu. Zonke izinto ezingaqhelekanga zesibeleko zinokudityaniswa nemicimbi yokuchuma.
• Iingxaki zobufazi: Intombazana encinci ingazalwa ingenalo ilungu lobufazi okanye ukuvuleka kobufazi kuvalwe luthotho lweeseli eziphakame kakhulu kwilungu lobufazi kunalapho ikhoyo ingqumbo. Ubufazi obulahlekileyo buhlala busenzeka ngenxa yesifo sikaMayer-Rokitansky-Kuster-Hauser. Kule syndrome, umntwana ulahlekile yinxalenye okanye onke amalungu omzimba okuzala (isibeleko, umlomo wesibeleko, kunye neetyhubhu ze-fallopian). Okunye okungaqhelekanga kubandakanya ukuba ne-vaginas ezi-2 okanye ubufazi obuvula kumchamo wokuchama. Amanye amantombazana anokuba nesibeleko esimile okweentliziyo okanye isibeleko esinodonga embindini womngxunya.

Iimpawu ziyahluka ngokwengxaki ethile. Banokubandakanya:

• Amabele akakhuli
• Ayinakukhupha isinyi
• Isigaxa esiswini, ngesiqhelo ngenxa yegazi okanye i-mucus engakwaziyo ukuphuma
• Ukuhamba sexesheni okwenzekayo ngaphandle kokusebenzisa itampon (uphawu lwesini lesibini)
• Ukunyanga ngenyanga okanye iintlungu, ngaphandle kokuya exesheni
• Akukho sexesheni (amenorrhea)
• Intlungu ngesondo
• Ukuphindaphinda kwesisu okanye ukuzalwa kwangaphambi kokubeleka (kusenokwenzeka ngenxa yesibeleko esingaqhelekanga)

Umboneleli unokuthi aqaphele iimpawu zesifo sokukhula kwangoko. Ezo mpawu zinokubandakanya:

• Ubufazi obuqhelekileyo
• Umlomo wesibeleko ongaqhelekanga okanye olahlekileyo
• Isinyi ngaphandle komzimba
• Izitho zangasese ekunzima ukuzichonga njengentombazana okanye inkwenkwe (intsholongwane)
• I-Labia ezinamathele kunye okanye ezingaqhelekanga ngobukhulu
• Akukho kuvuleka kwindawo yesini okanye ukuvulwa okukodwa kwamalungu
• I-clitoris edumbileyo

Indawo esiswini inokudumba okanye kuva iqhuma kwi-groin okanye isisu. Umboneleli angaqaphela ukuba isibeleko asiziva siqhelekile.

Uvavanyo lunokubandakanya:

• I-Endoscopy yesisu
• Uvavanyo lweKaryotyping
• Amanqanaba eHormone, ngakumbi i-testosterone kunye ne-cortisol
• I-Ultrasound okanye i-MRI yendawo ye-pelvic
• Umchamo kunye ne-serum electrolyte

Oogqirha bahlala becebisa ukuba batyandelwe amantombazana aneengxaki zokukhula kwamalungu angaphakathi okuzala. Umzekelo, umntu obhinqileyo ovaliweyo unokuhlala elungiswa ngokuhlinzwa.

Ukuba umntwana oyintombazana ulahlekile kwilungu lobufazi, umboneleli unokuyalela i-dilator xa umntwana efikelela ebudaleni. Isithambisi sisixhobo esinceda ukolula okanye ukwandisa indawo apho ubufazi kufanele ukuba bubekhona. Le nkqubo ithatha iinyanga ezi-4 ukuya kwezi-6. Utyando lunokwenziwa ukwenza ubufazi obutsha. Utyando kufuneka lwenziwe xa umfazi osemncinci ekwazi ukusebenzisa i-dilator ukugcina ubufazi obutsha buvulekile.

Iziphumo ezilungileyo zixeliwe ngeendlela zoqhaqho nezinganyangwa.

Unyango lokungaqhelekanga kwe-cloacal ihlala ibandakanya utyando oluntsonkothileyo oluninzi. Olu tyando lungisa iingxaki nge-rectum, lobufazi, kunye nomchamo.

Ukuba ukukhubazeka kokuzalwa kubangela iingxaki ezibulalayo, utyando lokuqala lwenziwa kwakamsinya emva kokuzalwa. Utyando lolunye uphuhliso lokuphazamiseka kokuzala lunokwenziwa ngelixa umntwana elusana. Olunye utyando lunokulibaziseka ade abe mdala kakhulu umntwana.

Ukufumanisa kwangoko kubalulekile, ngakumbi kwimeko yesini esingaqondakaliyo. Umboneleli makaqwalasele ngononophelo ngaphambi kokuthatha isigqibo sokuba umntwana uyinkwenkwe okanye uyintombazana. Oku kukwabizwa ngokuba kukunikezela ngesini. Unyango kufuneka lubandakanye ukucebisa abazali. Umntwana uyakufuna ukucetyiswa njengokuba ekhula.

Ezi zixhobo zilandelayo zinokubonelela ngolwazi oluthe kratya malunga nengxaki zophuhliso ezahlukeneyo:

• Isiseko seCARES- www.caresfoundation.org
• I-DES Intshukumo yase-USA- www.desaction.org
• Umbutho we-Intersex waseMntla Melika- www.isna.org

Ukungaqheleki kwecloacal kunokubangela iingxaki ekubulaweni xa kuzalwa.

Iingxaki ezinokubakho zinokuphuhliswa ukuba ngaba isifo senziwe emva kwexesha okanye akulunganga. Abantwana abanamalungu esini esingaqondakaliyo abelwe isini esinye banokufunyanwa kamva benamalungu angaphakathi enxulumene nesini esahlukileyo apho bakhuliswa khona. Oku kunokubangela uxinzelelo olukhulu lwengqondo.

Iingxaki ezingafunyaniswanga kwindlela yokuzala yamantombazana zinokukhokelela ekungachumini kunye nobunzima bezesondo.

Ezinye iingxaki ezenzeka kamva ebomini zibandakanya:

• Endometriosis
• Ukuya emsebenzini ngokukhawuleza kakhulu (ukuhanjiswa kwangaphambi kwexesha)
• Iintlungu zesisu ezibuhlungu ezifuna utyando
• Ukuphindaphindwa kwesisu

Fowunela umnikezeli wakho ukuba intombi yakho ine:

• Isini esingaqhelekanga
• Iimpawu zobudoda
• Intlungu yenyanga kunye nokuxinana, kodwa ayiyi exesheni
• Andiqalanga ukuba sexesheni nge-16 yobudala
• Akukho kuphuhliswa kwebele xa ufikisa
• Akukho zinwele ze-pubic xa ufikisa
• Izigaqa ezingaqhelekanga esiswini okanye kwindawo yokugcuma

Abafazi abakhulelweyo akufuneki bathathe naziphi na izinto eziqukethe iihomoni zesilisa. Kuya kufuneka bajonge nomboneleli ngaphambi kokuba bathathe naluphi na uhlobo lwamayeza okanye izongezo.

Nokuba umama wenza yonke imizamo yokuqinisekisa ukukhulelwa okusempilweni, iingxaki zophuhliso kusana zisenokwenzeka.

Isiphene sokuzalwa - ubufazi, amaqanda, isibeleko kunye nomlomo wesibeleko; Isiphene sokuzalwa - ubufazi, amaqanda, isibeleko kunye nomlomo wesibeleko; Ukuphuhliswa kokuphazamiseka kwendlela yokuzala yabasetyhini

• Ukuphazamiseka kokukhula kwilungu lobufazi kunye nelungu lobufazi
• Iintsilelo zesibeleko esibelekweni

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UKaefer M.Ulawulo lokungaqhelekanga kwilungu lobufazi kumantombazana. Ku: Wein AJ, Kavoussi LR, Partin AW, Peters CA, ii-eds. UCampbell-Walsh Urology. Ngomhla we-11. IPhiladelphia, PA: Elsevier; I-2016: isahluko 149.

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