Ngaba abantu basetyhini baseMelika baneeHysterectomies ezingeyomfuneko?

Umxholo

• Okokuqala, yintoni i-hysterectomy?
• Kutheni abafazi abaninzi befumana i-hysterectomy?
• Umahluko ngokobuhlanga kwiHysterectomy
• Ulufumana Njani Ukhathalelo Olufaneleyo
• Uphengululo lwe

Ukususa isibeleko somfazi, ilungu elinoxanduva lokukhula, nokuthwala umntwana kunye nokuya exesheni idili enkulu. Ke unokumangaliswa kukwazi ukuba i-hysterectomy -ukususwa okungenakuguqulwa kususwe isibeleko-yenye yoqhaqho olwenziwa rhoqo kwabasetyhini e-US Yep, uvile ukuba kunjalo: Abanye 600,000 I-hysterectomy yenziwa rhoqo ngonyaka omnye e-US Kwaye ngamanye amaxesha, isithathu sabo bonke abafazi baseMelika baya kuba beneminyaka engama-60 ubudala.

"Phambi konyango lwale mihla, ii-hysterectomies zazibonwa njengonyango lwawo nawuphi na umba owayeza kufikwa ligqirha okanye ugqirha," ucacisa uHeather Irobunda, M.D., ob-gyn oqinisekiswe yibhodi kwisiXeko saseNew York. "Kwimbali yamva nje, naziphi na iingxaki eza kuziswa ngumfazi kugqirha wakhe ezibandakanya i-pelvis yakhe zinokuphathwa nge-hysterectomy."

Namhlanje, uninzi lwezifo-umhlaza, i-fibroids eyenzakalisayo (ukukhula okungenawo umhlaza kwimisipha yesibeleko sakho kunokuba super okubuhlungu), ukopha okungaqhelekanga - kunokukhokelela ugqirha ukuba acebise i-hysterectomy. Kodwa iingcali ezininzi zithi utyando lwenziwe ngaphezulu kwaye lumiselwe ngaphezulu, ngakumbi kwiimeko ezithile ezinje nge-fibroids-ngakumbi kubafazi abanemibala.

Ke yintoni okufuneka uyazi malunga nale nkqubo iqhelekileyo, ezi zintlukwano zobuhlanga, kwaye - okona kubaluleke kakhulu - kufuneka wenze ntoni wena ukwenza ukuba ukhe wanikwa njengonyango?

Okokuqala, yintoni i-hysterectomy?

Ngamafutshane, yinkqubo esusa isibeleko, kodwa kukho iintlobo ezahlukeneyo ze-hysterectomy. I-American College of Obstetricians and Gynecologists (ACOG) iphawula ukuba i-hysterectomy iyonke kuxa isibeleko sakho sonke (kubandakanywa nomlomo wesibeleko, isiphelo esisezantsi sesibeleko sakho esidibanisa isibeleko kunye nesetyhini). I-supracervical (aka a subtotal okanye inxenye) ye-hysterectomy kuxa nje indawo ephezulu yesibeleko sakho (kodwa hayi umlomo wesibeleko) isuswe. Kwaye i-hysterectomy eguqukayo kuxa une-hysterectomy iyonke kunye nokususwa kwezakhiwo ezinjengee-ovari zakho, okanye ii-fallopian tubes (yithi, kwimeko yomhlaza).

I-Hysterectomy iqhele ukusetyenziselwa ukunyanga ukubulawa kweemeko zempilo ukusuka kwi-fibroids kunye ne-uterine prolapse (xa isibeleko sihla saya ngapha nangapha okanye kwilungu lobufazi) ukuphuma kwegazi ngokungaqhelekanga, umhlaza we-gynecologic, iintlungu ezingapheliyo zentliziyo, kunye ne-endometriosis, ngokwe-ACOG.

Ngokuxhomekeke kuluphi uhlobo lwe-hysterectomy oyifunayo (kwaye sithini na isizathu sakho sokuyifuna), utyando lunokwenziwa ngeendlela ezimbalwa ezahlukeneyo: ngelungu lobufazi bakho, ngesisu sakho, okanye nge-laparoscopy - apho iteleskopu encinci ifakwe ukuze ibonakale kwaye Ugqirha wotyando uyakwazi ukwenza utyando ngezikeko ezincinci kakhulu.

Kutheni abafazi abaninzi befumana i-hysterectomy?

Ezinye ii-hysterectomies (ezinje ngezo zenziwe ngesisu sakho) zihlasele kakhulu kunezinye (enye yenziwe nge-laparoscopy). Kuyafaneleka ukuba uqaphele ukuba amaxesha amaninzi, nangona i-hysterectomy iboniswa, kukho ezinye iindlela zokonyango ezikhoyo (yithi, kwimicimbi efana ne-fibroids okanye i-endometriosis). Ingxaki? Olu khetho aluhlali luboniswa njengokhetho lokwenyani naphina.

"Ngamanye amaxesha, kuxhomekeke kwinxalenye yelizwe okulo, kukho oogqirha botyando abangakhululekanga ngonyango oluncinci olukhokelela ekubeni bonke abo basetyhini bafumane i-hysterectomy," uchaza uGqr. Irobuna.

Nanku umzekelo: Xa isetyenziselwa i-fibroids, i-hysterectomy yenza bathambekele ekuqinisekiseni ukuba iimpawu aziyi kubuya (emva kwayo yonke loo nto, isibeleko sakho apho i-fibroids ikhoyo sele ihambile), kodwa ungasusa ngocoselelo i-fibroids kwaye ushiye isibeleko endaweni. "Ndicinga ukuba kukho ii-hysterectomies ezinconyelwa ngoogqirha kuba befumana i-fibroids kuvavanyo," utshilo uJeff Arrington, MD, ugqirha ogqirha we-gynecologic oqhubela phambili kunye nengcali ye-endometriosis kwiziko le-Endometriosis e-Atlanta, GA. Kwaye ngelixa i-fibroids inokuba buhlungu ngokumangalisayo kwaye yenze buthathaka (kwaye i-hysterectomy inokunceda ukuphelisa loo ntlungu), ii-fibroids zinokuba buhlungu. "Kuya kubakho inani lezigulana eziya kuqonda kakuhle ukuba i-fibroids ikhona kwaye ayinabungozi," utshilo uGqr. Arrington ngokhetho lokungasebenzi.

Ezinye iinkqubo ezinobundlobongela zibandakanya i-myomectomy (utyando lokususa iifibroids kwisibeleko), unyango olufana ne-uterine fibroid embolization (ukunciphisa unikezelo lwegazi kwi-fibroids), kunye ne-radiofrequency ablation (etshisa i-fibroids). Ngaphezu koko, kukho iindlela ezininzi zonyango ezingathinteliyo ezifana nezithintelo zokukhulelwa ngomlomo kunye namanye amayeza.

Kodwa, nantsi into: "I-Hysterectomies sele ikhona ixesha elide, kwaye yonke i-gynecologist ifunda indlela yokuyenza kuqeqesho lwabo lokuhlala - [kodwa] oko akuyonyani kuzo zonke iindlela zonyango," kubandakanywa ezi nkqubo zincinci, Utshilo uGqirha Irobuna.

Kulo mthambo, ngelixa i-hysterectomy ithathwa njengonyango "olucacileyo" (funda: ngokusisigxina) unyango lwe-endometriosis, "akukho bungqina - akukho sifundo esinye - esibonisa ukuba ukungena kunye nokususa isibeleko ngomlingo kwenza yonke enye i-endometriosis ihambe. kude, "ucacisa uGqirha Arrington. Emva kwayo yonke loo nto, ngokwenkcazo, i-endometriosis kuxa izihlunu ezifanayo nezomgca wesibeleko zikhula ngaphandle wesibeleko. I-Hysterectomy, uthi, unako ukuphucula amanqanaba eentlungu ze-endometriosis zabanye abantu, kodwa ayenzi kwaye ngokwayo isinyange isifo. (Inxulumene: U-Lena Dunham wayenayo i-Hysterectomy epheleleyo yokuMisa i-Endometriosis Pain)

Ke kutheni i-hysterectomy ihlala inikezelwa kwabasetyhini abane-endometriosis? Kunzima ukuyithetha, kodwa inokuza kuqeqesho, intuthuzelo, kunye nokuvezwa, utshilo uGqirha Arrington. I-Endometriosis inyangwa kakuhle ngokususwa kwe-endometriosis uqobo, eyaziwa ngokuba kukuhlinzwa, utshilo. Kwaye akuyena wonke ugqirha oqeqeshwe ngolu hlobo lotyando ngendlela efanayo ne-hysterectomy efundiswa ngokuqhelekileyo.

Umahluko ngokobuhlanga kwiHysterectomy

Oku kugqitywa kokukhutshwa kwesibeleko kuyacaca ngakumbi xa kujongwa kwimbali yesiko phakathi kwabaguli abaNtsundu. Olunye uphando lubonisa ukuba abafazi abaMnyama banamathuba amane okufumana isibeleko kunabasetyhini abamhlophe. Amaziko oLawulo lweNtsholongwane kunye noThintelo (CDC) nawo axele ngedatha ebonisa ukungafani ngokobuhlanga phakathi kwabo banenkqubo. Kwaye olunye uphando lufumanisa ukuba abafazi abaMnyama bane-hysterectomy kumazinga aphezulu kunokuba nayiphi na olunye uhlanga.

Uphando kunye neengcali zicacile: Abafazi abamnyama ngenene kunokwenzeka kakhulu kunabafazi abamhlophe ukuba benze i-hysterectomy, utshilo uMelissa Simon, MD, umlawuli weZiko lezeMpilo yoLuntu kunye neZiko lezeMpilo kuTshintsho lwezeMpilo kwi-Feinberg School of Medicine. Ngokucacileyo, banokuthi batyhutyhe isibeleko sesisu esihlaselayo ngakumbi, wongeza.

Zininzi izizathu zoku. Kwelinye, abafazi abamnyama bafumana i-fibroids -esinye sezizathu eziqhelekileyo zokukhulelwa kwesibeleko phakathi kwalo naluphi na uhlanga- kumazinga aphezulu kunabafazi abamhlophe. "Amazinga eziganeko aphindwe kabini ukuya kathathu kubasetyhini baseMelika base-Afrika kunabasetyhini abamhlophe eMelika," utshilo uCharlotte Owens, MD, umlawuli wezonyango jikelele kwi-AbbVie. "Abasetyhini base-Afrika baseMelika bakwanokuphuhlisa iimpawu ezinzima nangaphambili, rhoqo bekwi-20s yabo." Iingcali aziqinisekanga ncam ukuba kutheni oku kunjalo, utsho uGqr. Owens.

Kodwa kunokwenzeka ukuba kukho ukungafani kobuhlanga kunezehlo ze-fibroids. Komnye, loo mba wofikelelo kunyango olungangeneleli kangako? Inokubabetha ngakumbi abafazi bemibala. "Ukuxhaswa ngemali kolunye lobuchwephesha obufunekayo ukuze kwenziwe unyango oluphambili kakhulu, unyango olungenakungena lungafumaneki kwizibhedlele ezinceda uluntu oluhlala abanye abantu basetyhini abaNtsundu," ucacisa watsho uGqirha Irobunda. (Nxulumeneyo: Lo Mfazi Okhulelweyo uNxibelela ngamava aqaqambisa ukuMahluko kukhathalelo lwempilo lwabafazi abaMnyama)

Kwakhona, xa kufikwa kukhetho lokhathalelo lwabasetyhini abanemibala kunye nonyango lwe-fibroid, iindlela ezahlukeneyo azikhe zixoxwe, utshilo uKecia Gaither, MD, MPH, ugqirha we-ob-gyn kunye noomama abakhulelweyo kwizibhedlele ze-NYC / eLincoln. "I-Hysterectomy inikwe njengeyona ndlela yonyango kuphela." Kodwa inyani yombandela yile, ngelixa i-hysterectomy ihlala ikhetha kwimenyu yabasetyhini kunyango, ihlala ingeyiyo kuphela ukhetho. Kwaye akufanele uzive ngathi kufuneka uyithathe okanye uyishiye xa kuziwa kwimpilo yakho.

Ukuza kuthi ga ngoku, kukho ubuhlanga kunye nenkqubo edlala indima apha, zitsho iingcali. Emva kwayo yonke loo nto, uninzi lweenkqubo ze-pelvic kunye nokuzala zineengcambu zobuhlanga njengoko zazinjalo ekuqaleni kwaye zazenziwa kumakhoboka amnyama amabhinqa. Kwii-2000s zakudala, bekukho amatyala okungavumi ukuvala inzala kwinkqubo yasejele yaseCalifornia, ucacisa uGqirha Irobuna.

"Iyaziwa into yokuba umkhethe ukhona kubafazi abamnyama nakwezonyango - ndizibonele ngokwam," utshilo uGqirha Gaither.

Ukuthambekela koogqirha botyando nako kunokuqaqamba. Ukuba ugqirha, umzekelo, ucinga ukuba abafazi abaMnyama abanakufane bahambelane neendlela zokonyango ezifana neepilisi zokulawula ukuzalwa kwansuku zonke okanye ukudubula (njengeDepo Provera enokukunceda kwintlungu ye-pelvic kunye nokuphuma kwexesha lokuya esikhathini), banokuba ngaphezulu ngokunokwenzeka ukunika unyango oluhlaselayo ngakumbi njenge-hysterectomy, utshilo. "Ngelishwa, ndinezigulana ezininzi zabantu basetyhini abamnyama beze kundibona ndinexhala emva kokunikwa ezinye iindlela zoqhaqho besibeleko kwaye bengaqinisekanga ukuba uqhaqho olususwini yeyona ndlela ilungileyo yonyango kubo."

Ulufumana Njani Ukhathalelo Olufaneleyo

I-Hysterectomy lunyango oluxabisekileyo kwiingxaki ezithile zonyango-akukho mbuzo. Kodwa inkqubo kufuneka inikezwe njenge inxalenye yesicwangciso sonyango esinokubakho, kwaye rhoqo njengokhetho. "Kubalulekile ukuba ngesigqibo esibaluleke njengokususa ilungu, isiguli siyakuqonda ukuba kuqhubeka ntoni ngomzimba waso kwaye loluphi uhlobo lwezinto ezikhoyo onokukhetha kuzo kunyango," utshilo uGqirha Irobunda.

Emva kwayo yonke loo nto, i-hysterectomy iza neziphumo ebezingalindelekanga-yonke into ekubeni ingasakwazi ukuzala abantwana ekuqunjelweni okanye ekudakaleni ngokweemvakalelo kunye nokuyeka ukuya exesheni kwangoko nangoko ukuba awukwenzi ngokwemvelo oku. (BTW, i-hysterectomy ngomnye woonobangela *baninzi* bokuyeka ukuya exesheni kwangoko.)

Ngaba ezinye zezinto ekufuneka uzigcine engqondweni ukuba i-hysterectomy iza kwincoko? Ndihlala ndicebisa abaguli, ingakumbi abagulayo ngombala kunye nabagulayo abaMnyama, ukuba bangoyiki ukubuza imibuzo, utshilo uGqirha Simon. "Buza ukuba kutheni ugqirha okanye ugqirha ecebisa indlela ethile yonyango kwimeko ethile, buza ukuba kukho ezinye iindlela zonyango, kwaye-ukuba kunqunywe ukuba i-hysterectomy ngu indlela oza kuhamba ngayo - buza malunga neendlela ezinokusetyenziswa, ezinje ngendlela encinci engenayo. "

Ngamafutshane: Kufuneka uzive ngathi uphendulwe imibuzo yakho kwaye uyaviwa. Ukuba awuyenzi, funa uluvo lwesibini (okanye lwesithathu), utshilo. (Izinto ezi-4 ezifunwa nguMfazi ngamnye ngeMpilo yakhe yezesondo, ngokutsho kwe-Ob-Gyn)

Ekugqibeleni, i-hysterectomy lukhetho lomntu oluxhomekeke kuyo yonke into ukusuka kwiyiphi ingxaki ojongene nayo, yeyiphi inqanaba lobomi okhoyo, kunye nenjongo onayo. Kwaye eyona nto iphambili kukuba uqiniseke ukuba unolwazi ngangoko kubalulekile.

"Ndizama ukuhamba kuzo zonke iindlela ezahlukeneyo, ezilungileyo nezingalunganga, ndize ndincedise isigulana ukuba sithathe isigqibo sokuba loluphi ukhetho olulungele bona," utshilo uGqirha Arrington.

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