I-Phalloplasty: Ugqirha loqinisekiso lwesini

Umxholo

• Yintoni eyenzekayo ngexesha le-phalloplasty?
• Ubuchule bePloploplasty
• Ingalo yomsinga iphalloplasty yasimahla
• Ngaphambili umlenze wethanga uhambise i-phalloplasty
• Iphalloplasty esiswini
• Imisculocutaneous latissimus dorsi flap phalloplasty
• Iingozi kunye neengxaki
• Ukuchacha
• Emva kokhathalelo
• Imibuzo yokubuza ugqirha wakho wotyando
• Imbonakalo

Ushwankathelo

Iphalloplasty kukwakhiwa okanye ukwakhiwa kwakhona kwepenisi. I-phalloplasty lukhetho oluqhelekileyo lotyando lwe-transgender kunye nabantu abangathathi ntweni abanomdla kuqhaqho lwesini. Isetyenziselwa ukwakha ipenisi kwimeko yomothuko, umhlaza, okanye isiphene sokuzalwa.

Injongo ye-phalloplasty kukwakha ipenisi yokuthambisa enobungakanani obaneleyo obunokuziva uziva kunye nokukhulula umchamo kwindawo emileyo. Yinkqubo entsonkothileyo esoloko ibandakanya utyando olungaphezulu kwesinye.

Ubuchwephesha bePhalloplasty buqhubeka buguquka kunye neendawo zotyando lweplastiki kunye nomchamo. Okwangoku, inkqubo esemgangathweni yegolide ye-phalloplasty yaziwa ngokuba yiphalloplasty ye-radial free-flap (RFF). Ngexesha lale nkqubo, oogqirha basebenzisa i-flap yesikhumba kwingalo yakho yokwakha i-shaft yelungu lobudoda.

Yintoni eyenzekayo ngexesha le-phalloplasty?

Ngexesha le-phalloplasty, oogqirha basusa isikhumba esivela kwindawo yomnikeli womzimba wakho. Banokususa le flap ngokupheleleyo okanye bayishiye inxenye iqhotyoshelwe. Esi sihlunu sisetyenziselwa ukwenza zombini i-urethra kunye neshafti yelungu lobudoda, kwityhubhu engaphakathi-kwityhubhu. Umbhobho omkhulu usongwe ngokujikeleza ityhubhu yangaphakathi. Ukufakelwa kolusu kuthathwe kwiindawo ezingaziwayo emzimbeni, apho kungayi kushiya mabala abonakalayo, kwaye kumiliselwe kwindawo yomnikelo.

I-urethra yabasetyhini imfutshane kune-urethra eyindoda. Oogqirha banokuyandisa i-urethra kwaye bayincamathisele kwi-urethra yabasetyhini ukuze kuchame umchamo ukusuka kwincam yelungu lobudoda. I-clitoris ihlala ishiyeka kufutshane nesiseko sobudoda, apho isenakho ukuvuselelwa. Abantu abanokufezekisa i-orgasm ngaphambi kotyando lwabo banokuhlala bekwenza oko emva kotyando lwabo.

I-phalloplasty, ngakumbi, kuxa ogqirha beguqula isikhumba somnikeli kwi-phallus. Kodwa ngokubanzi, ibhekisa kwinani leenkqubo ezahlukeneyo ezihlala zisenziwa ngokulandelelana. Ezi nkqubo zibandakanya:

• i-hysterectomy, ngexesha apho oogqirha basusa isibeleko
• i-oophorectomy yokususa ii-ovari
• i-vaginectomy okanye i-vaginal mucosal ablation ukususa okanye ukususa ngokungagqitywanga ilungu lobufazi
• I-phalloplasty yokujika isikhumba somnikeli kwi-phallus
• i-scrotectomy yokuguqula i-labia majora kwi-scrotum, nokuba kungenayo okanye ngaphandle kokufakwa kwamatyhalarha
• urethroplasty yokwandisa kwaye uyixhome kwi-urethra ngaphakathi kwe-phallus entsha
• i-glansplasty yokukrola ukubonakala kwencam engalukanga
• Ukufakwa kwe-penile ukuvumela ulwakhiwo

Akukho odolo okanye ixesha elinye lale nkqubo. Abantu abaninzi abazenzi zonke. Abanye abantu bayazenza kunye, ngelixa abanye bezisasaza ngaphezulu kweminyaka. Ezi nkqubo zifuna ogqirha abavela kwizakhono ezintathu ezahlukeneyo: izifo zamanina, i-urology kunye neplastiki.

Xa ufuna ugqirha wotyando, unokufuna ukukhangela elinye neqela elisekwe. Ngaphambi kwalo naluphi na ungenelelo lonyango, thetha nogqirha wakho malunga nokulondolozwa kokuchuma kunye nefuthe ekusebenzeni ngokwesondo.

Ubuchule bePloploplasty

Umahluko phakathi kweendlela ezixhaphakileyo ze-phalloplasty yindawo apho ulusu lomnikeli luthathwa khona kunye nendlela esuswe ngayo kwaye iphinde ifakwe. Iindawo ezinikelwayo zinokubandakanya isisu esisezantsi, i-groin, i-torso, okanye ithanga. Nangona kunjalo, indawo ekhethiweyo yoogqirha abaninzi yingalo yangaphambili.

Ingalo yomsinga iphalloplasty yasimahla

Ingalo yasimahla ye-radial free-flap (RFF okanye i-RFFF) ye-phalloplasty yeyona nto iphambili ekwakhiweni ngokutsha kwamalungu esini. Kwinkqubo yasimahla yokubhabha, izicwili zisuswe ngokupheleleyo kwingalo yangaphambili kunye nemithambo yegazi kunye nemithambo luvo. Le mijelo yegazi kunye neentsholongwane zidityaniswe ngokuchaneka kwe-microsurgical, ukuvumela igazi ukuba ligele ngokwemvelo kwi-phallus entsha.

Le nkqubo ikhethwa kwezinye iindlela kuba inika ubuntununtunu obugqwesileyo kunye neziphumo ezilungileyo zobuhle. I-urethra inokwakhiwa kwityhubhu engaphakathi-kwityhubhu, evumela ukuma umchamo. Kukho indawo yokumiliselwa kamva kwentonga yokwakha okanye impompo ye-inflatable.

Amathuba okonakaliswa kokuhamba kwisiza sabanikeli nawo asezantsi, nangona kunjalo ukufakelwa kolusu kwingalo kusoloko kushiya ukumodareyitha ukuya kubukhali obukhulu. Le nkqubo ayilunganga kumntu oxhalabileyo ngamanxeba abonakalayo.

Ngaphambili umlenze wethanga uhambise i-phalloplasty

Umlenze wangaphambili wangaphandle (ALT) ophethe i-flap phalloplasty ayilona khetho olukhokelayo kubagqirha abaninzi kuba lubangela amanqanaba asezantsi okuziva ubuthathaka kwilungu lobudoda elitsha. Kwinkqubo ye-pedicled flap, izicubu ziyahlulwa kwimithambo yegazi kunye ne-nerves. I-urethra inokuphinda ihlelwe kwakhona ukuze ime ngokuchama, kwaye kukho indawo eyaneleyo yokufakwa kwe-penile.

Abo bathe bayifumana le nkqubo bonelisekile ngokubanzi, kodwa baxela amanqanaba asezantsi obuntununtunu. Kukho inqanaba eliphezulu ngale nkqubo kune-RFF. Ukufakelwa kolusu kunokushiya ukoyikeka okukhulu, kodwa kwindawo ethe kratya.

Iphalloplasty esiswini

I-phalloplasty yesisu, ekwabizwa ngokuba yi-supra-pubic phalloplasty, lukhetho olufanelekileyo kumadoda atshintshayo angafuni i-vaginectomy okanye i-urethra ehlengahlengisiweyo. I-urethra ayizukuhamba ngencam yelungu lobudoda kwaye ukuchama kuya kuqhubeka kufuna indawo yokuhlala.

Njenge-ALT, le nkqubo ayifuni microsurgery, ke ayibizi kakhulu. I-phallus entsha iya kuba nokuthambeka, kodwa hayi imvakalelo e-erotic. Kodwa i-clitoris, egcinwe kwindawo yayo yoqobo okanye ingcwatyiwe, isenokuvuseleleka, kwaye ukufakwa kwe-penile kunokuvumela ukungena.

Inkqubo ishiya isikroba esithe tyaba esisuka esinqeni siye emathangeni. Esi sibazi sifihlwa ngokulula ngempahla. Kuba ayibandakanyi urethra, inxulunyaniswa neengxaki ezimbalwa.

Imisculocutaneous latissimus dorsi flap phalloplasty

I-musculocutaneous latissimus dorsi (MLD) i-phalloplasty ithatha izicwili zomnikeli kwimisipha yangasemva phantsi kwengalo. Le nkqubo ibonelela ngochuku olukhulu lwethishu yabanikeli, evumela abagqirha ukuba benze ipenisi enkulu. Kukulungele kakuhle ukwakhiwa ngokutsha kwe-urethra kunye nokongezwa kwesixhobo se-erectile.

Isikhumba sesikhumba kubandakanya imithambo yegazi kunye neethishu zemithambo-luvo, kodwa inwebu enye yemoto ayinabuthathaka kangako kunemithambo-luvo enxulumene ne-RFF. Indawo yomnikeli iyaphilisa kakuhle kwaye ayiphantse ibonakale njengezinye iinkqubo.

Iingozi kunye neengxaki

I-Phalloplasty, njengalo lonke utyando, iza nomngcipheko wosulelo, ukopha, ukonakala kwethishyu kunye nentlungu. Ngokungafaniyo nezinye iindlela zotyando, nangona kunjalo, kukho umngcipheko ophezulu kakhulu weengxaki ezinxulumene ne-phalloplasty. Ezona ngxaki zixhaphakileyo zibandakanya urethra.

Iingxaki ezinokwenzeka ze-phalloplasty zibandakanya:

• fistula zesisu
• Uxinzelelo lwe-urethral (ukunciphisa i-urethra ethintela ukuhamba komchamo)
• ukusilela kweflap kunye nelahleko (ukusweleka kwethishu ehanjisiweyo)
• Ukuqhekeka kwenxeba (ukuqhekeka ecaleni kwemigca yokusika)
• ukuphuma kwegazi lomqolo okanye iintlungu
• isinyi okanye ukwenzakala emqolo
• ukunqongophala kwemvakalelo
• Isidingo sexesha elide sokuhambisa amanzi (ukukhutshwa kunye nolwelo kwindawo yenxeba efuna ukunxitywa)

Indawo yokunikela ikwumngcipheko weengxaki, ezi zibandakanya:

• ukungabonakali kakuhle okanye umbala
• ukonakala kwenxeba
• i-granulation yeethishu (bomvu, isikhumba esinamaqhuma kwindawo yenxeba)
• ukunciphisa ukuhamba (kunqabile)
• ukugruzuka
• ukuncipha kwemvakalelo
• intlungu

Ukuchacha

Kuya kufuneka ubuyele emsebenzini malunga neeveki ezine ukuya kwezintandathu emva kwe-phalloplasty yakho, ngaphandle kokuba umsebenzi wakho ufuna umsebenzi onzima. Emva koko kuya kufuneka ulinde iiveki ezintandathu ukuya kwezisibhozo. Kuphephe ukuzilolonga nokuphakamisa iiveki zokuqala, nangona ukuthatha uhambo olukhawulezileyo kulungile. Uya kuba ne-catheter endaweni yeeveki zokuqala. Emva kweeveki ezimbini ukuya kwezintathu ungaqala uchame kwi-phallus.

I-phalloplasty yakho inokuqhekeka ngezigaba, okanye unokuba ne-scrotoplasty, ukuvuselelwa kwe-urethral kunye ne-glansplasty kanyekanye. Ukuba uyahlulahlula, kuya kufuneka ulinde ubuncinci iinyanga ezintathu phakathi kwenqanaba lokuqala nelesibini. Kwinqanaba lokugqibela, elilelokufakwa kwe-penile, kuya kufuneka ulinde malunga nonyaka omnye. Kubalulekile ukuba ube nemvakalelo epheleleyo kwilungu lakho lobudoda ngaphambi kokumiliselwa.

Kuxhomekeka kuhlobo luphi lotyando obukade unalo, ngekhe ungabinayo imvakalelo ye-erotic kwi-phallus yakho (kodwa usenakho ukuba ne-clitoral orgasms). Kuthatha ixesha elide ukuphilisa izicwili zemithambo-luvo. Unokuba nemvakalelo yokuthambeka ngaphambi kokuziva inkanuko. Ukuphilisa ngokupheleleyo kungathatha ukuya kwiminyaka emibini.

Emva kokhathalelo

• Gwema ukubeka uxinzelelo kwi-phallus.
• Zama ukuphakamisa i-phallus ukunciphisa ukudumba kunye nokuphucula ukujikeleza (yiphakamise kunxibo lotyando).
• Gcina ukusikwa kucocekile kwaye komile, phinda ufake iilokhwe, kwaye uhlambe ngesepha namanzi njengoko kuyalelwe ngugqirha wakho wotyando.
• Musa ukufaka umkhenkce kuloo ndawo.
• Gcina indawo ejikeleze amadreyini icocekile kunye nesiponji.
• Musa ukushawa iiveki ezimbini zokuqala, ngaphandle kokuba ugqirha wakho ukuxelele ngenye indlela.
• Musa ukutsala i-catheter, kuba oku kungonakalisa isinyi.
• Khuphela isikhwama somchamo kathathu ngemini.
• Ungazami ukuchama kwi-phallus yakho ngaphambi kokuba ufanele.
• Ukurhawuzelela, ukudumba, ukugruzuka, igazi kumchamo, isicaphucaphu, kunye nokuqhinwa konke kuqhelekile kwiiveki zokuqala.

Imibuzo yokubuza ugqirha wakho wotyando

• Yeyiphi indlela oyithandayo ye-phalloplasty?
• Zingaphi izinto ozenzileyo?
• Ngaba unganikezela ngeenkcukacha-manani malunga nenqanaba lakho lempumelelo kunye nokuvela kweengxaki?
• Ngaba unayo iphothifoliyo yemifanekiso yasemva kokusebenza?
• Ndifuna kangaphi utyando?
• Linganyuka kangakanani ixabiso ukuba ndineengxaki ezifuna utyando?
• Ndiza kuhlala ixesha elingakanani esibhedlele?
• Ukuba ndivela ngaphandle kwedolophu. Kufuneka ndihlale ixesha elingakanani edolophini emva kotyando?

Imbonakalo

Ngelixa ubuchwephesha be-phalloplasty buye baphucuka kule minyaka idlulileyo, akukabikho nkqubo ilungileyo. Yenza itoni yophando kwaye uthethe nabantu eluntwini ngaphambi kokwenza isigqibo malunga nokuba loluphi uhlobo lotyando olungezantsi olulungele wena. Kukho iindlela ezizezinye kwi-phalloplasty, kubandakanya ukupakisha kunye nenkqubo encinci yomngcipheko ebizwa ngokuba yi-metoidioplasty.