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Nzira yeUkushandisaNzira yekufambisa isati isiri, chirwere chekusununguka chekuzvarwa . Izvi zvinoshandiswa pakuita sterilization hazvidi kuti zvigadziriswe uye zvinoshandiswa zvinyorova, zvinoshandiswa zvinogadziriswa (mapiritsi emashiripiti) akaiswa mu fallopian tubes. Iyo imwe nzira yakanaka kune tubal ligation nokuti mamwe mhando dzose dzekudzivirira kwemadzimai dzinoda kuvharwa (ndezvekuvhiya).
Nzira yekufambisa inongotora inotora inenge maminitsi gumi, inowanzoitwa muhofisi yechiremba, uye haifaniri kuti igare usiku hwose.
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Dilation yeChirvixNhanho yekutanga panguva yeChirongwa cheEssure chirwere chechivharo. Chiremba wako achashandisa anesthesia yemunharaunda kuti avhare murwere. Vamwe vanachiremba vanogona kupawo mamwe mishonga inogona kukubatsira kuti ufare uye / kana kuderedza marwadzo ose. Kuti ugone kuisa mapepi emakona, chiremba wako achafanira kupfuurira zvishoma nezvishoma (kana kuzarura) chibereko chechirwere.
Chirwere chinokonzera chinogona kuitika nenzira mbiri:
1. Chiremba wako angashandisa speculum kuvhara mukadzi. Ichi chigadzirwa chakafanana nesimbi yematare edha. Chimbo chacho chinopindirwa mukati memudzimai, uye mavara acho akaoma akaparadzaniswa uye akachengetwa. Chiremba wako achazoisa tsvimbo yakanyoro, tsvina yesimbi zvinyoro-nyoro kupinda mumuviri uye kusvika muduku duku remudumbu. Tsvimbo yacho inobviswa muchidimbu munzvimbo, inotorwa, uye inotsiviwa nemuduku mukuru. Izvi zvinodzokororwa kusvikira chivharox yakakura zvakakwana kuti zvibvumire kuti zvigadziriswe zviiswe panzvimbo. Izvi zvinotora anenge maminitsi gumi, uye iwe unganzwa kuputika uye kusagadzikana kunokonzerwa nokupararira kwemasumbu emumuromo wechikadzi kuti agone tsvimbo imwe neimwe.
2. Imwe nzira yekuderedza chiremera chemuviri ndeyekushandiswa kwe- osmotic dilator , chigadziro chinotora unyoro kubva mumasukirwo akavharidzira pamuviri uye zvishoma nezvishoma kuwedzera. Kuwedzerwa kwe dilator kunotanga kuzarura chibereko chechivharo uye kazhinji kunokonzera kusagadzikana. Pane mavara maviri akafanana easmotic dilators:
- Laminaria ibhuku duku rakagadzirwa nemagungwa akaomeswa akaiswa mukati memuchivi 8 kusvika ku 24 maawa asati asvika tubal ligation nzira; inowanzodikanwa kuti mukadzi auye zuva risati rasvika kuti aise izvi. Zvizhinji zvekudzivirira kwemirasi inoitika mukati maawa matanhatu okutanga, uye kuwedzera kukuru kunopera maawa 12 kusvika ku 24 mushure mekunge yaiswa.
- Dilapan (synthetic dilator) inenge yakaoma, sponge isina kuvharwa iyo inowanikwa mumuviri wechibereko maawa akawanda isati yasvika. Chigadziri chinogadziriswa chinowedzera kuva nyore kuisa nekuzarura chivharox munguva shomanana kupfuura nzira ye laminaria.
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Nzira yeUkushandisaMunguva yedzimwe nzira yekugadzirisa, iwe uchagadzwa nemakumbo ako akazaruka uye mukurwisana, zvakaenzana nekuita kwaunenge uri kuongororwa kwepilvic. Chiremba wako achaisa catheter uye chidimbu, chitinha-sechiridzwa (hysteroscope) muchikadzi, kuburikidza nemukati, uye kusvika mudumbu. Ikamera pamagumo emhara inobvumira chiremba wako kuti aone muchibereko. Iyo inonzi Insure inosungirirwa inoshandiswa kuburikidza ne catheter uye inowanikwa mukuvhura kweiyo fallopian tube. Chimwe chechipiri chinogadziriswa chinobva chaiswa kune imwe imwe fallopian tube nenzira imwecheteyo. Iwe unogona kunge uchienda kumwedzi-kufanana nekupwanya panguva uye mushure mekuita izvi. Kana izvi zvaitika, x-ray inogona kutorwa kuti ivimbise kuti mapiritsi epiil ari munzvimbo. Iyo yose nzira inotora anenge 10-30 maminiti.
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Chii Chaungatarisira Mushure meNzira YokutangaVakadzi vanowanzogona kudzokera kumusha mumaminitsi makumi mana mushure mekutsvaga nzira, uye vakadzi vakawanda vanoshanda zvakare vakatangazve basa mukati maawa makumi maviri nemaviri kana kupfuura. Vakawanda vevakadzi vakadzokera kumabasa ezvakanaka mukati me1 kusvika kwemazuva maviri, asi vakadzi vazhinji vanotaura kuti vakakwanisa kudzoka mabasa ezvakanaka zvezuva rimwechete sezvinoitwa.
Mushure mekunge maitiro eNyaya, vakadzi vakarondedzera vachiona:
- Kubuda ropa kumakumbo kunokonzerwa nekufamba kwechibereko mukati mekuita.
- Kunyoroka kuenzanisa marwadzo uye / kana kupwanya kwemazuva mashomanana mushure mekuita.
- Kuchinja kwenguva pfupi kumwedzi yavo (yakaoma kana yakareba kupfuura nguva dzinowanzoitika, kubuda kana kuonekwa pakati pezviitiko).
- Tsvina, mimba, uye / kana kurwadziwa shure.
- Kuzvidemba pamusoro pezvisarudzo zvavo.
Iwe unogona kutangazve zvepabonde pakarepo kana iwe uchinzwa kwazviri, uye hazvikonzeri kurwadziwa. Kune vakadzi vazhinji, izvi zvinotora anenge vhiki imwe mushure mekuvhiyiwa. Zvakakosha kuti iwe ushandise nzira yekudzivirira kuberekwa patsva kwemwedzi mitatu yekutanga mushure mokunge kuiswa kweEssure. Zvinotora nguva yakawanda yenguva yechipfuva chine ruvara kumativi akapoteredza mapuranga, nokudaro ichidzivirira mafuro. Kusvikira ichinyatsosimbiswa kuti mavhara akavharwa, imwe nzira yekudzivirira inofanira kushandiswa.
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Muedzo weHysterosalpingogram (HSG)Muedzo unonzi hysterosalpingogram (HSG) unoitwa mwedzi mitatu mushure mekuita nzira yako yekuEssure kusimbisa kana kwete fallopian tubes iri kudzivirirwa zvachose. Uyu muedzo unofanirwa kurongwa muvhiki mushure mekutora nguva yako kuti uone kuti hausi pamuviri. Iwe unogona kunge uchida kutora fomu yemvumo zvakare.
IHSG ichaitwa mudhipatimendi rehudhiology uchishandisa tafura ine x-ray mumusoro wepamusoro. Iva wakagadzirira kurara patafura uye kuisa tsoka dzako mukugumburwa, sezvaunoita panguva yekuongorora kwepinivic. Panguva ino, dhayi ichave yakakonzerwa nemukirini wako uye chiberekero kuburikidza necatheter shoma. Zvadaro, x-ray inotorwa kuti ibudise mifananidzo yemubereki uye fallopian tubes. IHSG icharatidza kana mapiritsi epiil ari munzvimbo yakakodzera uye inoratidza kana ma tubes akabudirira kubuvha. Kana vakadaro, hauchazofaniri kushandisa imwe nzira yekuberekwa kwekuberekwa. Zvakare, kuwedzera kwepabonde kunofanira kushandiswa kusvikira muongorori hweHSG unopupurira kuti mhando dzemawere dzakadzivirirwa zvachose nematombo.
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Kubatsira kuHysteroscopic Tubal LigationNzira yekugadzirisa inoshandiswa yekushandisa tubal implants inopa zvimwe zvinobatsira kana ichienzaniswa nemitambo, yakasarudzwa ye tubal ligation .
Haisi chete yakachengeteka, hapana mavanga, uye vakadzi vanowanzotaura zvisina kunaka.
99% yevakadzi avo vakawana nzira yeEssure vakaratidza nguva yavo yakareba yenyaradzo sezvakanaka kune yakanakisa uye vakadzi 95% vakati vaizokurudzira nzira yacho kune shamwari.
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Kukanganiswa kweHysteroscopic Tubal LigationImwe yezvisingabatsiri zveEssure tubal ligation nzira ndeyekuda kushandisa imwe nzira yekudzivirira kuberekwa kwemwedzi mitatu kusvikira zvisikwa zvemavara uye zvinodzivirira ma fallopian tubes.
Kuwedzeresa, iyo Essure hysteroscopic sterilization nzira haisi kuchinjwa . Nemhaka yekuti fallopian tube tissue uye mapiritsi emapiranga anokura pamwechete kuti aite gwaro rakavharwa, micro-inserts haigoni kuvhiyiwa pasina kukanganisa tambo dzinoshandiswa.
Iko kusungira tubal kunogona kuva kwakaoma kuisa, saka imwe yechipiri dzimwe nguva inofanirwa kubvisa zvachose maviri. Muchikoro chekuchirapa, vanenge 1 kubva pavakadzi vose vanomwe vakanga vasingakwanisi kuva nemishonga yakaiswa mukati mawo maviri fallopian tubes munguva yekutanga yekugadzirisa.
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Nzira yeUkushandisa NengoziSekumwe mushumo wekuchengetedzwa kwegore ra2014 FDA, nzira yeEssure haina kuonekwa inokonzera madhara emigumisiro yakareba. Semhando ipi neipi ye tubal ligation, pane nguva dzose mukana wekuti ectopic pregnancy inogona kuitika.
Maererano neCarned Parenthood, zvidzidzo zvekutevera zvinotungamirirwa nevakadzi makore maviri mushure mekunge nzira yeEssure inoratidza izvi zvinogona kuisa njodzi.
- Iyo michina yakawanda inogona kunge yakadzingwa kunze kwe fallopian tubes.
- Iko kusungirirwa kweiripi kungave kwakaiswa kure, kana kwete kure zvakakwana, kupinda mu fallopian tubes.
- Iko-micro-inserts inogona kunge yakakonzerwa nemubereki kana fallopian tube wall (perforation). Izvi zvinofanira kuitika, kuvhiyiwa kunogona kudiwa kuti kugadzirisa mamiriro acho ezvinhu.
- Izvo zvinokonzerwa neiripi zvinogona kuparadzwa mune dzimwe nzira dzezvehutano, dzakadai sedendometrial biopsy, dilation, uye curettage (D & C), kana nzira dzinoda kushandiswa kwemafaira eredhiyo.
Zvimwe zvinetso zvinogona kuitika panguva yekuiswa kwezvinyorwa zveEssure zvinosanganisira:
- Unyoro kuenzanisa marwadzo
- Nausea uye / kana kurutsa
- Kurasikirwa kutevera nzira
- Kurwara
- Mimba isina kuonekwa
Vakadzi vane chirongwa ichi chakaitwa mukati mehafu yechipiri chekuenda kumwedzi (pashure pekuvhura) kune ngozi yakawanda yekusaziva kuti uri nepamuviri panguva yekufamba. Zvinokurudzirwa kuti nzira yekugadzirisa inowanikwa mukati mehafu yekutanga yekuenda kumwedzi kusati kwasvika ovulation.
Zvinokwanisika kuti chikamu chekuisa chiparadzanise kana kuti mukadzi ave nehuwandu hwehuwandu hwemvura, kunyangwe izvi zvinetso zvisingasviki kune zvimwe zvakanyorwa. Pakave pasina ruzivo rwepakisi rakaputsika rinokonzera marwadzo kana zvinetso pakudzivirira kubata pamuviri. Kunyanya kunwa kwemvura kunogona kukonzera kupererwa kwepfufu kana chidimbu chemishonga kuti ibvise zvinodhaka zvakanyanya. Izvi zvinofanira kutarisirwa pakarepo kuti zvidzivirire matambudziko akaoma, kusanganisira kufa.
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Kubudirira kwehutanoKutsvakurudza kunoratidza kuti Essure hysteroscopic inotyisa nzira yehutano ndiyo nzira yakanakisisa ye tubal ligation , uyezve vanachiremba vava kutoshandura nenzira iyi.
Kutsvakurudza kwakaratidza kuti pasi pevakadzi vatatu kubva pa1 000 vanopedzisira vava nepamuviri makore mashanu mushure meitiro (99.83% inoshanda).
Nedzimwe mwedzi mitatu yekutevera Hysterosalpingogram (HSG) Test:
- Inenge 1% yevakadzi inogona kunge ine imwe yemapilisi epiil aripo.
- 96% yevakadzi vezvipfeko zvinotapira zvichave zvabudidzirwa kudziviswa.
Pakazosvika mwedzi mitanhatu mushure mekugadzirisa, vakadzi vane zana muzana vanofanira kunge vane mavhiri maviri akavharwa zvizere.
Zvimwe Zvokufungisisa Pamusoro peEssure:
Vana makumi masere nevatanhatu zvevakadzi vanogona kuve nemapuranga akaiswa zvakanaka kuburikidza nemitambo imwe yeUtsva, asi 10% yevakadzi vachiri kukwanisa kuve nemakumbo avo akaiswa zvakanaka kuburikidza nemitemo miviri. Pakupedzisira, 3% yevakadzi vanoona kubudirira kwekuiswa kweEssure inowanika havakwanise kuramba vachishandisa izvi semhando yavo yekudzivirira kubata pamuviri nekuda kwezvimwe zvikonzero.
References:
(1990). Cervical ripening agents - Synthetic dilator yakaitwa nepolyacrylonitrile hydrogel, Dilapan. American Family Physician, 42 (3), 775-776.
Essure Website. (nd). Mibvunzo Inowanzoitika.
Knowles, J. (2005). Tubal Sterilization . Planned Parenthood.