Kuvhiya Tubal Ligation Options, Risks, uye Alternatives
Kana uri kufunga nezvekutora ma tubes akasungwa-tubal ligation-chii chaunofanira kuziva? Ndeipi nzira dzakasiyana dzekuita mararamiro uye ndeupi sarudzo inogona kukubatsira iwe? Ndezvipi zvinokonzera njodzi? Uye ndeipi nzira inoshandiswa inowanikwa inowanika yekudzivirira nekuzvarwa kwekusingaperi?
Kuva Nehuputi Dzako Kusungirirwa
Tubal ligation inzira yakasimba yekubata pamuviri kana kuberekwa.
Kuwana mathesi ako akasungirirwa ndeimwe nzira yekureva kuti iwe une tubal ligation. Izvi zvinogonawo kutumidzwa sechikadzi kuberekwa kana kusagadzikana kusingaperi.
Hazvina mhosva kuti izwi rinoshandiswa sei, chirwere chinonzi tubal ligation inzira inodzima yako fallopian tubes. Kana imwe nguva mabheji ako akaiswa chisimbiso, chirume hachizokwanisi kupfuura nepakati pehutoripian tube kuti inoswe mazai-zvinoreva kuti iwe haugone kutora pamuviri.
Iyi nzira inowanzokurudzirwa kuvarume vakuru vakwegura vanoziva kuti havadi kutora pamuviri mune ramangwana. Kune mibvunzo yakawanda yekufungisisa pakusarudza kubata pamuviri , asi kune vakadzi vanoitwa vane vana, tubal ligation isarudzo yakakurumbira zvikuru pamusana pekusununguka pamwe nekushayikwa kwemigumisiro inogona kuitika nenzira dzenguva yekudzivirira kuberekwa.
Ndizvo Zvangu Zvitsotsi Zvakanamatira?
Iko mafungiro ako echokwadi ane akasungirirwa here kana une tubal ligation?
Zvichida. Iko kune nzira dzakasiyana-siyana apo chiremba wako anogona kusimbisa yako tubes kusanganisira:
- Kuvarovera nemhete, kumira, kana zvidimbu
- Kucheka uye kuisa mucherechedzo pamwe chete nemagetsi emagetsi (electrocautery)
- Kusungira mabhute ako, kuvheta, uye kuisa kana kuvhara magetsi
Kufunga nezvekuti mabhii ako achaiswa chisimbiso zvinorwadza sei, asi nzira inoitwa pasi peanesthesia kuitira kuti urege kunzwa chero chinhu.
Kuvhiya Tubal Ligation Options
Pane dzimwe nzira dzakasiyana-siyana dzokusarudza kubva pazvinouya kune tubal ligation nzira, uye iwe nachiremba wenyu vanogona kukurukura kuti ndeipi nzira yakakunakira iwe pachako. Chiremba wako achaona zvinhu zvakadai semuviri wako wehutano uye kana usati wamboita chirwere chepamuviri. Izvi zvinotevera zvipfeko zvakasiyana-siyana zvekuvhiya zvekuti mavharo ako akasungirirwa:
1. Laparoscopy
Ikopa inoparoscopic ndeimwe yenzira mbiri dzakajairika dzekuti mabhati ako akasungiriwe uye inowanzoitwa pasi pese anesthesia (iwe uchange wakarara muimba yekushandira.) Panguva iyi, tsvina shoma inogadzirwa mukati kana pedyo nebhokisi rako rekubvumira kuti ubvumire nokuda kwe laparoscope (duku, telescope-sechiridzwa chine chiedza) kuiswa. Carbon dioxide gas inorowa kuitira kuti iwe ukwirire rusvingo rwako rwemimba kubva kune nhengo dzako dzepachiviri, uchibvumira chiremba wako kuti aone yako fallopian tubes. Chiremba wacho anogona kuisa chimwe chigadzirwa kuburikidza ne laparoscope kuti chisimbise yako fallopian tubes (kana kuti inosungira ma tubes kuburikidza nedimwe tsvina yakawanda). Zvadaro izvo zvinotarisirwa zvakavharwa. A tubal laparoscopy nzira inotora anenge maminitsi makumi matatu. Iko kunowanzosvibiswa zvishoma, uye iwe unogona kunge uchienda kumusha musi iwoyo.
2. Mini-laparotomy
I -mini-laparotomy (kana mini-lap) tubal ligation ndiyo imwe nzira inowanzoita yekuti mabhuti ako akasungirirwe. Vakawanda vakadzi vachaita izvi nenzira yekuita mushure mekusununguka. Munguva yepaspartum mini-laparotomy, chiremba wako anoita chidimbu chiduku chiri pasi pechigumbu chako. Nemhaka yokuti chibereko chako chichiri kuwedzera kubva pakuve nepamuviri, yako fallopian tubes yakarurama kumusoro kwechibereko-iyo iri pasi pechigumbu chako. Izvo zvinokonzera matope zvinobva zvasungirirwa mukati kana kubva kunze kwekuvharwa uye ndokuvhara kunze, ndokudzosa zvakare panzvimbo, uye kukanganisa kunogadziriswa.
3. Laparotomy (Open Tubal Ligation)
A laparotomy procedure (inozivikanwawo seyovhu rakavhurika) inonzi inoshandiswa zvikuru-saka haisashandiswi seinojairika sa laparoscopy uye mini-laparotomy. Chiremba anovhiya achaita kuvhara kukuru (anenge masendimita maviri kusvika mashanu murefu) mudumbu. Izvo zvinokonzerwa nematope zvichabva zvasungirirwa mukati kana kuti kunze kwekuvharwa, kuvhara / kuvharwa mukati, nekudzosa panzvimbo. Iyo incision ichabva yasungirwa yakavharwa. Anotapurirwa tubal ligation inowanzoitwa mushure mekunge kana mushure meimwe rudzi rwekuvhiyiwa kwemuviri kusina kubatana, zvakadai sechikamu cheCesarea.
4. Culdoscopy uye Colpotomy
Culdoscopy uye colpotomy ndiyo miviri miviri yekufungidzirwa inoshandiswa panguva yemakadzi ekuvhara ropa . Kuva nehuputi yako yakasungirirwa nemudzimai wegadziriro yaimbova nzira yakasarudzwa. Asi, sezvo culdoscopy uye colpotomy vane njodzi dzakakwirira, kurapwa kweparoscopic ikozvino ndiyo nzira yakajairika yekuita kuti mabhuti ako akasungirirwe. Chiremba wako angasarudza kuita culdoscopy kana colpotomy kana iwe uri wanyanyisa (kana kuti uwandisa kwazvo) kana uine chibereko chekuberekwa (chakashandura chiberekero.) Zvose izvi ndezvidiki zvisinganzwisisiki zvakaitwa mumadziro emadzimai-asi zvinogona kuva zvakaoma kuita nokuti iwe unofanira kunge uri mu lithotomy (maitiro mumakumbo) apo uri pasi peanesthesia.
5. Hysterectomy
A hysterectomy ndiyo nzira iyo chibereko chako chakabviswa uye chinonzi chichiremba chikuru. A hysterectomy inyanzvi haisi iyo tubal ligation nzira. Asi, kana chibereko chako chabviswa, hapana nzvimbo yeii yekuisa (kuitira kuti iwe usakwanisa kutora pamuviri). Irosterectomy inogona kuitwa kuburikidza nemukadzi (vaginal hysterectomy) kana mimba (mumimba hysterectomy). Munguva yakapfuura, hysterectomy dzimwe nguva yakaitwa senzira yekurapa apo tubal ligation yaionekwa sechikonzero chezvikonzero zvechitendero.
Makomborero ekuwana zvipembenene zvako zvakasungwa
Kana iwe wakagadzira chirwere chako chakasungirirwa, iwe ungangodaro wakagamuchira mamwe mazano ekurapa. Kutsvakurudza kunoratidza kuti kuva ne-tubal ligation kunoderedza ngozi yako yekenza yevana mavari asi kusvika 30 muzana. Kunyange zvazvo chikonzero chaicho cheizvi chisingazivikanwi, pane mazano maviri ehurukuro iyi:
- Paunenge uine mabhuti ako akasungirwa, ropa rinowanikwa mumavhura ako rinokanganiswa. Izvi zvinogona kushandura mazinga ehomoni, izvo zvinoita kuti panjodzi yakaderedzwa yekenza yevana.
- Kuvharwa kweve fallopian tubes, zvichida, kunodzivirira mazai kubva kumagadzirirwo emagariro anokonzera kukenza.
Asi rimwe rubatsiro rwe tubal ligation ndechokuti kuva nemabhati ako akasungirirwa kunogona kuderedza mikana yako yokugadzira chirwere cheplvic inflammatory (PID.) Kunyange zvazvo njodzi yePID inogona kuderedzwa, zvakadaro, tubal ligation haina kupa chero kudzivirira kune zvirwere zvepabonde .
Ngozi dze Tubal Ligation
Sezvakaita chero nzira ipi zvayo yokuvhiya, tubal ligation ine ngozi. Zvinetso zvinogona kuitika zvinogona kuputsika muzvikamu zvitatu:
- Njodzi dzinokonzerwa nemitemo chaiyo: Izvi zvinogona kusanganisira kusagadzikana kusina kukwana kwematope (zvichiita kuti pamuviri muvakadzi vanenge 1 kubva pa200,) vakuvadzwa kune nhengo dzenharaunda kana zvivako zvinokonzerwa nemichina yekuvhiya, uye kuwedzerwa kwehutachiwana hweEctopic pregnancy kana kuberekwa kuchiitika pashure tubal ligation.
- Ngozi dzinobatanidza kushandiswa kweanesthesia: Rudzi rweaneshehesia rinoshandiswa runobva pane nzira yekuvhiya yakasarudzwa. Tubal ligation inogona kuitwa neve conscious sedation (chimiro cheanesthesia apo mukadzi wacho akamuka, asi akasununguka uye akachembera) kana yakadzika sedation ( inowanzoita manzwiro anopiwa uye mukadzi ari kurara.) Anesthesia inogona kunge iri munzvimbo, iyo (mutumbi yakasara kubva pamabheti pasi,) kana sarudzo (inosanganisira muviri wose,)
- Ngozi dzekuvhiyiwa munazvo: Njodzi dzakawanda dzekuvhiya dzinosanganisira utachiona uye kubuda ropa.
Zvaunotarisira
Vazhinji vakadzi vanogona kudzokera kubasa mukati memazuva mashomanana mushure mekunge vane tubal ligation. Mishonga inorwadza inogona kubatsira kubvisa kusagadzikana kupi zvako. Zvinokurudzirwa kuti vakadzi vadzivise kushanda kwakasimba kwemazuva mazhinji. Muzhinji, vazhinji vakadzi vanonzwa vakagadzirira kuita zvepabondezve mukati mevhiki.
Ruzhinji rwevakadzi rinodzokorora kubva pane izvi nenzira isina matambudziko. Kusiyana nehutachiona hwemurume (vasectomy), hapana kuongororwa kunofanirwa kutarisa kushaya simba.
A tubal ligation haina kuderedza kufadza kwevakadzi kuita zvepabonde uye haibatsiri mukadzi. Sezvo pasina zvipfeko kana nhengo dzomukati zvabviswa kana kushandurwa uye mahomoni ose acharamba achibudiswa, a tubal ligation haafaniri kushandura zvepabonde kana kupindira nekushanda kwezvikadzi zvepabonde.
Zvinodhura
Iko-iyo mari yekodhi ye tubal ligation, kana ichienzaniswa nedzimwe nzira dzekudzivirira, inogona kukuponesa mazana emadhora kwechinguva. Mutengo wekuva ne tubal ligation unogona kubva pakati pe $ 1 000 kusvika ku $ 3,000, asi inogona kunge yakakwirira kana uine matambudziko. Mukadzi anofanira kutarisa nehutano hwehutano yehutano sezvo huwandu hwekudzivirira kuberekwa hunosiyana. Medicaid uye yehutano inshuwalhu yehutano inogona kuvhara mari ye tubal ligation.
Kubudirira
Tubal ligation inopfuura 99% inoshanda. Kuduku kuderera kunowanikwa nokuti pane dzimwe nguva fallopian tubes inogona kubvumirana zvakare pachavo. Kana kana pamuviri uchiitika mushure mekutakura, pane 33 mukana wekuti uve ectopic pregnancy. Kunyange zvakadaro, muwandu wehutachiwana hwakanyanya kuderera, kuti mukana wemukadzi wekuve ne ectopic pamuviri wakadzika zvikuru kupfuura zvaizopiwa iye haana kuwana tubal ligation yakaitwa pakutanga.
Tubal Ligation Reversal
Mukadzi anofanira kunyatsocherechedza kana kana kwete tubal ligation (kusagadzirisisa kuperesa muviri) ndiyo nzira yakanakisisa kwaari. Kunyangwe nekufungisisa kwakanaka, zvakadaro, vamwe vakadzi vane tubal ligation vanoguma vachizvidemba chisarudzo chavo gare gare. Mukadzi anonyanya kuzvidemba kuti mavharo ake akasungirwa kana:
- Iye achiri muduku
- Ane vashoma kana vasina vana
- Akasarudza nzira iyi kwete nekuda kwaaida asi nokuti mudzimai wake aida kuti zviitike
- Akasarudza pane tubal ligation nokuti aifunga kuti yaizogadzirisa nyaya dzemari kana kana akafunga kuti nzira yacho yaizobatsira kugadzirisa matambudziko ehukama
A tubal ligation haafaniri kuonekwa sechinguvana. Dzimwe nguva kugadziriswa kwetabha kunogona kuitika kana mukadzi akazofunga kuti anoda kuva nepamuviri. Kunyange zvakadaro, kuchinja kwehutari ndiyo nzira huru yekuvhiya iyo isingagumisi nguva dzose pamuviri. Inenge 50 kubva muzana kusvika ku80 muzana yevakadzi vane vane tubal reversed vangava nepamuviri.
Permanent Contraception Alternatives
A tubal ligation inogona kuva yakanakisisa yehutano hwekuzvarwa nekusingaperi, nehuwandu hwakanaka hwekubudirira mukudzivirira kubata pamuviri. Izvo zvinewo zvakanakira zvimwe zvekunogona kuderedza dambudziko rako rekenza yevavari kana chirwere chinoputika.
Izvo zvakati, havasi vose vanoda kutungamira nenzira iyi uye iyo yakabatana (kunyange iri duku) ngozi dzekuvhiya uye aneshehesia yakawanda.
Kune zvakawanda zvenguva pfupi zvingasarudzwa zvekuberekwa kana zvichiitika. Panewo dzimwe nzira mbiri dzinogara nokusingaperi. Imwe, ndeye vasectomy . Kufananidza musoro kusvika kumusoro, vasectomy inotakura dambudziko rakawanda kupfuura tubal ligation, asi vamwe varume havafariri nenzira iyi nekuda kwezvikonzero zvakawanda.
Kune mukadzi, kune imwe nzira isingasarudze yekuzvarwa kwekuzvarwa kwekuzvidzivirira inonzi inonzi Essure . Nzira inonzi Essure (inonziwo hysteroscopic sterilization) inzira inoshandiswa nayo miduku yakawanda yesimbi yakaiswa mumuromo wechivi uye kusvika kune fallopian tubes kuti ivhare. Nzira yekugadzirisa yave iripo kubva muna 2002, asi haisipo kwose kwose sezvo vanachiremba vachida chiziviso chakakosha kuti vaite iyo nzira. Kubva munaNovember 2016, Chinyorwa chine kunyeverwa kwebhokisi kunotarisirwa kuve nechokwadi chokuti vanhu vakadzidziswa pamusoro pezvinetso zvingangodaro zvekugadzirisa uye nzira dzakasiyana.
Kubudirira Kufananidza Tubal Ligation Nzira
Ikoko hakuratiki kuva nechinopesana chakakosha mukubudirira kwe laparoscopy, lapartomy, kana hysteroscopy pamusoro pekubudirira asi kuda kwekudzokorora nzira inogona kunge yakanyanya kune yakakura kune avo vane nzira yekugadzirisa.
Pasi Pano paNzira dze Tubal Ligation
Pane nzira dzakasiyana-siyana umo tubal ligation inogona kuitwa, uye chisarudzo chakanaka kwauri chimwe chinhu chaunoda kuzokurukura zvakanyatsonaka nachiremba wako. Nzira yakanakisisa ichabva pane zvinhu zvakawanda, zvakadai sekunge uri pamuviri, wakave nekuvhiyiwa kwepamuviri, kana uri kunyanya kuwandisa, kana kuti une chibereko chinokanganisa. Kunyange zvazvo tubal ligation inogona kuva nezvimwe zvikomborero, zvakadai sedambudziko rakaderera rekenza yevana, pane dzimwe nzira dzingagadziriswa dzekuzvarwa dzinogona kuwanikwa.
> Sources:
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> Jokinen, E., Heino, A., Karipohia, T., Gissler, M., naR. R. Hurskainen. Kudzivirirwa uye kubudirira kweMukadzi Tubal Sterilization neHysteroscopy, Laparascopy, kana Laparotomy: A Register Based Based Study. BJOG . 2017 May 2. (Epub mberi kwekudhinda).
> Rice, M., Murphy, M., uye S. Tworoger. Tubal Ligation, Hysterectomy uye Ovarian Cancer: A Meta-Analysis. Zvinyorwa zveOvarian Research . 2012. 5 (1): 13.
> US Food and Drug Administration. Chinhu Chinogara Chigarire Kudzorwa Nenzira neBayer Healthcare: FDA Chiziviso - Zita Rinochinja. 11/15/16. https://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm529241.htm