Izitho zangasese eziyindida

Izitho zobulili eziyindida yisici sokuzalwa lapho izitho zangasese zangaphandle zingenakho ukubukeka okufana nokwomfana noma kwentombazane.

Ubulili bezakhi zofuzo bomntwana bunqunywa ngesikhathi sokukhulelwa. Iseli leqanda likamama liqukethe i-X chromosome, kuyilapho isidoda sikababa sine-X noma i-Y chromosome. La ma-chromosomes ama-X no-Y anquma ucansi lofuzo lengane.

Imvamisa, usana luzuza ama-chromosomes ocansi ama-1, i-1 X kumama ne-1 X noma i-Y eyodwa kubaba. Ubaba "unquma" ubulili bengane bomntwana. Ingane ezuza i-X chromosome kuyise ingowesifazane wofuzo futhi inama-chromosomes ama-2 X. Ingane ezuza njengefa i-chromosome Y evela kubaba iyindoda yofuzo futhi ine-chromosome engu-1 X no-1.

Izitho zokuzala zowesilisa nowesifazane nezitho zobulili zombili zombili zivela ezicutshini ezifanayo embungwini. Izitho zangasese eziyindida zingakhula uma inqubo ebangela ukuthi izicubu zombungu zibe "owesilisa" noma "owesifazane" ziphazamiseke. Lokhu kwenza kube nzima ukukhomba kalula usana njengowesilisa noma owesifazane. Ubungako bokungaqondakali buyehluka. Kuyaqabukela kakhulu, ukubukeka komzimba kungakhula ngokuphelele njengokuphambene nobulili bezakhi zofuzo. Isibonelo, owesilisa ofuzo kungenzeka ukuthi athuthukise ukubonakala kowesifazane ojwayelekile.

Ezimweni eziningi, izitho zangasese eziyindida kwabesifazane bezakhi zofuzo (izingane ezinama-chromosomes ama-2 X) zinezici ezilandelayo:

• Ingquza ekhulisiwe ebukeka njengepipi elincane.
• Ukuvulwa kwe-urethral (lapho kuphuma khona umchamo) kungaba kunoma yikuphi lapho kuhamba khona, ngenhla, noma ngaphansi kobuso be-clitoris.
• I-labia ingahle ihlanganiswe futhi ibukeke njenge-scrotum.
• Usana kungacatshangwa ukuthi luyindoda enamasende angafunwanga.
• Kwesinye isikhathi kunesigaxa sezicubu esizwakala ngaphakathi kwelebia elihlanganisiwe, siphinde sikwenze kubukeke njengesikhutha esinamasende.

Kowesilisa (1 X no-1 Y chromosome), izitho zangasese eziyindida zivame ukufaka lezi zinto ezilandelayo:

• Ipipi elincane (elingaphansi kwamasentimitha ama-2 kuye kwayi-3, noma u-3/4 kuye ku-1 1/4 amayintshi) elibukeka njenge-clitoris ekhulisiwe (i-clitoris yowesifazane osanda kuzalwa ivame ukukhuliswa ngesikhathi sokuzalwa).
• Ukuvulwa kwe-urethral kungaba noma kuphi lapho, ngenhla, noma ngaphansi kwepenisi. Ingatholwa iphansi njenge-perineum, iqhubeke nokwenza ukuthi ingane ibonakale ingowesifazane.
• Kungaba nesikhwama esincane esihlukanisiwe futhi esibukeka njenge-labia.
• Amasende angahluziwe avame ukwenzeka ngezitho zangasese eziyindida.

Ngaphandle kokumbalwa, izitho zangasese eziyindida ngokuvamile azisongeli impilo. Noma kunjalo, kungadala izinkinga zomphakathi ezinganeni nasemndenini. Ngalesi sizathu, iqembu lochwepheshe abanolwazi, kubandakanya izazi ze-neonatologists, izazi zofuzo, odokotela be-endocrinologists, nodokotela bengqondo noma abasebenzi bezenhlalakahle bazobandakanyeka ekunakekelweni kwengane.

Izimbangela zezitho zobulili eziyindida zifaka:

• I-Pseudohermaphroditism. Izitho zobulili zingezobulili obubodwa, kepha ezinye izici zomzimba zobunye ubulili zikhona.
• I-hermaphroditism yangempela. Lesi yisimo esingajwayelekile, lapho izicubu ezivela kuwo womabili amaqanda kanye namasende zikhona. Ingane ingaba nezingxenye zombili izitho zangasese zowesilisa nowesifazane.
• I-gonadal dysgenesis exubile (MGD). Lesi yisimo se-intersex, lapho kunezakhiwo ezithile zabesilisa (i-gonad, testis), kanye nesibeletho, isitho sangasese sowesifazane, kanye namashubhu we-fallopian.
• I-hyperplasia yokuzalwa ye-adrenal. Lesi simo sinezindlela eziningi, kepha ifomu elijwayeleke kakhulu lidala ukuthi owesimame wofuzo avele njengowesilisa. Izifundazwe eziningi zivivinya lesi simo esingaba yingozi empilweni ngesikhathi sokuhlolwa kokuzalwa kwezingane ezisanda kuzalwa.
• Ukungajwayelekile kwe-Chromosomal, kufaka phakathi i-Klinefelter syndrome (XXY) ne-Turner syndrome (XO).
• Uma umama ethatha imishanguzo ethile (efana ne-androgenic steroids), owesifazane ophathelene nezakhi zofuzo angabukeka eyindoda ethe xaxa.
• Ukuntuleka kokukhiqizwa kwamahomoni athile kungadala ukuthi umbungu ukhule ngohlobo lomzimba wesifazane, noma ngabe ucansi lofuzo.
• Ukuntuleka kwama-testosterone cell receptors. Noma umzimba wenza ama-hormone adingekayo ukuze akhule abe owesilisa ophathekayo, umzimba awukwazi ukuphendula lawo ma-hormone. Lokhu kuveza uhlobo lomzimba wesifazane, noma ngabe ucansi lofuzo lungowesilisa.

Ngenxa yemiphumela engaba khona emphakathini nakwezengqondo yalesi simo, abazali kufanele bathathe isinqumo sokuthi bazokhulisa ingane njengendoda noma owesifazane ngaphambi kokutholakala kwesifo. Kungcono uma lesi sinqumo senziwe ezinsukwini ezimbalwa zokuqala zokuphila. Kodwa-ke, lesi yisinqumo esibalulekile, ngakho-ke abazali akufanele basigijimele.

Xhumana nomhlinzeki wakho wezokunakekelwa kwezempilo uma ukhathazekile ngokuvela kwezitho zobulili zangaphandle zengane yakho, noma ingane yakho:

• Kuthatha ngaphezu kwamaviki ama-2 ukubuyisa isisindo sakhe sokuzalwa
• Ukuhlanza
• Kubukeka kuphelelwe amanzi emzimbeni (komile ngaphakathi emlonyeni, azikho izinyembezi lapho ukhala, amanabukeni angaphansi kwamane emanzi ngamahora angama-24, amehlo abukeka eshonile)
• Unesifiso esinciphile
• Ineziphonso eziluhlaza okwesibhakabhaka (izinkathi ezimfushane lapho inani elincishisiwe legazi lingena emaphashini)
• Unenkinga yokuphefumula

Zonke lezi kungaba yizimpawu zokuzalwa kwe-adrenal hyperplasia.

Izitho zobulili eziyindida zingatholwa ngesikhathi sokuhlolwa kwengane yokuqala kahle.

Umhlinzeki uzokwenza ukuhlolwa komzimba okungaveza izitho zangasese ezingezona "ezejwayelekile zowesilisa" noma "owesifazane ojwayelekile," kepha endaweni ethile phakathi.

Umhlinzeki uzobuza imibuzo yomlando wezokwelapha ukusiza ukukhomba noma yikuphi ukuphazamiseka kwe-chromosomal. Imibuzo ingafaka:

• Ingabe ukhona umlando womndeni wokukhulelwa kwesisu?
• Ingabe ukhona umlando womndeni wokuzalwa komuntu oshonile?
• Ingabe ukhona umlando womndeni wokufa ngaphambi kwesikhathi?
• Ngabe kukhona amalungu omndeni abenezinsana ezafa emasontweni ambalwa okuqala okuphila noma abenezitho zangasese eziyindida?
• Ngabe ukhona umlando womndeni wanoma yikuphi ukuphazamiseka okubanga izitho zangasese eziyindida?
• Yimiphi imithi umama ayithatha ngaphambi noma ngesikhathi sokukhulelwa (ikakhulukazi ama-steroids)?
• Yiziphi ezinye izimpawu ezikhona?

Ukuhlolwa kofuzo kungakhomba ukuthi ngabe ingane yowesilisa noma owesifazane. Imvamisa isampula elincane lamaseli lingasuswa ngaphakathi kwezihlathi zengane ngalokhu kuhlolwa. Ukuhlola lawa maseli kuvame ngokwanele ukuthola ubulili bosana bosana. Ukuhlaziywa kwe-Chromosomal ukuhlolwa okubanzi okungadingeka ezimweni ezingabaza kakhulu.

I-Endoscopy, i-x-ray yesisu, i-ultrasound yesisu noma i-pelvic, kanye nokuhlolwa okufanayo kungadingeka ukunquma ubukhona noma ukungabikho kwezitho zangasese zangaphakathi (njengama-testes angavumelekile).

Ukuhlolwa kwelabhoratri kungasiza ekunqumeni ukuthi izitho zokuzala zisebenza kahle kangakanani. Lokhu kungafaka ukuhlolwa kwe-adrenal ne-gonadal steroids.

Kwezinye izimo, i-laparoscopy, i-laparotomy yokuhlola, noma i-biopsy yama-gonads ingadingeka ukuze kuqinisekiswe ukuphazamiseka okungadala isitho sangasese esiyindida.

Ngokuya ngesizathu, ukuhlinzwa, ukufaka ama-hormone esikhundleni, noma ezinye izindlela zokwelapha kusetshenziselwa ukwelapha izimo ezingadala izitho zangasese eziyindida.

Kwesinye isikhathi, abazali kufanele bakhethe ukuthi bazomkhulisa yini umntwana njengowesilisa noma owesifazane (ngaphandle kwama-chromosomes engane). Lokhu kukhetha kungaba nomthelela omkhulu kwezenhlalo nezingqondo enganeni, ngakho-ke ukwelulekwa kaningi kuyanconywa.

Qaphela: Imvamisa kuba lula ukuphatha ngokomthetho (ngakho-ke ukukhulisa) ingane njengowesifazane. Lokhu kungenxa yokuthi kulula ukuthi udokotela ohlinzayo enze izitho zangasese zowesifazane kunokuba enze izitho zobulili zabesilisa. Ngakho-ke, kwesinye isikhathi lokhu kuyanconywa noma ngabe ingane ingowesilisa ngokwezakhi zofuzo. Kodwa-ke, lesi yisinqumo esinzima. Kufanele uxoxe ngayo nomndeni wakho, umhlinzeki wengane yakho, udokotela ohlinzayo, i-endocrinologist yengane yakho, namanye amalungu eqembu lezempilo.

Izitho zangasese - eziyindida

• Ukuphazamiseka kokuthuthuka kwesitho sangasese sowesifazane kanye nesitho sangasese

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