Ingabe Abesifazane BaseMelika Banama-Hysterectomies Angadingeki?

-Delile

• Okokuqala, yini i-hysterectomy?
• Kungani abesifazane abaningi kangaka bethola ama-hysterectomies?
• Umehluko Wobuhlanga Ku-Hysterectomy
• Ungakuthola Kanjani Ukunakekelwa Okukufanele
• Buyekeza kwe-

Ukususa isibeletho sowesifazane, isitho esibhekele ukukhula, nokuthwala ingane nokuya esikhathini yi into enkulu. Ngakho-ke ungase umangale ukwazi ukuthi i-hysterectomy - ukususwa kokuhlinzwa okungenakuguqulwa kwesibeletho - ingenye yokuhlinzwa okwenziwa njalo kwabesifazane e-U.S. Yep, ukuzwile lokho kulungile: Abanye 600,000 I-hysterectomy yenziwa njalo ngonyaka owodwa e-U.S. Futhi ngezinye izibalo, ingxenye yesithathu yabo bonke abesifazane baseMelika bayobe sebenayo eyodwa lapho beneminyaka engama-60.

“Ngaphambi kwemithi yesimanje, i-hysterectomy yayibhekwa njengokwelapha kunoma iyiphi inkinga owesifazane ayengaya kudokotela noma kumelaphi,” kuchaza uHeather Irobunda, M.D., i-ob-gyn eqinisekisiwe yebhodi eNew York City. "Emlandweni wakamuva kakhulu, noma yiziphi izinkinga owesifazane abengaziletha kudokotela wakhe ezithinta ukhalo lwakhe bezingalashwa ngesibeletho."

Namuhla, izifo eziningi - umdlavuza, ama-fibroids aqeda amandla (ukukhula okungewona umdlavuza emisipha yesibeletho sakho okungenzeka kuhle kakhulu okubuhlungu), ukuphuma kwegazi ngokungajwayelekile - kungaholela kudokotela ukuthi ancome nge-hysterectomy. Kepha ochwepheshe abaningi bathi ukuhlinzwa kwenziwa ngokweqile futhi kunqunyelwe ngokweqile, ikakhulukazi ezimeni ezithile ezifana ne-fibroids - ikakhulukazi kwabesifazane abanemibala.

Ngakho-ke yini okudingeka uyazi mayelana nale nqubo ejwayelekile, lokhu kwehluka ngokobuhlanga, futhi - okubaluleke kakhulu - okufanele wena wenzani uma uke wanikezwa eyodwa njengokwelashwa?

Okokuqala, yini i-hysterectomy?

Ngamafuphi, yinqubo esusa isibeletho, kodwa kunezinhlobo ezahlukene ze-hysterectomy. I-American College of Obstetricians and Gynecologists (ACOG) iphawula ukuthi i-hysterectomy isiyonke lapho isibeletho sakho sonke (kufaka phakathi umlomo wesibeletho sakho, ukuphela kwesibeletho sakho okuxhuma isibeletho nesitho sangasese sowesifazane). I-hysterectomy ye-supracervical (eyaziwa nangokuthi i-subtotal noma ingxenye) yilapho ingxenye engenhla yesibeletho sakho (kodwa hhayi umlomo wesibeletho) ikhishwa. Futhi i-hysterectomy eqinile lapho une-hysterectomy ephelele kanye nokususwa kwezakhiwo ezinjengama-ovari akho, noma amashubhu e-Fallopian (yithi, esimweni somdlavuza).

I-Hysterectomy ivamise ukusetshenziselwa ukwelapha ukubulawa kwezimo zempilo ezisuka ku-fibroids kanye ne-uterine prolapse (lapho isibeletho sishona phansi sibheke noma singene esithweni sangasese) siye ukopha okungavamile, umdlavuza we-gynecologic, ubuhlungu be-pelvic obungapheli, ngisho ne-endometriosis, ngokusho kwe-ACOG.

Ngokuya ngohlobo lwe-hysterectomy oludingayo (nokuthi siyini isizathu sakho sokusidinga), ukuhlinzwa kungenziwa ngezindlela ezimbalwa ezahlukahlukene: ngesitho sakho sangasese, ngesisu sakho, noma nge-laparoscopy - lapho kufakwa khona isibonakude esincane ukuze kubonakale futhi udokotela ohlinzayo uyakwazi ukwenza ukuhlinza ngemisiko emincane kakhulu.

Kungani abesifazane abaningi kangaka bethola ama-hysterectomies?

Amanye ama-hysterectomies (njengalawo enziwe ngesisu sakho) ahlasela kakhulu kunamanye (enziwe nge-laparoscopy). Futhi kufanele wazi ukuthi izikhathi eziningi, noma ngabe i-hysterectomy ikhonjisiwe, kunezinye izindlela zokwelashwa ezitholakalayo (yithi, ngezinkinga ezinjenge-fibroids noma i-endometriosis). Inkinga? Lezo zinketho azihlali zivezwa njengezinketho ezingokoqobo yonke indawo.

Kwesinye isikhathi, kuya ngengxenye yezwe okulo, kunodokotela abahlinzayo abangakuthandi ukwelapha okungatheni okuholela ekutheni bonke labo besifazane bathole i-hysterectomy,” kuchaza uDkt. Irobuna.

Nasi isibonelo: Uma isetshenziselwa i-fibroids, i-hysterectomy kwenza bathambekele ekuqinisekiseni ukuthi izimpawu ngeke zibuye (phela, isibeletho sakho lapho lezo fibroids zazikhona manje asisekho), kodwa ungakwazi ukukhipha ama-fibroids ngokuhlinzwa bese ushiya isibeletho sisendaweni. "Ngicabanga ukuthi kukhona ama-hysterectomy atuswa odokotela ngoba nje bathola ama-fibroids lapho behlolwa," kusho uJeff Arrington, MD, udokotela ohlinzayo wezifo zabesifazane othuthuke kancane nochwepheshe be-endometriosis e-Center for Endometriosis e-Atlanta, GA. Futhi ngenkathi i-fibroids ingaba buhlungu kakhulu futhi ikhubaze (futhi i-hysterectomy ingasiza ekuqedeni lobo buhlungu), i-fibroids nayo ayinabuhlungu. "Kungaba neziguli eziningi ebezizoqonda kahle ukuthi i-fibroids ikhona nokuthi ayinabungozi," kusho uDkt Arrington ngenketho yokungasebenzi.

Ezinye izinqubo ezingezansi ezinolaka zifaka i-myomectomy (ukuhlinzwa ukususa ama-fibroids esibelethweni), izindlela zokwelapha ezinjenge-uterine fibroid embolization (ukusika ukunikezwa kwegazi kuye ku-fibroids), kanye ne-radiofrequency ablation (eshisa ama-fibroids). Ngaphezu kwalokho, kunezinketho eziningi zokwelapha ezingahlaseli ezifana nezivimbela-nzalo ezithathwa ngomlomo kanye neminye imithi.

Kepha, nansi into: "Ama-Hysterectomies abekhona isikhathi eside, futhi wonke udokotela wezifo zabesifazane ufunda ukuthi angakwenza kanjani ekuqeqesheni ukuhlala kwawo - [kodwa lokho akulona iqiniso kuzo zonke izindlela zokwelashwa," kufaka phakathi lezi zinqubo ezingezinhle kangako, kusho uDkt Irobuna.

Kulo mthambo, kuyilapho i-hysterectomy ibhekwa njengokwelashwa "okuqinisekile" (funda: unomphela) kwe-endometriosis, "abukho ubufakazi - akukho nocwaningo olulodwa - olubonisa ukuthi ukungena nokukhipha isibeletho ngomlingo kwenza yonke enye i-endometriosis ihambe. kude,” kuchaza uDkt. Arrington. Ngemuva kwakho konke, ngencazelo, i-endometriosis ilapho izicubu ezifana nalokho kolwelwesi lwesibeletho zikhula ngaphandle wesibeletho. I-Hysterectomy, uthi, can ukuthuthukisa amazinga obuhlungu be-endometriosis yabanye abantu, kepha akusona ngokwaso ukwelapha lesi sifo. (Okuhlobene: ULena Dunham Wayene-Hysterectomy Ephelele Yokumisa Ubuhlungu Bakhe be-Endometriosis)

Ngakho kungani i-hysterectomy ivame ukuhlinzekwa kwabesifazane abane-endometriosis? Kunzima ukusho, kepha kungahle kufike ekuqeqesheni, ekuthobekeni nasekuvezweni, kusho uDkt Arrington. I-Endometriosis yelashwa kangcono ngokususwa kokuhlinzwa kwe-endometriosis uqobo, eyaziwa ngokuthi yi-excision surgery, esho. Futhi akuwona wonke udokotela ohlinzayo oqeqeshwe kulolu hlobo lokuhlinzwa ngendlela efanayo nezindlela zokubeletha ezifundiswa kakhulu.

Umehluko Wobuhlanga Ku-Hysterectomy

Lokhu kuchazwa ngokweqile kwe-hysterectomy kubonakala nakakhulu uma kubhekwa umlando womkhuba phakathi kweziguli eziMnyama. Olunye ucwaningo luphakamisa ukuthi abesifazane abamnyama basemathubeni aphindwe kane okuthola ukukhishwa kwesibeletho kunabesifazane abamhlophe. ICenters for Disease Control and Prevention (CDC) nayo ibike imininingwane egqamisa ukuhlukana kwezinhlanga phakathi kwalabo abanale nqubo. Futhi olunye ucwaningo luthola ukuthi abesifazane abamnyama bane-hysterectomy ngamanani aphezulu kunalawo noma yikuphi olunye uhlanga.

Ucwaningo nochwepheshe bacacile: Abesifazane abamnyama empeleni basemathubeni amaningi okwenziwa isibeletho esibelethweni kunabesifazane abamhlophe, kusho uMelissa Simon, M.D., umqondisi we-Institute for Public Health and Medicine Center for Health Equity Transformation at Northwestern's Feinberg School of Medicine. Ngokuphawulekayo, futhi maningi amathuba okuthi bahlinzwe i-hysterectomy yesisu ehlasela kakhulu, uyanezela.

Kungaba nezizathu eziningi zalokhu. Kokukodwa, abesifazane abamnyama baba nama-fibroids - esinye sezizathu ezivamile zokukhishwa kwe-hysterectomy phakathi kwanoma yiluphi uhlanga - ngamanani aphezulu kunabesifazane abamhlophe. "Izibalo zikhulu ngokuphindwe kabili kuya kathathu kwabesifazane baseMelika base-Afrika kunabesifazane abamhlophe eMelika," kusho uCharlotte Owens, MD, umqondisi wezokwelapha jikelele wezokwelapha kwa-AbbVie. "Abesifazane base-Afrika baseMelika nabo bavame ukuba nezimpawu ezinzima kakhulu futhi ngaphambili, ngokuvamile eminyakeni yabo yama-20." Ochwepheshe abaqiniseki ukuthi kungani kunjalo, kusho uDkt. Owens.

Kepha kungenzeka ukuthi kunokwehluka ngokobuhlanga kunezigameko ze-fibroids. Kokukodwa, leyo nkinga yokuthola ukwelashwa okuncane okungahlaseli? Kungashaya kakhulu abesifazane abanemibala. "Ukuxhaswa ngezimali kobunye ubuchwepheshe obudingekayo ukwenza imishanguzo esezingeni eliphakeme, engenasifo esingahlasela kungenzeka ingatholakali ezibhedlela ezisiza eminye yemiphakathi lapho kuhlala khona abesifazane abaNsundu," kuchaza uDkt Irobunda. (Okuhlobene: Lokhu Okuhlangenwe Nakho Kokukhulelwa Kwabesifazane Abakhulelwe Kuqokomisa Ukungafani Kwezokunakekelwa Kwezempilo Kwabesifazane Abamnyama)

Futhi, uma kukhulunywa ngezinketho zokunakekelwa kwabesifazane abanemibala nokwelashwa kwe-fibroid, izinketho ezahlukahlukene azivamisile ukuxoxwa, kusho uKecia Gaither, MD, MPH, udokotela wezokwelapha ob-gyn nowomama abakhulelwe ezibhedlela ze-NYC Health / Lincoln. "I-Hysterectomy inikezwa njengokuphela kwendlela yokwelapha." Kodwa iqiniso lendaba liwukuthi, nakuba i-hysterectomy ivame ukukhetha kumenyu yokwelashwa kowesifazane, ngokuvamile akuyona indlela yokwelashwa. kuphela ukukhetha. Futhi akufanele neze uzizwe sengathi kufanele uyithathe noma uyiyeke uma kukhulunywa ngempilo yakho.

Kuze kube manje, kunobandlululo oluhlelekile nokuchema okudlala indima lapha, kusho ochwepheshe. Ngemuva kwakho konke, izinqubo eziningi ze-pelvic nokuzala zinezimpande zobandlululo njengoba zazenziwa ekuqaleni futhi zazenziwa ngezigqila zabesifazane abaMnyama. Ngasekuqaleni kweminyaka yama-2000, kwakukhona namacala okuvala inzalo engavumelekile ohlelweni lwejele laseCalifornia, kuchaza uDkt Irobuna.

"Kuyaziwa ukuthi kukhona ukwenzelela njengoba kuhlobene nabesifazane abaMnyama nokunakekelwa kwezempilo - ngizibonele ngawami," kusho uDkt Gaither.

Ukuchema kodokotela abahlinzayo nakho kungagqama. Uma udokotela ohlinzayo, ngokwesibonelo, ecabanga ukuthi abesifazane abamnyama ngeke bavumelane nezinketho zokwelapha njengephilisi lokulawula inzalo lansuku zonke noma isibhamu (njenge-Depo Provera engasiza ngobuhlungu be-pelvic nokopha okukhulu kokuya esikhathini), bangase babe ngaphezulu. kungenzeka anikeze ukwelashwa okuthe xaxa njenge-hysterectomy, uthi. "Ngeshwa, ngiye ngaba neziguli eziningi zabesifazane abaMnyama eza ukuzongibona nginokukhathazeka ngemuva kokunikezwa abanye odokotela abahlinzayo futhi bengingenaso isiqiniseko sokuthi i-hysterectomy iyindlela efanele yokwelashwa kubo."

Ungakuthola Kanjani Ukunakekelwa Okukufanele

Ama-Hysterectomies ayindlela yokwelapha ebalulekile yezinkinga ezithile zezokwelapha - akukho mbuzo. Kodwa inqubo kufanele inikezwe njenge ingxenye wohlelo lokwelashwa olungaba khona, futhi njalo njengenketho. “Kubalulekile ukuthi ngesinqumo esibaluleke njengokukhipha isitho, isiguli siqonde ukuthi kwenzekani ngomzimba waso nokuthi yiziphi izinhlobo ezitholakalayo zokwelashwa,” kusho uDkt. Irobunda.

Ngemuva kwakho konke, i-hysterectomy iza nemiphumela engemihle - konke ukungasakwazi ukuzala izingane ukuqunjelwa noma ukwehla ngokomzwelo kanye nokunqamuka kokuqala nokushesha uma ungakakwenzi lokhu ngokwemvelo. (I-BTW, ama-hysterectomies angenye yezimbangela * eziningi * zokunqamuka kokuya esikhathini kokuqala.)

Ezinye izinto okufanele uzikhumbule uma i-hysterectomy ivela engxoxweni? “Ngihlale ngiluleka iziguli, ikakhulukazi iziguli zekhaladi kanye neziguli eziMnyama ukuthi zingesabi ukubuza imibuzo,” kusho uDkt Simon. "Buza ukuthi kungani udokotela ohlinzayo noma udokotela encoma indlela ethile yokwelapha isimo esithile, buza ukuthi zikhona yini ezinye izindlela zokwelapha, futhi - uma kunqunywa ukuthi i-hysterectomy kuyinto indlela ozohamba ngayo - buza ngezindlela ezingasetshenziswa, njengezindlela ezingena kancane. "

Ngamafuphi: Kufanele ube nomuzwa wokuthi imibuzo yakho iphenduliwe nokuthi uyezwa. Uma ungakwenzi, funa umbono wesibili (noma wesithathu), usho kanjalo. (Kuhlobene: Izinto ezi-4 Wonke Umuntu Owesifazane Okumele Azenze Ngempilo Yakhe Yezocansi, Ngokusho kuka-Ob-Gyn)

Ekugcineni, i-hysterectomy ukukhetha komuntu siqu okuncike kukho konke kusuka kunkinga obhekene nayo, ukuthi ukuphi isigaba sempilo, nokuthi iyiphi inhloso onayo. Futhi okubalulekile ukuthi ukwenza isiqiniseko sokuthi unolwazi ngangokunokwenzeka kuyisihluthulelo.

"Ngizama ukubhekana nazo zonke izindlela ezihlukene, okuhle nokubi, bese ngisiza isiguli ukuthi sinqume ukuthi iyiphi indlela engcono kakhulu," kusho uDkt. Arrington.

Buyekeza kwe-