I-Phalloplasty: Ukuhlinzwa Kokuqinisekisa Ubulili

-Delile

• Kwenzekani ngesikhathi se-phalloplasty?
• Amasu we-Phalloplasty
• Ingalo ye-Radial free-flap phalloplasty
• Ithanga langaphambili le-lateral pedicled flap phalloplasty
• I-phalloplasty yesisu
• I-musculocutaneous latissimus dorsi flap phalloplasty
• Izingozi nezinkinga
• Ukubuyiselwa
• Ukunakekelwa ngemuva
• Imibuzo ongayibuza udokotela wakho ohlinzayo
• Umbono

Ukubuka konke

I-phalloplasty ukwakhiwa noma ukwakhiwa kabusha kwepipi. I-phalloplasty iyindlela ejwayelekile yokuhlinzwa yabantu abadlulayo nabangewona abanesifiso sokuhlinzwa kobulili. Ibuye isetshenziselwe ukwakha kabusha ipipi ezimeni zokuhlukumezeka, umdlavuza, noma ukukhubazeka okuzelwe.

Umgomo we-phalloplasty ukwakha ipipi elikhangayo elilinganayo elilinganayo elikwazi ukuzwa imizwa nokukhulula umchamo endaweni emi. Kuyindlela eyinkimbinkimbi evame ukubandakanya ukuhlinzwa okungaphezu kokukodwa.

Amasu we-Phalloplasty ayaqhubeka nokuvela nezinsimu zokuhlinzwa kwepulasitiki ne-urology. Njengamanje, inqubo ejwayelekile yegolide ye-phalloplasty yaziwa njenge-radial forearm free-flap (RFF) phalloplasty. Phakathi nale nqubo, odokotela abahlinzayo basebenzisa isikhumba esikhwameni sakho kusuka engxenyeni yesandla sakho ukwakha shaft yepipi.

Kwenzekani ngesikhathi se-phalloplasty?

Ngesikhathi se-phalloplasty, odokotela basusa isikhumba esivela endaweni yomnikeli womzimba wakho. Bangasusa ngokuphelele le phopho noma bayishiye inamathiselwe kancane. Lezi zicubu zisetshenziselwa ukwenza kokubili i-urethra kanye ne-shaft yepenisi, esakhiweni se-tube-within-a-tube. Ishubhu elikhudlwana lisongwe ngokuzungeza ithubhu langaphakathi. Ukufakwa esikhunjeni kuthathwa ezindaweni ezingabonakali zomzimba, lapho kungazukushiya khona zibazi ezibonakalayo, bese kuxhunyelelwa endaweni yomnikelo.

I-urethra yesifazane imfushane kune-urethra yesilisa. Odokotela abahlinzayo bangayandisa i-urethra bese bayinamathisela kwi-urethra yabesifazane ukuze umchamo ugeleze usuka ekugcineni kwepipi. I-clitoris ivame ukushiywa endaweni eseduze kwesisekelo sowesilisa, lapho isengakhuthazeka khona. Abantu abangakwazi ukufeza i-orgasm ngaphambi kokuhlinzwa kwabo ngokuvamile basengakwenza lokho ngemuva kokuhlinzwa kwabo.

I-phalloplasty, ikakhulukazi, ilapho odokotela abahlinzayo beguqula isikhumba sabanikeli sibe yiphallus. Kepha ngokujwayelekile, kubhekiswa ezinkambisweni eziningi ezihlukile ezivame ukwenziwa ngokulandelana. Lezi zinqubo zifaka:

• i-hysterectomy, lapho odokotela besusa khona isibeletho
• i-oophorectomy ukususa ama-ovari
• i-vaginectomy noma i-vaginal mucosal ablation yokususa noma ukususa kancane isitho sangasese sowesifazane
• i-phalloplasty yokuguqula isikhumba somnikeli sibe yiphallus
• i-scrotectomy yokuguqula i-labia majora ibe i-scrotum, kungaba ngokufaka noma ngaphandle kokufakwa kwamasende
• i-urethroplasty yokwelula nokuxhuma i-urethra ngaphakathi kwe-phallus entsha
• i-glansplasty yokuqopha ukubukeka kwethiphu engasokile
• ukufakwa kwe-penile ukuvumela ukwakhiwa

Akukho ukuhleleka okukodwa noma umugqa wesikhathi walezi zinqubo. Abantu abaningi abazenzi zonke. Abanye abantu bazenza ndawonye, ​​kanti abanye bazisabalalisa eminyakeni eminingi. Lezi zinqubo zidinga odokotela abahlinzayo abavela emikhakheni emithathu ehlukene: i-gynecology, urology, kanye neplastiki.

Lapho ufuna udokotela ohlinzayo, ungahle uthande ukumfuna ngeqembu elisunguliwe. Ngaphambi kwanoma yikuphi ukungenelela kwezokwelapha, khuluma nodokotela wakho ngokulondolozwa kokuzala kanye nomthelela ekusebenzeni kocansi.

Amasu we-Phalloplasty

Umehluko phakathi kwezinqubo ze-phalloplasty ezikhona indawo lapho isikhumba somnikeli sithathwa khona nendlela esuswa futhi sixhunywe ngayo. Amasayithi abanikeli angafaka isisu esingezansi, i-groin, i-torso, noma ithanga. Kodwa-ke, indawo ekhethwayo yodokotela abaningi abahlinzayo ingalo yangaphambili.

Ingalo ye-Radial free-flap phalloplasty

I-phalloplasty yomsakazo we-radial free-flap (RFF noma i-RFFF) ingukuziphendukela kwemvelo kwakamuva kakhulu ekwakhiweni kabusha kwezitho zobulili. Ngenqubo ye-flap yamahhala, izicubu zisuswa ngokuphelele engalweni nemithambo yegazi nezinzwa ziqinile. Le mithambo yegazi nezinzwa zixhunywe kabusha ngokunemba kwe-microsurgical, okuvumela igazi ukuba ligobhoze ngokwemvelo liye ku-phallus entsha.

Le nqubo incanyelwa kwamanye amasu ngoba inika ukuzwela okuhle kakhulu kanye nemiphumela emihle yobuhle. I-urethra ingakhiwa nge-tube-within-a-tube fashion, evumela ukuma okumiyo. Kukhona indawo yokufakelwa kamuva kwenduku yokwakhiwa noma ipompo e-inflatable.

Amathuba okulimala kokuhamba esizeni sabanikeli nawo aphansi, kepha ukufakelwa kwesikhumba engxenyeni engaphambili kuvame ukushiya isibazi esilinganiselwe siye kwesibi. Le nqubo ayilungile kumuntu okhathazekile ngezibazi ezibonakalayo.

Ithanga langaphambili le-lateral pedicled flap phalloplasty

Ithanga langaphambilini le-lateral (ALT) elenziwe nge-flap phalloplasty akuyona inketho ehamba phambili yodokotela abahlinzayo abaningi ngoba liphumela ezingeni eliphansi kakhulu lokuzwela ngokomzimba epeni elisha. Enkambeni ye-flap ehambisanayo, izicubu zihlukaniswa nemithambo yegazi nezinzwa. I-urethra ingahle ihlelwe kabusha ukuze ime umchamo, futhi kunendawo eyanele yokufakwa kwe-penile.

Labo abenze le nqubo ngokuvamile banelisekile, kepha babika amazinga aphansi wokuzwela okuvusa inkanuko. Kunezinga eliphakeme ngale nqubo kune-RFF. Okuxhunywe esikhunjeni kungashiya ukwethuka okuphawulekayo, kepha endaweni ehlukile.

I-phalloplasty yesisu

I-phalloplasty yesisu, ebizwa nangokuthi i-supra-pubic phalloplasty, iyisinqumo esihle sabesilisa abadlulayo abangadingi i-vaginectomy noma i-urethra ehlelwe kabusha. I-urethra ngeke idlule esihlokweni sowesilisa futhi ukuchama kuzoqhubeka nokudinga indawo yokuhlala.

Njenge-ALT, le nqubo ayidingi microsurgery, ngakho-ke ayibizi kakhulu. I-phallus entsha izoba nokuthinta okuthintekayo, kepha hhayi ukuzwa okuvusa inkanuko. Kepha i-clitoris, egcinwe endaweni yayo yasekuqaleni noma ingcwatshwe, isengakhuthazeka, futhi ukufakwa kwe-penile kungavumela ukungena.

Le nqubo ishiya isibazi esivundlile esisuka esinqeni siye okhalweni. Lesi sibazi sifihlwa kalula yizingubo. Ngoba ayibandakanyi i-urethra, ihlotshaniswa nezinkinga ezimbalwa.

I-musculocutaneous latissimus dorsi flap phalloplasty

I-musculocutaneous latissimus dorsi (MLD) flap phalloplasty ithatha izicubu zabanikeli emisipheni engemuva ngaphansi kwengalo. Le nqubo ihlinzeka ngesicubu esikhulu sezicubu zabanikeli, esivumela odokotela abahlinzayo ukuthi bakhe ipipi elikhulu. Kukulungele kahle ukwakhiwa kabusha kwe-urethra nokwengezwa kwedivayisi ye-erectile.

Ukuchaphazeleka kwesikhumba kufaka imithambo yegazi nezicubu zemizwa, kepha inzwa eyodwa yemoto ayizweli kangako kunemizwa exhunywe ne-RFF. Isiza sabanikeli siphulukisa kahle futhi asibonakali njengezinye izinqubo.

Izingozi nezinkinga

I-Phalloplasty, njengakho konke ukuhlinzwa, iza nengozi yokutheleleka, ukopha, ukulimala kwezicubu nobuhlungu. Ngokungafani nokunye ukuhlinzwa, noma kunjalo, kunengozi enkulu impela yezinkinga ezihambisana ne-phalloplasty. Izinkinga ezivame ukwenzeka zibandakanya urethra.

Izinkinga ezingenzeka ze-phalloplasty zifaka:

• ama-fistula we-urethral
• ukuqina kwe-urethral (ukuncipha kwe-urethra evimbela ukugeleza komchamo)
• ukwehluleka kwe-flap nokulahleka (ukufa kwezicubu ezidlulisiwe)
• ukuphuka kwesilonda (kuqhekeka emigqeni wokusika)
• ukopha okhalo noma ubuhlungu
• ukulimala esinyeni noma emunxeni
• ukungabi nemizwa
• isidingo eside samanzi (ukukhipha kanye noketshezi endaweni yesilonda edinga ukugqokwa)

Indawo yokunikela nayo isengozini yezinkinga, lokhu kufaka:

• izibazi ezingabonakali noma ukushintsha kombala
• ukuwohloka kwesilonda
• i-tissue granulation (isikhumba esibomvu, esinamaqhuqhuva endaweni yesilonda)
• ukwehla kokuhamba (okungavamile)
• ukulinyazwa
• ukuncipha kwemizwa
• ubuhlungu

Ukubuyiselwa

Kufanele ukwazi ukubuyela emsebenzini cishe amasonto amane kuya kwayisithupha ngemuva kwe-phalloplasty yakho, ngaphandle kokuthi umsebenzi wakho udinga umsebenzi onzima. Ngemuva kwalokho kufanele ulinde amasonto ayisithupha kuya kwayisishiyagalombili. Gwema ukuzivocavoca nokuphakamisa phakathi namasonto ambalwa okuqala, yize ukuthatha uhambo olunamandla kulungile. Uzoba ne-catheter endaweni yamasonto ambalwa okuqala. Ngemuva kwamasonto amabili kuya kwamathathu ungaqala ukuchama nge-phallus.

I-phalloplasty yakho ingahle yehlukaniswe ngezigaba, noma ungaba ne-scrotoplasty, ukwakhiwa kabusha kwe-urethral, ​​ne-glansplasty ngasikhathi sinye. Uma uwahlukanisa, kufanele ulinde okungenani izinyanga ezintathu phakathi kwesigaba sokuqala nesesibili. Esigabeni sokugcina, okufakelwa i-penile, kufanele ulinde isikhathi esingangonyaka. Kubalulekile ukuthi ube nokuzizwa okugcwele epeni lakho elisha ngaphambi kokufaka okufakelwayo.

Ngokuya ngohlobo lokuhlinzwa obukade unalo, ungaze ube nokuzwa okuvusa inkanuko ku-phallus yakho (kepha usengaba nama-orgasms e-clitoral). Kuthatha isikhathi eside ukuthi izicubu zemizwa ziphole. Ungaba nokuzwa okuthintekayo ngaphambi kokuzwa okuvusa inkanuko. Ukuphulukiswa ngokugcwele kungathatha iminyaka emibili.

Ukunakekelwa ngemuva

• Gwema ukubeka ingcindezi kwi-phallus.
• Zama ukukhulisa i-phallus ukuze wehlise ukuvuvukala futhi uthuthukise ukujikeleza kwegazi (yiphakamise ekugqokeni okuhlinzekwayo).
• Gcina ukusikeka kuhlanzekile futhi komile, ufake kabusha okokugqoka, futhi ugeze ngensipho namanzi njengoba kuyalelwe ngudokotela ohlinzayo.
• Ungafaki iqhwa endaweni.
• Gcina indawo ezungeze imisele ihlanzekile ngokugeza isiponji.
• Ungagezi amasonto amabili okuqala, ngaphandle kokuthi udokotela wakho akutshele ngenye indlela.
• Ungadonsi ipayipi le-catheter, ngoba lokhu kungalimaza isinye.
• Khipha isikhwama somchamo okungenani kathathu ngosuku.
• Ungazami ukuchama kusuka ku-phallus yakho ngaphambi kokuthi kufanele.
• Ukulunywa, ukuvuvukala, ukulinyazwa, igazi emchameni, isicanucanu, nokuqunjelwa konke kujwayelekile emasontweni ambalwa okuqala.

Imibuzo ongayibuza udokotela wakho ohlinzayo

• Iyiphi inqubo oyikhethayo ye-phalloplasty?
• Zingaki osuzenzile?
• Ungazinikeza yini izibalo mayelana nezinga lakho lempumelelo kanye nokuvela kwezinkinga?
• Ingabe unayo iphothifoliyo yezithombe zangemva kokuhlinzwa?
• Ngizodinga ukuhlinzwa okungaki?
• Intengo ingakhuphuka ngamalini uma nginezinkinga ezidinga ukuhlinzwa?
• Ngizodinga isikhathi esingakanani ukuhlala esibhedlela?
• Uma ngivela ngaphandle kwedolobha. Ngizohlala isikhathi esingakanani ngemuva kokuhlinzwa kwami?

Umbono

Ngenkathi amasu e-phalloplasty ethuthukile eminyakeni edlule, ayikho inqubo efanelekile. Yenza ucwaningo ngethani bese ukhuluma nabantu emphakathini ngaphambi kokwenza isinqumo ngokuthi hlobo luni lokuhlinzwa oluphansi olulungele wena. Kunezinye izindlela zokusebenzisa i-phalloplasty, kufaka phakathi ukupakisha kanye nenqubo engeyona ingozi ebizwa nge-metoidioplasty.