Kodi Amayi Achimereka Ali Ndi Ziphuphu Zosafunika?

Zamkati

• Choyamba, kodi hysterectomy ndi chiyani?
• Nchifukwa chiyani amayi ambiri akudwala hysterectomy?
• Kusiyana Kwamitundu mu Hysterectomy
• Momwe Mungapezere Chisamaliro Chomwe Mukuyenera
• Onaninso za

Kuchotsa chiberekero cha mkazi, chiwalo chomwe chimakula, ndi kunyamula mwana ndi kusamba ndi chachikulu. Chifukwa chake mutha kudabwitsidwa kudziwa kuti hysterectomy - kuchotsedwa kwa chiberekero kosasinthika - ndi imodzi mwama opaleshoni omwe amachitidwa pafupipafupi kwa amayi ku US Yep, mudamva izi molondola: Ena 600,000 ma hysterectomies amachitika chaka chilichonse ku U.S. Ndipo ena amati, gawo limodzi mwa magawo atatu a azimayi onse aku America adzakhala atakwanitsa zaka 60.

"Asanachitike mankhwala amakono, maufulu opatsirana pogonana anali kuwonedwa ngati chithandizo chazovuta zilizonse zomwe mayi amabwera kwa dokotala kapena mchiritsi," akufotokoza a Heather Irobunda, M.D., ob-gyn ovomerezeka ndi board ku New York City. "M'mbiri yaposachedwa, vuto lililonse lomwe mayi angabweretse kwa dokotala yemwe amakhudza chiuno chake akanatha kuthandizidwa ndi hysterectomy."

Masiku ano, matenda ambiri - khansa, ma fibroids ofooka (osakhala khansa ophuka mu chiberekero chanu chomwe chingakhale wapamwamba zopweteka), kutuluka magazi mosazolowereka - kumatha kupangitsa dokotala kuti alangize za hysterectomy. Koma akatswiri ambiri amanena kuti opaleshoniyi amachitidwa mopitirira muyeso ndipo amapatsidwa malire, makamaka pazinthu zina monga fibroids - makamaka azimayi amtundu.

Ndiye muyenera kudziwa chiyani za njirayi, kusiyana kwamitundu iyi, ndipo - chofunikira kwambiri - choyenera kuchita chiyani inu Kodi mungapatsidwe chithandizo chilichonse?

Choyamba, kodi hysterectomy ndi chiyani?

Mwachidule, ndi njira yomwe imachotsa chiberekero, koma pali mitundu yosiyanasiyana ya hysterectomy. American College of Obstetricians and Gynecologists (ACOG) amanenanso kuti chiberekero chonse ndi pomwe chiberekero chanu chonse (kuphatikiza khomo pachibelekeropo, kumapeto kwenikweni kwa chiberekero chanu komwe kumalumikiza chiberekero ndi kumaliseche). A supracervical (aka subtotal kapena partial) hysterectomy ndi pamene gawo lapamwamba la chiberekero chanu (koma osati khomo lachiberekero) limachotsedwa. Ndipo hysterectomy yowonjezereka ndi pamene muli ndi hysterectomy yonse kuphatikizapo kuchotsa zinthu monga mazira anu, kapena machubu a Fallopian (nenani, ngati muli ndi khansa).

Hysterectomy imagwiritsidwa ntchito pochiza matenda angapo kuchokera ku fibroids ndi uterine prolapse (pamene chiberekero chimatsikira kumunsi kapena kumaliseche) kupita ku magazi osazolowereka, khansa ya m'mimba, kupweteka kwa m'mimba, komanso endometriosis, malinga ndi ACOG.

Kutengera mtundu wamtundu wa hysterectomy womwe mukufuna (ndi malingaliro anu ofunikira), opareshoniyo imatha kuchitidwa m'njira zingapo: kudzera kumaliseche kwanu, m'mimba mwanu, kapena kudzera pa laparoscopy - pomwe telescope yaying'ono imayikidwa kuti iwoneke komanso dokotalayo amatha kuchita opaleshoniyo pang'onopang'ono.

Nchifukwa chiyani amayi ambiri akudwala hysterectomy?

Zina zotere (monga zomwe zimachitika m'mimba mwanu) ndizowopsa kwambiri kuposa zina (zomwe zimachitika kudzera pa laparoscopy). Ndikofunikanso kudziwa kuti nthawi zambiri, ngakhale hysterectomy ikuwonetsedwa, pali njira zina zamankhwala zomwe mungapeze (kunena, pazinthu monga fibroids kapena endometriosis). Vutolo? Zosankhazi sizimaperekedwa nthawi zonse ngati zosankha kulikonse.

"Nthawi zina, kutengera dera lomwe mukukhalamo, pali madokotala ochita opaleshoni omwe sagwirizana ndi mankhwala ochepetsa omwe amachititsa kuti azimayi onsewa atenge mimba," akufotokoza Dr. Irobuna.

Nachi chitsanzo: Akagwiritsidwa ntchito pa fibroids, hysterectomy amachita amakonda kuwonetsetsa kuti zizindikiritso sizibwerera (pambuyo pake, chiberekero chanu komwe ma fibroids adakhalako tsopano chapita), koma mutha kuchititsa opareshoni ndikuchotsa chiberekero m'malo mwake. "Ndikuganiza kuti pali ma hysterectomy omwe amalangizidwa ndi madokotala chifukwa chakuti amapeza ma fibroids pamayeso," akutero Jeff Arrington, MD, dokotala wa opaleshoni yachikazi komanso katswiri wa endometriosis ku Center for Endometriosis ku Atlanta, GA. Ndipo ngakhale fibroids imatha kukhala yopweteka kwambiri komanso yofooketsa (ndipo hysterectomy itha kuthandizira kuthetsa ululuwo), ma fibroids amathanso kukhala opanda ululu. "Pangakhale odwala angapo omwe angamvetse bwino kuti fibroids ilipo komanso kuti ndi abwino," akutero Dr. Arrington posankha kuti asagwire ntchito.

Njira zina zosautsa kwambiri ndi monga myomectomy (opaleshoni yochotsa fibroids m'chiberekero), mankhwala monga uterine fibroid embolization (kudula magazi kupita ku fibroids), ndi radiofrequency ablation (yomwe imawotcha fibroids). Kuphatikiza apo, pali njira zambiri zosasokoneza monga mankhwala akumwa ndi mankhwala ena.

Koma nayi chinthu ichi: "Ma Hysterectomies adakhalako kwanthawi yayitali, ndipo mayi aliyense wazamayi amaphunzira momwe angachitire izi pophunzitsira kukhalanso - [koma] izi sizowona pazosankha zonse zamankhwala," kuphatikiza njira zochepa izi, akutero Dr. Irobuna.

Munjira iyi, pomwe hysterectomy imawerengedwa kuti ndi "yotsimikizika" (werengani: yokhazikika) yothandizira endometriosis, "palibe umboni - palibe kafukufuku m'modzi - yemwe akuwonetsa kuti kungolowa ndikuchotsa chiberekero kumapangitsa endometriosis ina yonse kupita kutali,” akufotokoza motero Dr. Arrington. Kupatula apo, mwa tanthawuzo, endometriosis ndi pamene minofu yomwe ili yofanana ndi ya chiberekero imakula. kunja wa m'mimba. Hysterectomy, akuti, angathe Kuchepetsa ululu wa endometriosis wa anthu ena, koma sikuti ndiwo okha omwe amachiza matendawa. (Yokhudzana: Lena Dunham Anali ndi Hysterectomy Yonse Yothetsera Kupweteka Kwake kwa Endometriosis)

Ndiye nchifukwa chiyani hysterectomy nthawi zambiri imaperekedwa kwa amayi omwe ali ndi endometriosis? Ndizovuta kunena, koma zitha kubwera pakuphunzitsidwa, kumasuka, komanso kuwonekera, akutero Dr. Arrington. Endometriosis imachiritsidwa bwino kudzera pakuchotsa opaleshoni ya endometriosis yomwe, yotchedwa opaleshoni yopanga, akutero. Ndipo si dokotala aliyense wa opaleshoni amene amaphunzitsidwa opaleshoni yamtunduwu monganso momwe ma hysterectomies amaphunzitsidwira.

Kusiyana Kwamitundu mu Hysterectomy

Kulongosola kopitilira muyeso kwa ma hysterectomies kumawonekeranso kwambiri mukamayang'ana mbiri ya mchitidwewu pakati pa odwala akuda. Kafukufuku wina akuwonetsa kuti azimayi akuda ali ndi mwayi wochulukirapo kuposa anayi azungu. Centers for Disease Control and Prevention (CDC) idanenanso zambiri zomwe zikuwonetsa kusiyana kwamitundu pakati pa omwe ali ndi njirayi. Ndipo kafukufuku wina wapeza kuti azimayi akuda ali ndi ma hysterectomies pamitengo yayitali kuposa zilizonse mtundu wina.

Kafukufukuyu ndi akatswiri akuwonekeratu: Akazi akuda ali pachiwopsezo chachikulu kuposa azungu azimayi kuti atenge chiberekero, atero a Melissa Simon, MD, director of the Institute for Public Health and Medicine Center for Health Equity Transformation ku Feinberg School of Medicine yaku Northwestern. Makamaka, nawonso ali ndi chiopsezo chotenga kachilombo koyambitsa matenda m'mimba, akuwonjezera.

Pakhoza kukhala zifukwa zambiri za izi. Kwa amodzi, azimayi akuda amakumana ndi ma fibroids - chimodzi mwazifukwa zofala zochotsera matenda pakati pa mtundu uliwonse - pamitengo yayitali kuposa azungu. "Ziwerengerozi ndizochulukirapo kuwirikiza katatu kuposa azimayi aku America aku Africa kuposa azimayi azungu ku America," atero a Charlotte Owens, MD, oyang'anira zamankhwala ku AbbVie. "Amayi aku Africa aku America nawonso amakhala ndi zizindikilo zowopsa komanso m'mbuyomu, nthawi zambiri azaka za m'ma 20." Akatswiri sadziwa kwenikweni chifukwa chake zili choncho, akutero Dr. Owens.

Koma pali zowonjezereka zakusiyana kwamitundu kuposa zochitika za fibroids. Choyamba, nkhani yofikira kuzithandizo zochepa zowononga? Itha kugunda azimayi amtundu wolimba. "Ndalama zothandizira ukadaulo wina womwe ukufunika kuti muchite chithandizo chazotsogola kwambiri, chocheperako sichingakhalepo kuzipatala zomwe zimathandiza madera ena omwe azimayi akuda amakhala," akufotokoza Dr. Irobunda. (Zogwirizana: Chokumana nacho Chowopsya cha Mayi Wapakati Chikuwunikira Kusiyanaku Pakusamalira Thanzi Kwa Akazi Akuda)

Komanso, pankhani ya zosankha za chisamaliro cha amayi amtundu ndi chithandizo cha fibroid, zosankha zosiyanasiyana sizimakambidwa nthawi zambiri, akutero Kecia Gaither, M.D., M.P.H., dokotala wamankhwala a ob-gyn ndi amayi oyembekezera ku NYC Health Hospitals/Lincoln. "Hysterectomy imaperekedwa ngati njira yokhayo yothandizira." Koma zoona zake n'zakuti, pamene hysterectomy nthawi zambiri ndi chisankho pa mndandanda wa chithandizo cha amayi, nthawi zambiri si njira yopangira chithandizo. kokha kusankha. Ndipo musamamve ngati muyenera kutenga kapena kusiya izo zikafika pa thanzi lanu.

Mpaka pano, pali kusankhana mitundu komanso kukondera komwe kumagwira ntchito pano, akutero akatswiri. Kupatula apo, njira zambiri za m'chiuno ndi zoberekera zili ndi mizu yakusankhana mitundu monga momwe zidachitikira poyambirira komanso moyesera pa akapolo achikazi akuda. Kumayambiriro kwa zaka za 2000, padalinso milandu yolera osavomerezeka m'ndende yaku California, akufotokoza Dr. Irobuna.

"Ndizodziwika bwino kuti kukondera kulipo monga momwe zimakhudzira azimayi akuda komanso chithandizo chamankhwala - ndidaziwonera ndekha," akutero Dr. Gaither.

Kukondera kwa maopaleshoni kungawonekerenso. Ngati dokotala wa opaleshoni, mwachitsanzo, akuganiza kuti amayi akuda sangatsatire njira zochiritsira monga mapiritsi oletsa kubereka tsiku ndi tsiku kapena kuwombera (monga Depo Provera yemwe angathandize ndi ululu wa m'chiuno ndi kutuluka magazi kwambiri), akhoza kukhala ochulukirapo. mwina kuti apereke mankhwala owopsa ngati hysterectomy, akutero. "Tsoka ilo, ndakhala ndikudwala odwala azimayi akuda ambiri kuti adzandiwone ali ndi nkhawa atapatsidwa opaleshoni ndi madotolo ena ndipo sindinadziwe ngati njira yochotsera njira yochiritsira inali njira yoyenera kwa iwo."

Momwe Mungapezere Chisamaliro Chomwe Mukuyenera

Ma hysterectomies ndi mankhwala othandiza pamavuto ena azachipatala - palibe funso. Koma njirayi iyenera kuperekedwa ngati gawo za njira yothandizira, ndipo nthawi zonse ngati njira. Irobunda anati: “N’kofunika kwambiri kuti munthu akasankha chinthu chofunika kwambiri ngati kuchotsa chiwalo, amvetsetse zimene zikuchitika m’thupi lake komanso kuti apeze chithandizo chanji.

Kupatula apo, hysterectomy imabwera ndi zotsatira zoyipa - chilichonse kuyambira pakulephera kubereka mpaka kudzimbidwa kapena kukhumudwa komanso kutha msinkhu komanso nthawi yomweyo ngati simunadutsepo kale. (BTW, hysterectomies ndi chimodzi mwazomwe zimayambitsa kusamba koyambirira.)

Zinthu zina zomwe muyenera kukumbukira ngati hysterectomy ikubwera pokambirana? "Nthawi zonse ndimalangiza odwala, makamaka odwala akuda ndi akuda, kuti asachite mantha kufunsa mafunso," akutero Dr. Simon. "Funsani chifukwa chomwe dokotalayo kapena dokotala akulangiza njira zina zochizira matenda ena ake, funsani ngati pali njira zina zochiritsira, ndipo - ngati atsimikiza kuti ndi njira yoti mupite - funsani za njira zomwe zingagwiritsidwe ntchito, monga njira yochepetsera. "

Mwachidule: Muyenera kumva kuti mwayankhidwa mafunso anu ndikuti mukumvedwa. Ngati simutero, funani lingaliro lachiwiri (kapena lachitatu), akutero. (Zokhudzana: 4 Zinthu Zomwe Mkazi Wonse Amayenera Kuchita Kuti Agonane Naye, Malinga ndi Ob-Gyn)

Pamapeto pake, hysterectomy ndi chisankho chaumwini chomwe chimatengera chilichonse kuchokera pamavuto omwe mukukumana nawo, gawo lanji la moyo lomwe muli, komanso cholinga chomwe muli nacho. Chofunika kwambiri ndikuti kuwonetsetsa kuti mukudziwa momwe mungathere ndichofunikira.

"Ndimayesetsa kudutsa njira zosiyanasiyana, ubwino ndi kuipa, ndiyeno ndithandize wodwala kusankha chomwe chili chabwino kwa iwo," akutero Dr. Arrington.

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