Phalloplasty: Opaleshoni Yotsimikizira Kugonana

Zamkati

• Kodi chimachitika ndi chiyani pa phalloplasty?
• Njira za Phalloplasty
• Zozungulira mkono womasuka wopanda phalloplasty
• Anterior lateral thigh pedicled flap phalloplasty
• M'mimba phalloplasty
• Musculocutaneous latissimus dorsi kukupiza phalloplasty
• Zowopsa ndi zovuta
• Kuchira
• Pambuyo pa chisamaliro
• Mafunso oti mufunse dokotalayo
• Chiwonetsero

Chidule

Phalloplasty ndikumanga kapena kumanganso mbolo. Phalloplasty ndichisankho chofala cha ma transgender komanso anthu osagwiritsa ntchito mabakiteriya omwe ali ndi chidwi chotsimikizika kuti ndi amuna kapena akazi. Amagwiritsidwanso ntchito kukonzanso mbolo pakagwa zoopsa, khansa, kapena vuto lobadwa nalo.

Cholinga cha phalloplasty ndikumanga mbolo yokongoletsa yokwanira yokwanira yomwe imatha kumva kutulutsa ndikutulutsa mkodzo pamalo ataimirira. Ndi njira yovuta yomwe nthawi zambiri imakhudza maopaleshoni angapo.

Njira za Phalloplasty zimapitilizabe kusintha ndimalo opangira pulasitiki ndi urology. Pakadali pano, njira yovomerezeka ya golide yotchedwa phalloplasty imadziwika kuti phaloplasty (radial forearm free-flap). Pochita izi, madokotala ochita opaleshoni amagwiritsa ntchito khungu pakhungu lanu kuti apange shaft ya mbolo.

Kodi chimachitika ndi chiyani pa phalloplasty?

Pakati pa phalloplasty, madokotala amachotsa khungu kuchokera kwa omwe amapereka thupi lanu. Amatha kuchotsa chikwapu chonsecho kapena kuchisiya pang'ono. Minofu imeneyi imagwiritsidwa ntchito kupangira mtsempha wamkati ndi shaft ya mbolo, mu chubu-mkati-chubu. Chitoliro chokulirapo chimakulungidwa mozungulira chubu lamkati. Ankalumikiza khungu amatengedwa m'malo osawoneka bwino mthupi, momwe sangasiyire zipsera zowoneka, ndikuphatikizidwa kumtunda wa zoperekazo.

Mkodzo wachikazi ndi wamfupi kuposa mkodzo wamwamuna. Madokotala ochita opaleshoni amatha kutalikitsa mtsemphawo ndikuuphatika ku mkodzo wachikazi kuti mkodzo utuluke kuchokera kumapeto kwa mbolo. Clitoris nthawi zambiri imasiyidwa pafupi ndi tsinde la mbolo, pomwe imatha kulimbikitsidwabe. Anthu omwe amatha kuchita chiwerewere asanachite opareshoni amatha kuchita izi atachitidwa opaleshoni.

Phalloplasty, makamaka, ndi pamene madokotala ochita opaleshoni amatembenuza khungu la wopereka kukhala phallus. Koma kawirikawiri, limatanthawuza njira zingapo zosiyana zomwe nthawi zambiri zimachitika motsatana. Njirazi ndi monga:

• kachilombo ka HIV, komwe madokotala amachotsa chiberekero
• oophorectomy kuchotsa thumba losunga mazira
• vaginctomy kapena nyini mucosal ablation kuchotsa kapena kuchotsa pang'ono nyini
• phalloplasty yosinthira khungu laopereka kukhala phallus
• scrotectomy yosinthira labia majora kukhala chikopa, mwina ndi zopangira kapena zopanda testicular
• urethroplasty wokulitsa ndikulumikiza urethra mkati mwa phallus yatsopano
• glansplasty yosema mawonekedwe a nsonga yosadulidwa
• Kukhazikika kwa penile kulola kuti pakhale erection

Palibe dongosolo limodzi kapena mndandanda wa ndondomekoyi. Anthu ambiri sachita zonsezi. Anthu ena amachita zina mwa izo palimodzi, pomwe ena amafalitsa kwa zaka zambiri. Njirazi zimafuna madokotala ochita opaleshoni ochokera kuzinthu zitatu zosiyana: gynecology, urology, ndi opaleshoni ya pulasitiki.

Pofunafuna dokotala wa opaleshoni, mungafunefune yemwe ali ndi gulu lokhazikika. Musanachitike izi, lankhulani ndi dokotala wanu za kuteteza chonde ndi momwe zimakhudzira kugonana.

Njira za Phalloplasty

Kusiyanitsa pakati pa njira zamakono za phalloplasty ndi malo omwe khungu la woperekayo limachotsedwa ndi momwe amachotsedwera ndikulumikizananso. Malo opereka amatha kuphatikiza pamunsi pamimba, kubuula, torso, kapena ntchafu. Komabe, malo omwe madokotala ambiri ochita opaleshoni amakonda ndiwo mkono.

Zozungulira mkono womasuka wopanda phalloplasty

Phokoso lamtundu waulere (RFF kapena RFFF) phalloplasty ndiye kusintha kwatsopano kwambiri pakumangidwanso kwa maliseche. Mothandizidwa momasuka, minyewa imachotsedwa pamtsogolo pamitsempha yamagazi ndi mitsempha. Mitsempha yamagazi iyi ndi mitsempha imalumikizidwanso ndi microsurgical mwatsatanetsatane, kulola magazi kutuluka mwachilengedwe ku phallus yatsopano.

Njirayi imakondedwa ndi njira zina chifukwa imapereka chidwi komanso zotsatira zabwino. Urethra imatha kupangidwa mu chubu-mkati-mwa-chubu mafashoni, yolola kuyimilira pokodza. Pali malo oti pambuyo pake pakhale ndodo yomangirira kapena mpope wa inflatable.

Mwayi wowonongeka kwa omwe amapereka malo nawonso ndi otsika, komabe zolumikizira khungu kumanja nthawi zambiri zimasiya zipsera pang'ono. Njirayi siyabwino kwa wina amene akuda nkhawa ndi mabala owoneka.

Anterior lateral thigh pedicled flap phalloplasty

Ntchafu yambuyo (ALT) yokhotakhota phalloplasty siyomwe imasankha madokotala ambiri ochita opaleshoni chifukwa imapangitsa kutsika kwakanthawi kochepa mu mbolo yatsopano. Munjira yoyenda modzidzimutsa, minyewa imasiyanitsidwa ndi mitsempha yamagazi ndi mitsempha. Mitsempha ya mkodzo imatha kukonzedweratu kuti muyime pokodza, ndipo pali malo okwanira kupangira penile.

Omwe adachitapo izi nthawi zambiri amakhutira, koma amafotokoza zazing'ono zomwe sizingachitike. Pali chiwopsezo chachikulu cha njirayi kuposa ndi RFF. Zomatira pakhungu zimatha kusiya kuwopsa kwakukulu, koma m'malo owonekera kwambiri.

M'mimba phalloplasty

Mimba yam'mimba, yotchedwanso supra-pubic phalloplasty, ndi chisankho chabwino kwa amuna osunthika omwe safuna vaginectomy kapena urethra wokonzanso. Mtsempha wa mkodzo sungadutse kumapeto kwa mbolo ndipo kukodza kudzapitiliza kufuna kukhala pansi.

Monga ALT, njirayi siyifuna microsurgery, motero siyotsika mtengo. Phallus yatsopano idzakhala ndi zovuta, koma osati zotengeka. Koma clitoris, yomwe imasungidwa pamalo pomwe idayikidwa kapena kuyikidwa m'manda, imatha kulimbikitsidwa, ndipo kuyika kwa penile kumatha kuloleza kulowa.

Njirayi imasiya chilonda chopingasa kuyambira m'chiuno kupita m'chiuno. Chipsera ichi chimabisidwa mosavuta ndi zovala. Chifukwa sichiphatikiza urethra, imalumikizidwa ndi zovuta zochepa.

Musculocutaneous latissimus dorsi kukupiza phalloplasty

Chotupa cha musculocutaneous latissimus dorsi (MLD) phalloplasty chimatenga minofu yaopereka kuchokera kumtundu wakumbuyo kunsi kwa mkono. Njirayi imapereka chikoka chachikulu cha zopereka, zomwe zimalola ochita opaleshoni kupanga mbolo yokulirapo. Ndizoyenera pakukonzanso urethra ndikuwonjezera chida cha erectile.

Khungu lokhazikika limaphatikizapo mitsempha ya mitsempha ndi minofu ya mitsempha, koma mitsempha imodzi yokha imakhala yovuta kwambiri kuposa mitsempha yolumikizidwa ndi RFF. Tsambalo laopereka limachira bwino ndipo silimawonekera kwambiri ngati njira zina.

Zowopsa ndi zovuta

Phalloplasty, monga maopaleshoni onse, amabwera ndi chiopsezo chotenga matenda, kutuluka magazi, kuwonongeka kwa minofu, ndi kupweteka. Mosiyana ndi maopaleshoni ena ena, komabe, pali chiopsezo chachikulu cha zovuta zomwe zimakhudzana ndi phalloplasty. Zovuta zomwe zimachitika kwambiri zimakhudza urethra.

Mavuto omwe angakhalepo a phalloplasty ndi awa:

• fistula ya urethral
• kutsekemera kwa urethral (kuchepa kwa mtsempha wa mkodzo womwe umalepheretsa kutuluka kwamkodzo)
• kulephera ndi kutaya (kufa kwa minofu yosamutsidwa)
• kuwonongeka kwa mabala (kumang'ambika pamizere)
• Kutuluka m'chiuno kapena kupweteka
• chikhodzodzo kapena kuvulala kwammbali
• kusowa chidwi
• kusowa kwakanthawi kwamadzi (kutulutsa ndi madzimadzi pamalo ovulala omwe amafunikira mavalidwe)

Malo operekera ndalama ali pachiwopsezo chazovuta, monga awa:

• mabala osawoneka bwino kapena kupindika
• kuwonongeka kwa mabala
• granulation ya minofu (khungu lofiira, lophulika pamalo obala)
• kuchepa kwa kuyenda (kawirikawiri)
• kuvulaza
• kuchepa kwachisoni
• ululu

Kuchira

Muyenera kubwereranso kuntchito pafupifupi milungu inayi kapena isanu ndi umodzi mutatulutsa phalloplasty, pokhapokha ngati ntchito yanu ikufuna zovuta. Kenako muyenera kudikira milungu isanu ndi umodzi kapena isanu ndi itatu. Pewani kuchita masewera olimbitsa thupi ndikukweza masabata angapo oyambilira, ngakhale kuyenda mofulumira kuli bwino. Mudzakhala ndi catheter m'malo mwa milungu ingapo yoyambirira. Pambuyo pa milungu iwiri kapena itatu mutha kuyamba kukodza kudzera pamphongo.

Phalloplasty yanu imatha kuthyoka magawo, kapena mutha kukhala ndi scrotoplasty, kumanganso urethral, ​​ndi glansplasty nthawi imodzi. Ngati muwalekanitsa, muyenera kuyembekezera miyezi itatu pakati pa gawo loyamba ndi lachiwiri. Pachigawo chomaliza, chomwe chimayambira penile, muyenera kudikirira pafupifupi chaka chimodzi. Ndikofunika kuti mumve bwino mu mbolo yanu yatsopano musanayike.

Kutengera mtundu wanji wa opareshoni yomwe mudakhala nayo, simungamakhale ndi chidwi chazakudya zanu (koma mutha kukhalabe ndi ziphuphu). Zimatengera nthawi yayitali kuti minofu yamitsempha ipole. Mutha kukhala ndi chidwi chokhudzidwa musanakhale ndi chidwi chazakugonana. Kuchira kwathunthu kumatha kutenga zaka ziwiri.

Pambuyo pa chisamaliro

• Pewani kuyika pamphuno.
• Yesetsani kukweza phallus kuti muchepetse kutupa ndikuwongolera kufalikira (perekani pazovala zamankhwala).
• Sungani cheke choyera ndi chouma, pezaninso mavalidwe, ndikusamba ndi sopo ndi madzi monga adalangizira dokotala wanu.
• Osayala ayezi kuderalo.
• Sungani malo oyandikana ndi ngalande mosambira.
• Osasamba milungu iwiri yoyambirira, pokhapokha dokotala atakuwuzani.
• Musakoke pa catheter, chifukwa izi zitha kuwononga chikhodzodzo.
• Tulutsani thumba la mkodzo katatu patsiku.
• Musayese kukodza kuchokera ku phallus yanu musanayenere.
• Kuyabwa, kutupa, kuphwanya, magazi mkodzo, nseru, ndi kudzimbidwa ndizabwino m'masabata angapo oyamba.

Mafunso oti mufunse dokotalayo

• Kodi mumakonda njira yotani ya phalloplasty?
• Mwachita zingati?
• Kodi mungapereke ziwerengero zakukula kwanu komanso zovuta zina?
• Kodi muli ndi mbiri yazithunzi zapa postoperative?
• Kodi ndidzafunika maopaleshoni angati?
• Kodi mtengo ungakwere bwanji ngati ndili ndi zovuta zomwe zimafuna kuchitidwa opaleshoni?
• Kodi ndiyenera kukhala nthawi yayitali bwanji muchipatala?
• Ngati ndikuchokera kunja kwa mzinda. Nditakhala nthawi yayitali bwanji nditachita opareshoni?

Chiwonetsero

Ngakhale njira za phalloplasty zakhala zikuyenda bwino kwazaka zambiri, palibe njira yabwino kwambiri. Chitani kafukufuku wamtundu umodzi ndikulankhula ndi anthu ammudzimo musanapange chisankho cha mtundu wamankhwala operewera oyenera. Pali njira zina zopangira phalloplasty, kuphatikiza kulongedza komanso njira zowopsa zotchedwa metoidioplasty.