Kukura kwekushungurudzika kweiyo mukadzi genital turakiti

Kukura kwekushungurudzika kwenzvimbo yekubereka yevakadzi matambudziko ari munhengo dzekubereka dzemwana musikana. Zvinoitika iye achiri kukura mudumbu raamai vake.

Nhengo dzechikadzi dzekubereka dzinosanganisira mukadzi, mazamu, chibereko, uye chibereko.

Mwana anotanga kuvandudza nhengo dzake dzekubereka pakati pemavhiki mana ne5 epamuviri. Izvi zvinoenderera kusvika vhiki ye20 yepamuviri.

Iko kuvandudza inzira yakaoma. Zvinhu zvakawanda zvinogona kukanganisa maitiro aya. Dambudziko remwana wako rakakura sei zvinoenderana nekuti kukanganiswa kwakaitika riini. Kazhinji, kana matambudziko akaitika pakutanga mudumbu, mhedzisiro yacho ichave yakapararira.Zvinetso mukukudziridzwa kwemitezo yekubereka yemusikana inogona kukonzerwa ne:

• Akaputsika kana kushaya majini (genetic defect)
• Kushandiswa kwemimwe mishonga panguva yekuzvitakura

Vamwe vacheche vanogona kuve nehurema mumagen'a avo ayo anotadzisa muviri wavo kuburitsa enzyme inonzi 21-hydroxylase. Iyo adrenal gland inoda iyi enzyme kugadzira mahormone akadai secortisol uye aldosterone. Aya mamiriro anonzi congenital adrenal hyperplasia. Kana mwana musikana achiri kukura akashaya enzyme iyi, anozozvarwa aine chibereko, mazai, uye mazamu machubhu. Zvisinei, nhengo dzake dzekunze dzinoita sedzinowanikwa pane vakomana.

Mimwe mishonga inotorwa naamai inogona kupfuura muropa remwana uye inokanganisa kukura kwenhengo. Mumwe mushonga unozivikanwa kuita izvi ndeye diethylstilbestrol (DES). Vanoona nezvehutano vakamboraira mushonga uyu kuvakadzi vane nhumbu kudzivirira kubata pamuviri nekukurumidza basa. Nekudaro, vesaenzi vakadzidza kuti vacheche vasikana vakazvarwa nevakadzi vakatora mushonga uyu vaive nechibereko chisina kujairika. Mushonga uyu wakawedzerawo mikana yevanasikana yekuvandudza chimiro chisingawanzoitika chegomarara remukadzi.

Mune zvimwe zviitiko, hosha yekukura inogona kuoneka nekukurumidza kana mwana achangozvarwa. Zvinogona kukonzera kutyisidzira hupenyu mumwana achangoberekwa. Dzimwe nguva, mamiriro acho haana kuongororwa kusvikira musikana akura.

Iyo yekubereka nzira inokura padhuze neiyo weti uye itsvo. Inokura zvakare panguva imwe chete nedzimwe nhengo dzinoverengeka. Nekuda kweizvozvo, matambudziko ekusimudzira mune echikadzi nzira yekubereka dzimwe nguva inoitika nematambudziko mune dzimwe nzvimbo. Idzi nzvimbo dzinogona kusanganisira iyo weti turakiti, itsvo, ura, uye pasi musana.

Dambudziko rekuvandudza remukadzi rekubereka rinosanganisira:

• Intersex
• Kusanzwisisika genitalia

Zvimwe kusagadzikana kwekusimukira kwenzvimbo yechikadzi yekubereka inosanganisira:

• Cloacal kusagadzikana: Iyo cloaca iri chubhu-senge chimiro. Mumatanho ekutanga ebudiriro, iyo weti turakiti, rectum, uye nyinyo zvese zvisina chinhu mune ino imwechete chubhu. Gare gare, iyo nharaunda nhatu dzinoparadzaniswa uye dzine yavo yakavhurika. Kana iyo cloaca ichiramba sekukura kwemwana musikana mudumbu, kuvhurika kwese hakugadzire uye kupatsanuka. Semuenzaniso, mwana anogona kuzvarwa aine chete kuvhura kuzasi kwemuviri padyo nenzvimbo yakatenderera. Weti netsvina hazvigone kubuda mumuviri. Izvi zvinogona kukonzera kuzvimba kwemudumbu. Kumwe kusagadzikana kwekuvhara kunogona kukonzera mwana musikana kuti aite kunge ane nhengo yemurume. Uku kuremara kwekuzvarwa kushoma.
• Matambudziko ekunze kwekunze: Matambudziko ekuvandudza anogona kutungamira kune yakazvimba clitoris kana yakasanganiswa labia. Yakabatanidzwa labia mamiriro apo mapfundo etinyama akakomberedza kuvhurika kwemukadzi akabatanidzwa pamwechete. Mazhinji mamwe matambudziko ezvekunze kwekunze ane hukama nehukama hwepabonde uye husina kujairika genitalia.
• Imperforate hymen: Iyo hymen idumbu rakatetepa iro pamwe rinovhara kuvhura kuchikadzi. Iyo isina kukwana hymen inovhara zvachose kuvhura kwemukadzi. Izvi zvinowanzo kutungamira mukuzvimba kunorwadza kwemukadzi. Dzimwe nguva, hymen inongova neakavhurika kadiki kana maburi madiki. Dambudziko iri rinogona kunge risingawanikwe kusvika pakuyaruka. Vamwe vana vasikana vanozvarwa vasina hymeni. Izvi hazvionekwe senge zvisina kujairika.
• Matambudziko eOvarian: Mwana musikana anogona kunge aine imwe ovary, mamwe matissue akasungirirwa kune ovary, kana zvivakwa zvinonzi ovotestes zvine zvese zvechirume neechikadzi.
• Matambudziko muchibereko uye pamuromo wechibereko: Mwana musikana anogona kuzvarwa aine rimwe chibereko nechibereko, chibereko chakaumbwa nehafu, kana kuvhara kwechibereko. Kazhinji, vasikana vanozvarwa vaine hafu yechibereko uye imwe hafu yemukadzi vanoshaya itsvo kudivi rimwe chete remuviri. Kazhinji kazhinji, chibereko chinogona kuumba nepakati "madziro" kana septum muchikamu chepamusoro chechibereko. Musiyano wechikanganiso ichi unoitika apo murwere anozvarwa nemuromo wechibereko asi uteri maviri. Chibereko chekumusoro dzimwe nguva haitaudzane nemuromo wechibereko. Izvi zvinotungamira kuzvimba uye kurwadziwa. Zvese uterine zvisina kujairika zvinogona kusanganiswa nenyaya dzekubereka.
• Matambudziko epamuviri: Mwana musikana anogona kuzvarwa asina nyini kana kuvhurika kusangana nekutsi kwemukadzi kwakadzivirirwa netaundi remasero akakwirira kumusoro mukati memukadzi pane pane hymen. Vakadzi vasipo kazhinji kazhinji nekuda kwaMayer-Rokitansky-Kuster-Hauser syndrome. Mune ino syndrome, mwana ari kushaya chikamu kana ese emukati nhengo yekubereka (chibereko, chibereko chechibereko, uye fallopian machubhu). Zvimwe zvakasarudzika zvinosanganisira kuve nemadzimai maviri emadzimai kana nyinyo inovhurika irimumugini weti. Vamwe vasikana vanogona kunge vane chibereko chakaita semoyo kana chibereko chine madziro pakati pegomba.

Zviratidzo zvinosiyana zvinoenderana nedambudziko chairo. Zvinogona kusanganisira:

• Mazamu haakure
• Haukwanisi kudurura dundira
• Bundu munzvimbo yemudumbu, kazhinji nekuda kweropa kana mamota asingakwanise kubuda
• Kuenda kumwedzi kunoitika kunyangwe uchishandisa tampon (chiratidzo chechipiri nyinyo)
• Kukanganiswa kwemwedzi kana kurwadziwa, pasina kuenda kumwedzi
• Kwete kuenda kumwedzi (amenorrhea)
• Marwadzo nebonde
• Kudzokororwa kwepamuviri kana kuberekwa kwekutanga (kungave kuri nekuda kwechibereko chisina kujairika)

Iye mupi anogona kuona zviratidzo zvechirwere chekukura ipapo. Zviratidzo zvakadaro zvinogona kusanganisira:

• Kusagadzikana nyinyo
• Cervix isina kujairika kana kushayikwa
• Dundira kunze kwemuviri
• Nhengo dzakaomarara kuzivikanwa semusikana kana mukomana (genitalia isina kujeka)
• Labia izvo zvakanamatira pamwe kana zvisina kujairika muhukuru
• Hapana kuvhurika munzvimbo yekubereka kana imwe chete rectal kuvhura
• Kuzvimba clitoris

Nzvimbo yedumbu inogona kunge yakazvimba kana bundu mukati meguruva kana dumbu rinogona kunzwika. Mupiro anogona kuona kuti chibereko hachinzwi chakajairika.

Miedzo inogona kusanganisira:

• Endoscopy yemudumbu
• Karyotyping (kuongorora majini)
• Mahomoni eHormone, kunyanya testosterone uye cortisol
• Ultrasound kana MRI yenzvimbo yepelvic
• Weti uye serum electrolytes

Vanachiremba vanowanzo kupa zano kuvhiyiwa kwevasikana vane matambudziko ekukura enhengo dzemukati yekubereka. Semuenzaniso, mukadzi akavharika anogona kugadziriswa nekuvhiyiwa.

Kana mwana musikana akashaya mukadzi, mupi anogona kunyorera dilator kana mwana asvika pazera rekukura. Chinosudurusa mudziyo unobatsira kutambanudza kana kukudza nzvimbo panofanirwa kunge pane nhengo yemukadzi. Izvi zvinotora mwedzi mina kusvika kumitanhatu. Kuvhiya kunogona kuitwawo kuti vagadzire nyowani nyowani. Kuvhiya kunofanirwa kuitwa apo mukadzi wechidiki anokwanisa kushandisa dilator kuchengetedza nyinyo nyowani yakavhurika.

Mhedzisiro yakanaka yakataurwa nezvose zviri zviviri nzira dzekuvhiya uye dzekuvhiya.

Kurapa kweacacacal kusagadzikana kunowanzo sanganisira kuvhiya kwakaomarara kwakawanda. Uku kuvhiya kunogadzirisa matambudziko neiyo rectum, mukadzi, uye weti turakiti.

Kana kuremara kwekuzvara kuchikonzera kuuraya kunetseka, kuvhiya kwekutanga kunoitwa nguva pfupi mushure mekuberekwa. Kuvhiya kwehumwe hutachiona hwekuvandudza kubereka kunogona kuitwawo apo mwana achiri mucheche. Kumwe kuvhiya kunogona kunonoka kusvika mwana akura zvakanyanya.

Kuonekwa kwekutanga kwakakosha, kunyanya mumamiriro ehunhu husina kujairika. Anokupa anofanira kutarisa nokungwarira asati afunga kuti mwana mukomana kana musikana. Izvi zvinonzi zvakare kupa murume kana murume. Kurapa kunofanirwa kusanganisira kuraira kwevabereki. Mwana anozodawo kurairwa pavanenge vachikura.

Izvi zvinotevera zviwanikwa zvinogona kupa rumwe ruzivo nezve akasiyana mabudiro ebudiriro:

• CARES Foundation - www.caresfoundation.org
• DES Chiito USA - www.desaction.org
• Intersex Sosaiti yeNorth America - www.isna.org

Kusanzwisisika kwecloacal kunogona kukonzera matambudziko anouraya pakuzvarwa.

Zvinogona kuitika zvinogona kuitika kana kuongororwa kwacho kukanonoka kana kutadza. Vana vane genitalia isinganzwisisike vanopihwa murume mumwe chete vanogona kuzowanikwa vaine nhengo dzemukati dzakanangana nebonde rakapesana nekwavakakurira. Izvi zvinogona kukonzera kushushikana kwakanyanya kwepfungwa.

Matambudziko asina kuzivikanwa munzira yekubereka yemusikana inogona kutungamira mukushaya mbereko uye kunetseka pabonde.

Mamwe matambudziko anoitika mushure mehupenyu anosanganisira:

• Endometriosis
• Kuenda mukushandirwa kare kare (preterm delivery)
• Zvinorwadza mapundu emimba anoda kuvhiyiwa
• Kudzokororwa kwepamuviri

Fonera waunopa kana mwanasikana wako aine:

• Nhengo dzisina kujairika dzinoratidzika
• Hunhu hwevanhurume
• Kurwadziwa kwepachivande kwemwedzi uye kupwanya, asi hakuendi kumwedzi
• Kwete kutanga kuenda kumwedzi nezera regumi neshanu
• Hapana kukura kwemazamu pakuyaruka
• Hapana vhudzi repabhawa pakuyaruka
• Mapundu asina kujairika mudumbu kana kugomera

Vakadzi vane nhumbu havafanirwe kutora chero chinhu chine mahormone echirume. Vanofanira kutarisa nemubatsiri vasati vatora chero rudzi rwemishonga kana zvinowedzera.

Kunyangwe amai vakaedza zvese kuita nhumbu ine hutano, matambudziko ekukura mumwana anogona achiri kuitika.

Congenital kuremara - kusangana nekutsi kwemukadzi, mazai, chibereko, uye chibereko; Kuremara kwekuzvarwa - kusangana nekutsi kwemukadzi, mazai, chibereko, uye chibereko; Kukura kwekusagadzikana kwenzvimbo yekubereka yevakadzi

• Kukura kwekushungurudzika kwemukadzi uye vulva
• Kuberekwa uterine anomalies

Dhayamondi DA, Yu RN. Kukanganisika kwekusimudzira bonde: etiology, ongororo, uye manejimendi manejimendi. Mune: Wein AJ, Kavoussi LR, Partin AW, Peters CA, eds. Campbell-Walsh Urology. 11th ed. Philadelphia, PA: Elsevier; 2016: chits. 150.

Eskew AM, Merritt DF. Vulvovaginal uye mullerian anomalies. Mune: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Chinyorwa chePediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020: chitsamba 569.

Kaefer M. manejimendi yekusagadzikana kweiyo genitalia muvasikana. Mune: Wein AJ, Kavoussi LR, Partin AW, Peters CA, eds. Campbell-Walsh Urology. 11th ed. Philadelphia, PA: Elsevier; 2016: chitsiko 149.

Rackow BW, Lobo RA, Lentz GM. Kuzvarwa kwakasarudzika kweiyo yekubereka yevakadzi: anomalies emukadzi, chibereko, chibereko, uye adnexa. Mune: Lobo RA, Gershenson DM, Lentz GM, Valea FA, eds. Yakakwana Gynecology. 7th ed. Philadelphia, PA: Elsevier; 2017: chits. 11.