Kusanzwisisika genitalia

Yakavanzika genitalia kuremara kwekubereka uko nhengo dzekunze dzisina chimiro chakajairika chemukomana kana musikana.

Iyo geni bonde remwana rinotemerwa pakubata. Zai rezai raamai rine X chromosome, nepo mbeu yemurume yababa iine X kana Y chromosome. Aya ma X uye Y ma chromosomes anosarudza bonde remwana.

Kazhinji, mucheche anogara nhaka 1 maviri echromosomes ebonde, 1 X kubva kuna amai uye 1 X kana imwe Y kubva kuna baba. Ivo baba "vanosarudza" jeni bonde remwana. Mucheche anowana nhaka yeCh chromosome kubva kuna baba ndeyechikadzi uye ane 2 X chromosomes. Mwana anowana nhaka y chromosome kubva kuna baba ndewemurume uye ane 1 X uye 1 Y chromosome.

Nhengo dzekuberekesa dzechirume neechikadzi nenhengo dzese dzesikarudzi dzinobva munyama imwe chete iri muchibereko. Genitalia isinganzwisisike inogona kukura kana maitiro anokonzeresa kuti fetus tishu kuti ive "yechirume" kana "yechikadzi" ikavhiringidzika. Izvi zvinoita kuti zvive zvakaoma kuzivisa zviri nyore mucheche semurume kana mukadzi. Kureba kwekusanzwisisika kunosiyana. Kashoma kwazvo, chitarisiko chemuviri chinogona kunge chakanyatso kuvandudzwa senzira yekusiyana kweiyo geni yebonde. Semuenzaniso, murume wechirume anogona kunge akagadzira chimiro chechikadzi chaicho.

Muzviitiko zvakawanda, genitalia isinganzwisisike mumageneti echikadzi (vacheche vane 2 X chromosomes) ane zvinotevera zvinhu:

• Yakawedzera clitoris inoita kunge diki mbichana.
• Iyo yekuvhura urethral (panobuda weti) inogona kuve chero iri pamwe, kumusoro, kana pasi pechiso cheiyo clitoris.
• Iwo marabi anogona kunge akasanganiswa uye anotaridzika kunge scrotum.
• Mwana angangofungidzirwa kuve murume ane machende asingadiwe.
• Dzimwe nguva bundu rezvinyama rinonzwika mukati meakasanganiswa marabi, zvichiwedzera kuitisa kuti itaridzike senzvimbo ine machende.

Mune genetic male (1 X uye 1 Y chromosome), genitalia isinganzwisisike kazhinji inosanganisira zvinotevera zvinhu:

• Mboro diki (isingasviki maviri kusvika matatu masendimita, kana 3/4 kusvika 1 1/4 mainchesi) inoratidzika kunge yakakwenenzverwa clitoris (iyo clitoris yemukadzi achangozvarwa inowanzo kuve yakati wandei pakuzvarwa).
• Iyo yekuvhura urethral inogona kuve chero kupi pamwe, kumusoro, kana pasi pemboro. Inogona kuve yakadzikira seye perineum, ichienderera mberi ichiita kuti mucheche aite kunge munhukadzi.
• Panogona kuve nechikwambo chidiki chakaparadzaniswa uye chinotaridzika kunge labia.
• Machende asina kubviswa anowanzoitika aine genitalia isinganzwisisike.

Kunze kwekusara kushoma, genitalia isinganzwisisike kazhinji haisi kutyisidzira hupenyu. Nekudaro, zvinogona kuumba matambudziko munharaunda kumwana uye nemhuri. Nechikonzero ichi, timu yenyanzvi vane ruzivo, vanosanganisira neonatologists, magene, endocrinologists, uye masayendisiti kana vashandi vezvemagariro vanove vanobatanidzwa mukutarisirwa kwemwana.

Zvinokonzera kusanzwisisika genitalia inosanganisira:

• Pseudohermaphroditism. Nhengo dzakavandika ndedzebonde rimwe chete, asi mamwe maitiro enyama ebonde aripo.
• Chokwadi hermaphroditism. Ichi chiitiko chisingawanzoitika, mune matishu kubva kune ese mairi uye machende aripo. Mwana anogona kunge aine zvikamu zvemurume nemukadzi.
• Yakasanganiswa gonadal dysgenesis (MGD). Iyi ihukama hwehukama, mune izvo zvimiro zvehurume (gonad, testis), pamwe nechibereko, nyini, uye fallopian machubhu.
• Kuberekwa adrenal hyperplasia. Iyi mamiriro ane mafomu akati wandei, asi fomu rakajairika kwazvo rinokonzera kuti mukadzi wechikadzi abve murume. Nyika zhinji dzinoyedza iyi inogona kutyisidzira hupenyu panguva yekuongororwa kwevana vachangoberekwa.
• Chromosomal kusagadzikana, kusanganisira Klinefelter syndrome (XXY) uye Turner syndrome (XO).
• Kana amai vakatora mimwe mishonga (yakadai se androgenic steroids), munhukadzi anokwanisa kutaridzika kunge murume.
• Kushaikwa kwekugadzirwa kwemamwe mahormone kunogona kukonzera kuti "embryo" ikure nemhando yemunhukadzi, zvisinei nebonde.
• Kushaikwa kwe testosterone maseru receptors. Kunyangwe kana muviri ukaita mahormone anodiwa kuti akure kuva murume chaiye, muviri haugone kupindura mahormone iwayo. Izvi zvinoburitsa mhando yemuviri wechikadzi, kunyangwe kana iyo geni yebonde iri murume.

Nekuda kweanogona kuitika munharaunda nemupfungwa mhedzisiro yeichi chiitiko, vabereki vanofanirwa kutora danho rekuti vorera mwana semurume kana mukadzi nekukurumidza mushure mekuongororwa. Zvakanakisa kana sarudzo iyi ikaitwa mukati memazuva ekutanga ehupenyu. Zvisinei, ichi chisarudzo chakakosha, saka vabereki havafanirwe kuchimhanyisa.

Bata wako mupi wezvehutano kana iwe uine hanya nezvechitarisiko chekunze kwemwana wako genitalia, kana mwana wako:

• Zvinotora anopfuura mavhiki maviri kuti uwanezve huremu hwekuzvarwa
• Kuri kurutsa
• Inoita seisina mvura (yakaoma mukati memuromo, pasina misodzi kana uchichema, asingasviki mana manapukeni akanyoro paawa makumi maviri nemana, maziso anotaridzika akanyura mukati)
• Ane chishuwo chakaderera
• Iine zvitema zvebhuruu (pfupi nguva apo yakaderedzwa huwandu hweropa hunoyerera mumapapu)
• Anonetseka kufema

Izvi zvese zvinogona kuve zviratidzo zvekuzvarwa adrenal hyperplasia.

Anovhiringidza genitalia anogona kuwanikwa panguva yekutanga zvakanaka-mucheche bvunzo.

Iye mupi achaita bvunzo dzepanyama dzinogona kuburitsa nhengo dzesikarudzi dzisiri "murume chaiye" kana "mukadzi chaiye," asi kumwe kuri pakati.

Iye mupi achabvunza nhoroondo yezvechiremba mibvunzo kuti abatsire kuona chero matambudziko echromosomal. Mibvunzo inogona kusanganisira:

• Kune here chero nhoroondo yemhuri yekuparara?
• Kune here chero nhoroondo yemhuri yekuberekwa?
• Iko kune chero nhoroondo yemhuri yekukurumidza kufa?
• Pane chero nhengo dzemhuri dzakange dziine vacheche vakafa mumavhiki mashoma ekutanga ehupenyu kana vaive neyakavanzika genitalia?
• Kune here chero nhoroondo yemhuri yechero ipi yematambudziko anokonzeresa genitalia?
• Ndeapi mishonga amai vakatora vasati kana panguva yepamuviri (kunyanya steroid)?
• Ndezvipi zvimwe zviratidzo zviripo?

Kuongorora genetic kunogona kuona kana mwana ari wemurume kana mukadzi. Kazhinji kamuenzaniso kadiki kemasero kanogona kubviswa kubva mukati mematama emwana kuyedzwa uku. Kuongorora masero aya kazhinji zvinokwana kuti uone kusangana pabonde kwemwana mucheche. Chromosomal ongororo ndeyeyakawanda bvunzo iyo inogona kudikanwa mune dzakawanda dzinopokana kesi.

Endoscopy, mudumbu x-ray, mudumbu kana pelvic ultrasound, uye bvunzo dzakafanana dzinogona kudikanwa kuona kuvepo kana kusavapo kwenhengo dzemukati (senge ma testes asina kukodzera).

Rabhoritari bvunzo dzinogona kubatsira kuona kuti nhengo dzekubereka dziri kushanda sei. Izvi zvinogona kusanganisira bvunzo dzeadrenal uye gonadal steroids.

Mune zvimwe zviitiko, laparoscopy, laparotomy yekuongorora, kana biopsy yemagonad ingangodikanwa kusimbisa kusagadzikana kunogona kukonzera genitalia isinganzwisisike.

Zvichienderana nechakakonzera, kuvhiya, kutsiva mahormone, kana kumwe kurapa kunoshandiswa kurapa mamiriro anogona kukonzeresa genitalia isinganzwisisike.

Dzimwe nguva, vabereki vanofanirwa kusarudza kurera mwana semurume kana mukadzi (zvisinei nema chromosomes emwana). Iyi sarudzo inogona kuita hukuru hwemagariro uye hwepfungwa pamwana, saka kurairwa kunowanzo kurudzirwa.

Ongorora: Kazhinji zvinehunyanzvi kurapa (uye nekudaro kurera) mwana seyemukadzi. Izvi zvinodaro nekuti zviri nyore kuti chiremba anovhiya agadzire genitalia pane kuita genitalia yechirume. Naizvozvo, dzimwe nguva izvi zvinokurudzirwa kunyangwe kana mwana ari genetically murume. Zvisinei, ichi chisarudzo chakaoma. Iwe unofanirwa kuzvikurukura nemhuri yako, mupi wemwana wako, chiremba anovhiya, wemwana wako endocrinologist, uye nedzimwe nhengo dzezvehutano.

Genital - zvakawanda

• Kukura kwekushungurudzika kwemukadzi uye vulva

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.

Rey RA, Josso N. Kuongorora uye kurapwa kwezvinetso zvekukura kwepabonde. Muna: Jameson JL, De Groot LJ, de Kretser DM, et al, eds. Endocrinology: Vakuru uye Chiremba. 7th ed. Philadelphia, PA: Elsevier Saunders; 2016: chits. 119.

Chena PC. Kukanganisika kwekusimudzira bonde. Mune: Goldman L, Schafer AI, eds. Goldman-Cecil Mushonga. 25th ed. Philadelphia, PA: Elsevier Saunders; 2016: chits. 233.

Chena PC. Congenital adrenal hyperplasia uye zvinetso zvinoenderana. Mune: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Chinyorwa chePediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020: chitsiko 594.