Ukwandiswa kwamathambo akuchaphazeli kuphela imithwalo yegazi yamalungu angaphantsi, kodwa kunye nemithanjeni yentambo ye-spermatic. Le fom yeemvumba ze-varicose ixhaphakile kwixesha lokukhulelwa, ngokukodwa ekuqalekeni kokutshatyalaliswa kwentsha . Ngaphandle kolwaphulo olwaneleyo, isifo singakhokelela kwimiphumo engapheliyo.
Varikotsele - izizathu
I-urologists abazi ngokuqinisekileyo oko kuvusa ingxaki echazwe. Into ephambili eyenza imivimbo ye-varicose ye-testicle iyinzala. Ukuba izalamane zineengxaki ezifanayo zesisombululo, iinyawo ezinqamlekileyo okanye ukungaphumeleli kwentliziyo, umngcipheko wokukhula kwesifo kumntwana ukwanda kakhulu. Ezinye izizathu ezityholweyo ze-varicocele eziselula:
- iingxaki ze-hormonal ngokudibanisa nokungafihleli kwindonga;
- umsebenzi owenzela umzimba;
- ukuphazamiseka kwenkqubo yokutshintshiselwa;
- u bunzima ;
- Uxinzelelo lwegazi oluphezulu kwindawo ye-pelvic.
I-Varicocele - degree
Izigaba ezi-4 zokuqhubela phambili kwi-pathology zihlolwe. Kwinqanaba le-zero okanye kwi-subclinical, imiva iyancipha kancane. Ngeli thuba i-varicocele kubantwana ayinakufumaneka kwi-examination kunye neengcali, kodwa iimethambo zegazi ezitshintshileyo zibonakala xa zenza i-phlebography okanye i-ultrasound. Ifom yesiqhelo sesifo asihambisani naluphina iimpawu, ngoko ke akunqabile ukuba ufumaneke.
I-Varicocele i-1 degree kwi-adolescents
Isigaba esilula sesi sifo sibonakaliswe ngokunyuka okungapheliyo kweemvini zentambo ye-spermatic. Kwinqanaba eli-1 le-testicular varicocele, umntwana osemva akasenayo imiqondiso yeenguqu zengxubevange, kodwa ingxaki inokuthi ifunyanwe kuviwo lwe-urologist. Kule nto, uvavanyo oluthile luye lwaphuhliswa, ngexesha apho uxinzelelo lwe-intra-esiswini lukhula ngokwaneleyo. Isigaba sokuqala sokuqhubela phambili kwe-varicocele kwiintsholongwane ziphawulwe kakuhle ngexesha lophando lwe-hardware. Iimvumba zomsindo ziyahlukahlula nge-imagy ultrasound kunye neziphumo ze-phlebography.
Ii-Varicocele 2 degrees
Umlinganiselo wesilinganiso se-varicose ubizwa ngokugqithiseleyo, izitya ezonakalisiweyo zihlanjululwe ngaphandle kokuxhatshazwa kwesisu nokunyuka kwengcinezelo esiswini. Olu hlobo lwe-varicocele ebusheni luvame ukufunyaniswa ukuba lunxibelelwano olukhuselekileyo lweengcali. I-lumen enesibindi kwisigaba sesi-2 sesi sifo asikabi kakhulu, kodwa iindonga ze-vascular sele ziphantsi kokusasazeka. Le nkwenkwe inokuziva iimpawu zokuqala zentsholongwane.
I-Varicocele 3 degrees
Uhlobo lwesifo esicatshulwayo kulula ukubona nokuzihlola. Iimvumba ezonakalisiweyo zibonakala ngokucacileyo ngaphandle kwezixhobo zonyango kunye neemvavanyo zelabhoratri. I-teenage varicocele kuma-3 amanqanaba idibene ne-atrophy yechungechunge. Utshintsho luvame ukuhlangenwe nakho kumacala omabini e-scrotum, nangona iimvumba ze-varicose zithintele itekisi enye kuphela (kakhulu ngakwesobunxele). I-varicocele ebonakalayo kwiintsholongwane ihamba kunye nemibonakaliso ecacileyo yesifo. Abafana bacinga ukuba:
- ukungathandeki, ukuva ubunzima xa uhamba okanye umile;
- intlungu kwi-scrotum;
- iinkqubo ezingekho phantsi kweengqungquthela kwiingqungquthela;
- ukuvuvukala okanye ukuvuvukala kweendawo ezonakalisiweyo;
- ukwanda kwentlungu ngexesha lomzimba;
- i-asymmetry yamathambo;
- kunciphisa umthamo nokuxinwa kwamathambo.
Yiyiphi i-varikotsele eyingozi?
Kukho iziphakamiso zokuthi i-varicose veins in the testicles ingabangela ukuphela komsebenzi wabo (ukuveliswa kwesidoda) kunye ne-atrophy. Okwangoku kuphela kumadoda amakhulu aphakanyisiwe ukuxhamla kokungabikho kwempilo kunye ne-varicocele - iziphumo zesifo ekufikeni kwentsha azifundanga kakuhle. Iingxaki ezi zifundo zibangelwa ubunzima bokufumana inoda kumakhwenkwe ngaphambi kokuphela komntwana. Ngaphandle kwimeko yezinto eziphilayo, ayikwazi ukuqikelelwa ngokuchanekileyo ngokwemigangatho eqhelekileyo, kuba iikhompyutheni zomzimba kwixesha lokusasaza ziyahluka.
Indlela yokuchonga i-varicocele?
Qinisekisa i-pathology echazwe kumanqanaba okuqala kunzima ngenxa yokungabikho kwempawu ezithile kunye nokubonakaliswa kwesi sifo. Ngoncedo lweendlela zelabhoratri, nakhona, akunakwenzeka ukuchonga i-varicocele-ukuxilongwa kwe-blood test ye-hormones ayikho inkcazelo. Iimvumba ze-Varicose kwi-scrotum ayikho nto ebangela ukungalingani kwe-endocrine kwaye oku kwenzeka kuphela kwizigaba ezizayo.
Ukuchonga i-varicocele kwiintsholongwane ezi zinto zisetyenziswa:
- Vavanyo lweValsalva. Inkwenkwe iyacelwa ukuba ibambe umoya kwaye ixinzelele. Le ndlela ikhuthaza ukwanda kweengcinezelo ze-intra-esiswini kunye nokuvuvukala kweenqwelo ezithanjisiweyo.
- Uvavanyo lwe-Ultrasound. Le teknoloji inikeza ukuhlolwa okuthembekileyo kwimeko yeemvini kwaye ibonisa isimo se-scrotum kwiiplanethi ezi-3.
- Testiculometry. Ngoncedo lwesicoco esikhethekileyo (orchidometer), ubungakanani obuchanekileyo bamathambo buzimisele.
- Dopplerography . Inkqubo yocandelo lophando, ebonisa isimo semithambo yegazi, iindonga zazo.
- Ikhompyutha. Le teknoloji isetyenziswe ngokungafanekiyo, kuyimfuneko yokwahlukana kweemvumba ze-varicose ezivela emathunjini kwindawo ye-retroperitoneal kunye ne-thrombosis ye-vena cava.
- Phlebography. Uhlolisiso lusetyenziswa ikakhulu kubantu abadala. Intombazana inikwe kuphela ukuba ulwazi lwezinto ezikhethiweyo zingaphantsi.
Indlela yokuphatha i-varicocele?
Ubunzima bokunyanga ingxaki ekuqwalaselwe ngayo kumakhwenkwe enyaka yenguqu yengozi yokuhlaziya kwakhona. Ngethuba lokuphelelwa komntwana, ukuzaliswa kwemifuno kunye noxinzelelo ngaphakathi kwendawo yesisu kuya kutshintshwa ngokukhawuleza, ngoko kungcono ukuyeka ukunyanga de kube le ncinane ineminyaka eyi-12 ubudala (ngaphandle kokuba kukho impawu ezithile zeemvini ze-varicose).
Abazali abaninzi banomdla nokuba i-varicocele ngokwayo ingadlulela kumntwana. I-urologists ayiphendula lo mbuzo kakubi, ichaza isifo nakweyiphi na isigaba sokuphuhliswa. Indlela yodwa yokulwa ngokukhawuleza ukukhutshwa kwe-varicocele kwintsholongwane - unyango ngaphandle kokuhlinzwa alukaphuhliswa. Amachiza okanye iindlela zokupheka zemihla ngemihla zivelisa imiphumo efanelekileyo yokwelapha. Ukusetyenziswa kwabo okuzimeleyo kunokukhokelela kwiinkathazo ezingenakunyuswa, kubandakanyeka.
Varikotsele kwiintsholongwane - ukusebenza
Ngaphambi kokuba kuqeshwe ukungenelela kokungenelela, uvavanyo olucokisekileyo kunye nokuqhutyelwa kwezixhobo ezixhasayo okanye ezixhobo. Oku kunceda ukuqikelela ubungakanani kunye nobunzima be-varicocele kwiintsholongwane-nokuba ngaba umsebenzi ugqitywa kuphela yi-urologist esekelwe kwiziphumo ezifunyenweyo, iimpawu ezizimeleyo kunye nobudala benkwenkwe. Ukuba isigulane sincinci ukuba senze le nkqubo, imithanjeni ye-varicose isigaba sokulula okanye sokuqala sokuqhubela phambili, unyango lotyando lunokuhlehliswa. Kwiimeko ezinjalo, zikhawulelwe ukubeka esweni rhoqo nokulawula iimvavanyo.
Ukunyangwa kwamanyathelo okunyanga kwama-varicocele kwintsholongwane kuyenziwa ngeendlela ezininzi:
- laparoscopy;
- Indlela yeMarmara;
- ngoncedo lwe endovascular;
- inkqubo Ivanissevich.
Varicocele - laparoscopic operation
Uhlobo olwenziweyo olwenziweyo lokungenelela luyingcipheko encinci. Inkqubo yenziwa phantsi kwe-anesthesia jikelele, kodwa ayifuni ukulungiswa kwexesha elide. Emva kwe-laparoscopic therapy varicocele kwiintsholongwane ungaya ekhaya ngosuku olulandelayo. Inkqubo epheleleyo yokuphucula ifikelele kwiiveki ezingama-4, kodwa ezininzi izigulane zifuna iintsuku ezili-12 ukuya kwi-15 kuphela. Kusebenza njani i-varicocele kwishumi elivisayo:
- Igumbi lomzimba lizaliswe nekhabhoni dioxide ukuququzelela ukufikelela kwimifuno.
- I-tube ye-10-mm (trocar) efakwe kwindawo yendawo. Ikhamera yevidiyo encinci ifakwe kuyo.
- Ngamacala ayifaka ama-tromars angama-5-millimeter, asebenza njenge "tunnels" kwizixhobo zonyango.
- Iziqeshana ezikhethekileyo zifakwa kwiimvumba ezikhulisiweyo.
- Igobolondo yentambo ye-spermatic i-sutured.
- AmaTrocars athatyathwa. Amanxeba avela ekuphunyezweni kwawo aphezulu.
Varikotsele - ukusebenza kweMarmara
Le nqubo ithathwa njengeyona nto ibuhlungu, iyasebenza kwaye iphephile. I-varicocelectomy ye-microsurgical inexabiso elibalulekileyo ngaphezu kwezinye iindlela zokuphelisa inkqubo ye-varicocele - iMarmara kakhulu ayixhamli kunye neengxaki kwaye ibuyele kwakhona (ngaphantsi kwe-4% yamatyala), izicubu zixinzeleleke kakhulu, ukufunyanwa kwezibhedlele akudingeki. Inkqubo:
- Ekuphumeni kwentambo ye-spermatic phantsi kwe-anesthhesia yendawo, i-incision encinci yenziwa (kufika kwi-3 cm).
- Ukusebenzisa i-microscope okanye i-binocular loupe, ugqirha uyazibona iimvumba ezonakalisiweyo kwaye uzibopha.
- Isibhengezo sutured.
Ukuhlinzwa okwenziwe nge-Endovascular - varicocele
Olunye igama lomsebenzi ophenywayo phantsi kokuqwalaselwa lugxininiso lwe-vein. Olu hlobo lonyango lwe-varicocele kubantwana nakwishumi elivisayo alunqunywanga ngokukhawuleza ngenxa yezinto ezibonakalayo zophuhliso lomzimba kunye nobubanzi bemithambo yegazi. Kwindlela yokugcina i-endovascular, i-puncture ye-vein ye-femin vein. Ngalo, i-catheter eguquguqukayo ifakiwe, leyo ingena emanzini alandelayo:
- vena cava;
- umvini we-renal;
- umgca wetekisi.
Zonke izixhobo zenzeke phantsi kokulawulwa kwezixhobo ze-X-ray. Xa izixhobo zonyango zifikelele ekujoliswe kuyo, ukuphuma kwegazi kuvaliwe (ukuhlanganiswa) ngokufaka iplagi ekhethekileyo. Olu khetho lonyango lufanelekile ukulwa ne-varicocele kubantu abadala kunye nentsha engama-16-17 ubudala. Kule minyaka, ububanzi bemithambo yegazi lihambelana nobungakanani bekathetha yokucoca.
I-Operation Ivanissevich kwi-varikotsele
Uhlobo oluchaziweyo lwenkqubo ngendlela yokusebenza ifana nokugqitywa kwesihlomelo esipheleleyo. Ukusebenza Ivanissevich - izixhobo:
- Kwimimandla yeliac, ukufakwa kwe-oblique malunga ne-5 cm ubude benziwe.
- Ngaloo nto, ugqirha ufumana ukufikelela kummandla we-retroperitoneal, apho ufumanisa khona umlenze owonakele.
- Iinqanawa ezandisiweyo kunye namasebe asondeleyo afakwa.
- Inxeba yokugqirha iyakuthiwa, i-bandage eyinyumba isetyenziswe ukusuka phezulu.
Ukunyanzelisa kwenziwa phantsi kwe-anesthesia yendawo, kodwa inkwenkwe iya kufuneka ichithe iintsuku eziliqela kwiwadi yesibhedlele. Kwi-scrotum kuyimfuneko ukuba unxibe i-corset ekhethekileyo (iintsuku ezi-3-5), enika ukunciphisa ubuncinci bentambo ye-spermatic kunye nokunciphisa ubunzima be-syndrome yesifo. Izihlalo zisuswe emva kweentsuku eziyi-8 emva kokuhlinzwa.
Varicocele - iingxaki
Kunqabile kakhulu, iindlela ezahlukahlukeneyo zokungenelela ngophando zihlanganiswe nemiphumo emibi:
- i-edema yeengqungquthela (i-hydrocele);
- hematoma;
- usulelo lwebhaktheriya;
- umonakalo komnatha kunye nokuchasana;
- i-atrophic testicular;
- buhlungu;
- thrombophlebitis;
- ukuphuma kunye nabanye.
Ingozi enkulu emva kokunyangwa ngonyango varicocele - ukuphindaphinda. Ubungakanani bokuba kwenzeka kuyo kuxhomekeke kwinkqubo ekhethiweyo yokungenelela. Izinketho ezikhethiweyo zi:
- Umsebenzi waseMarmara;
- ukuqulunqwa kwesisu;
- laparoscopic ligation.