Ukwandiswa kwemvelo akuthinti kuphela imithwalo yegazi yamagatsha angaphansi, kodwa futhi nemithanjeni yentambo ye-spermatic. Leli fomu lama-varicose veins livame esikhathini sokukhulelwa, ikakhulukazi ekuqaleni kokukhulelwa kwentsha. Ngaphandle kokwelashwa okwanele, lesi sifo singaholela emiphumeleni engenakuguquka.
Varikotsele - izizathu
Abakwa-Urologists abazi kahle ukuthi yini eyenza inkinga ichazwe. Isici esiyinhloko esibangela i-varicose veins ye-testicle yi-heredity. Uma izihlobo zinezinkinga ezifanayo ze-vascular, izinyawo eziphansi noma ukuhluleka kwenhliziyo, ingozi yokuthuthukisa lesi sifo emntwaneni ikhula kakhulu. Ezinye izimbangela ezisolakala zokuthi i-varicocele intsha:
- ukuphazamiseka kwe-hormonal kuhlangene nokungaqiniseki kodonga lwama-venous;
- umsebenzi omzimba ojulile;
- ukuphazamiseka ngezinqubo zokushintshanisa;
- ukukhuluphala ;
- umfutho wegazi ophezulu endaweni yangasese.
I-Varicocele - degree
Izigaba ezine zokuqhubeka kwe-pathology ehlolwayo zenziwa. Esikhathini sesigaba se-zero noma se-subclinical, umvuthwandaba uhlanjululwa kancane. Phakathi nalesi sikhathi i-varicocele ezinganeni ayitholakali ekuhlolweni nomchwepheshe, kodwa izitsha zegazi eziguquliwe zibonakala lapho zenza i-phlebography noma i-ultrasound. Ifomu lesigqila lesi sifo aluhambisani nanoma yiziphi izimpawu, ngakho-ke akutholakali ukutholakala.
I-Varicocele i-degree 1 ebantwaneni
Isigaba esilula saleso sifo sibonakala ngokunyuka okungenjalo okuqhubekayo kwemithanjeni yentambo ye-spermatic. Ku-degree 1 ye-testicular varicocele, ingane ayinayo izibonakaliso zezishintshe zamasongo, kodwa inkinga ingatholakala ekuhlolweni kwe-urologist. Ngenxa yalokhu, kuqalwe ukuhlolwa okhethekile, lapho ukucindezeleka kwangaphakathi kwesisu kuya kwanda ngokwanele. Isigaba sokuqala sokuqhubekela phambili kwe-varicocele ebusheni kubhalwe kahle ngesikhathi sokucwaninga kwe-hardware. Ukuvuvukala kwemivimbo kuhlukaniswa ukucabanga kwe-ultrasound kanye nemiphumela ye-phlebography.
Varicocele 2 degrees
Ubukhulu besilinganiso se-varicose bubonakala kakhulu, izitsha ezilimazayo zihlanjululwa ngisho ngaphandle kokucindezeleka kwesisu futhi zanda ingcindezi yesisu. Leli fomu le-varicocele ekukhuleni livame ukutholakala ukuthi linokubonisana nokuzivikela kokuzivikela kwesazi. I-lumen enezinyosi esiteji sesi-2 sesi sifo ayisakaze kakhulu, kepha izindonga zamasongo sezivele zisekelwe. Umfana angakwazi ukuzwa izimpawu zokuqala ze-pathology.
I-Varicocele 3 degrees
Uhlobo oluthile lwesifo kulula ukubona nokuzihlola. Izindwangu ezonakalisiwe zibonakala ngokucacile ngaphandle kwemishini yezokwelapha kanye nokuhlolwa kwelabhorethri. I-teenage varicocele ngezigaba ezintathu ihlanganiswe ne-atrophy ye-testicle. Izinguquko zivame ukuhlangenwe nakho ezinhlangothini zombili ze-scrotum, ngisho noma imivimbo ye-varicose ithinte isicathulo esisodwa kuphela (ikakhulu ngakwesobunxele). I-varicocele ebonakalayo ebantwaneni ihambisana nokubonakaliswa okusobala kwesifo. Abafana bazizwa:
- ukungathandeki, ukuzwa ubuhlungu ngenkathi uhamba noma umile;
- ubuhlungu ku-scrotum;
- ama-sinuous formations formations esihlokweni;
- ukuvuvukala noma ukuvuvukala kwezindawo ezilimele;
- ubuhlungu obukhulu ngesikhathi sokusebenza komzimba;
- i-asymmetry yamathambo;
- ukunciphisa ivolumu nobukhulu bama-testicles.
Iyini i-varikotsele eyingozi?
Kukhona iziphakamiso ukuthi i-varicose veins emaqenjini ingabangela ukuphela kwemisebenzi yabo (ukukhiqizwa kwesidoda) kanye ne-atrophy. Kuze kube manje kwabesilisa abadala kuphela abaye baboniswa ukuxhunywa kokungabi nabantwana kanye ne-varicocele - imiphumela yesifo ekukhuleni ayifundwanga kahle. Izinkinga kulezi zifundo zibangelwa ubunzima bokuthola isidoda kubafana ngaphambi kokuthomba kokugcina. Ngisho nalapho kukhona izinto eziphilayo, akukwazi ukulinganiswa ngokwethembeka ngokuvumelana nemigomo ejwayelekile, ngoba izinkomba zomzimba esikhathini sokudlula ziyahlukahluka kakhulu.
Indlela yokubona i-varicocele?
Qinisekisa ukuthi i-pathology echazwe ekuqaleni kulukhuni ngenxa yokuntuleka kwezibonakaliso ezithile nokubonakaliswa kwalesi sifo. Ngosizo lwezindlela ze-laboratory, futhi, akunakwenzeka ukubona i-varicocele - ukuxilongwa kokuhlolwa kwegazi kwama-hormone akuyona imininingwane. Imivimbo ye-Varicose e-scrotum ayifuni neze ukungalingani kwe-endocrine futhi lokhu kwenzeka kuphela ezinkathini ezisheshayo.
Ukunquma i-varicocele kwabasakhulayo amasu alandelayo asetshenziswa:
- Uhlolo lweValsalva. Umfana ucelwa ukuba abambe umoya wakhe futhi aqine kakhulu. Le ndlela yenza ukuba ukwanda kwe-intra-esiswini kwengcindezi nokuvuvukala kwemikhumbi ehlanjululwe.
- Ukuhlolwa kwe-Ultrasound. Lolu buchwepheshe lunikeza ukuhlolwa okunokwethenjelwa kwesimo semithanjeni futhi kubonisa isimo se-scrotum ezindizeni ezingu-3.
- I-Testiculometry. Ngosizo lwedivayisi ekhethekile (i-orchidometer), ubukhulu obuqondile bama-testicles bunqunywa.
- I-Dopplerography . Inqubo ye-apparatus yocwaningo, ekhombisa isimo semithambo yegazi, izindonga zawo.
- I-computer ye-tomography. Lolu buchwepheshe lusetshenziselwa ukungavamile, kubalulekile ukuhlukaniswa kwemivamisa ye-varicose kusuka emathunjini endaweni ye-retroperitoneal kanye ne-thrombosis ye-vena cava.
- I-Phlebography. Ucwaningo lusetshenziselwa kakhulu amadoda amadala. Intsha isabelwe kuphela uma ulwazi lwezinketho zangaphambilini luphansi.
Indlela yokuphatha varicocele?
Inzima yokwelapha inkinga ecatshangelwe kubafana beminyaka yobudala yengozi yingozi yokubuyela emuva okulandelayo. Ngesikhathi sokukhulelwa, ukugcwaliswa kwemifino nokucindezela ngaphakathi kwesikhala sesisu kuguquguqukayo njalo futhi ngokuphawulekayo, ngakho-ke kungcono ukuhlehlisa ukwelashwa kuze kube yilapho insizwa ineminyaka engu-12 ubudala (ngaphandle uma kunezimpawu ezithile ze-varicose veins).
Abazali abaningi banesithakazelo sokuthi i-varicocele ngokwayo ingadlula yini kusukela ebusheni. Ama-urrologists ayiphendula lo mbuzo ngokungathandeki, okuchazwe yisifo kunoma yisiphi isigaba sokuthuthukiswa akupheli. Indlela kuphela yokulwa ngokuphumelelayo ukukhishwa kwe-varicocele kwabaselula - ukwelashwa ngaphandle kokuhlinzwa akukakhiwa. Ayikho imikhiqizo noma imifino yabantu eveza umphumela wokwelapha okufanelekile. Ukusetshenziswa kwabo okuzimele kungaholela ezinkingeni ezingenakuguquka, kubandakanya ukungabi nabantwana.
I-Varikotsele entsheni - ukusebenza
Ngaphambi kokuba kuqashwe ukuhlinzekwa okuhlinzekwa ngokuhlinzwa, ukuhlolwa okuphelele nokwenziwa kokuhlolwa kwezinsimbi noma izinsimbi kwenziwa. Lokhu kusiza ukucacisa ubukhulu nobukhulu be-varicocele kwabaselula - ngabe ngabe ukusebenza kunqunywa kuphela yi-urologist esekelwe emiphumeleni etholakalayo, izimpawu ezizimele kanye nobudala bomfana. Uma isiguli sisencane kakhulu ukuba senze le nqubo, imivimbo ye-varicose isesiteji esilula noma sokuqala sokuqhubekela phambili, ukwelapha ukwelashwa kungahlehliswa. Ezimweni ezinjalo, zilinganiselwe ukuqapha nokulawula okujwayelekile kwezivivinyo.
Ukwelapha okwakhiwa kwamanje kwe-varicocele entsheni kwenziwa ngezindlela eziningana:
- i-laparoscopy;
- indlela yeMarmara;
- ukungenelela okungapheli;
- inqubo Ivanissevich.
Ukusebenza kwe-Varicocele - laparoscopic
Uhlobo olungenisiwe lwe-intervention intervention luyingozi kakhulu. Inqubo yenziwa ngaphansi kwe-anesthesia jikelele, kodwa ayidingi ukuvuselelwa isikhathi eside. Ngemuva kwe-laparoscopic therapy varicocele ezinganeni ungakwazi ukuya ekhaya ngosuku olulandelayo. Inkambo ephelele yokuphulukisa ingamaviki angu-4 ubukhulu, kodwa iziguli ezincane kakhulu zidinga izinsuku ezingu-12-15 kuphela. Ukusebenza kwe-varicocele kwentsha:
- Isigxobo sesisu sesigcwele i-carbon dioxide ukusiza ukufinyelela emithanjeni.
- I-tube-10 mm (i-trocar) efakwe endaweni yenkaba. Ikhamera yevidiyo encane ifakwe kuyo.
- Ezingxenyeni zifakwe ama-trogars angu-5-millimeter, asebenza ngokuthi "imigudu" yemishini yezokwelapha.
- Iziqeshana ezikhethekile zifakwe emithanjeni ekhulisiwe.
- Igobolondo yethambo ye-spermatic i-sutured.
- Ama-trocars akhishwa. Amanxeba avela ekusebenziseni kwawo ayenziwa sutured.
Varikotsele - ukusebenza kwe-Marmara
Le nqubo ibhekwa njengenabuhlungu kakhulu, ephumelelayo futhi ephephile. I-varicocelectomy ye-Microsurgical inezinzuzo ezibalulekile ngaphezu kwezinye izindlela zokuqeda inqubo ye-varicocele - Inqubo ye-Marmara ayikho kangako ehlangene nezinkinga futhi ibuyele emuva (ezingaphansi kwezingu-4% zamacala), ama-tissue ahlukumezeke kancane, akudingeki ukuba izivakashi zifakwe esibhedlela. Inqubo:
- Ekuphumeni kwentambo ye-spermatic ngaphansi kwe-anesthesia yendawo, ukucubungula okuncane kwenziwa (kufika ku-3 cm).
- Usebenzisa i-microscope noma i-loupe ye-binocular, udokotela uthola izivungu ezilimazayo futhi uzibopha.
- Ukukhwabanisa kukhishwa i-sutured.
Ukuhlinzeka nge-Endovascular - varicocele
Elinye igama lenqubo yokuhlinzekwa okucatshangelwayo yindlela yokwenza imithi. Ukwelashwa okunjalo ku-varicocele ezinganeni nasebancane akuvamile ukushiwo ngenxa yezici zokuthuthukiswa ngokomzimba kanye nobubanzi bemithwalo yegazi. Ngokwenqubo yokuqeda izidakamizwa, kukhishwa umvuthwandaba omkhulu wesisu. Ngalo, i-catheter eguquguqukayo ifakwe, okunye engena emithini elandelayo:
- i-inferior vena cava;
- i-veal renal;
- i-vein ye-testicle.
Zonke ukuxhaphazwa kwenzeka ngaphansi kokulawulwa kwezixhobo ze-X-ray. Lapho imishini yezokwelapha ifinyelela kulitshe, ukugeleza kwegazi kuvinjelwe (ukuhlanganiswa) ngokufaka ipulagi ekhethekile. Lolu khetho lwezokwelapha lungcono kakhulu ukulwa ne-varicocele kubantu abadala kanye nentsha engaphezu kweminyaka engu-16-17 yobudala. Kule minyaka yobudala, ububanzi bemithini yegazi bufana nobukhulu be-catheter yokuhlinza.
Ukusebenza i-Ivanissevich ku-varikotsele
Uhlobo oluchazwe lwenqubo ngendlela yokukhipha kufana nokugqama kwesithasiselo esikhishwe. Ukusebenza Ivanissevich - imishini:
- Esikhathini se-aliac, ukuqubuka kwe-oblique okungaba ngu-5 cm ubude kwenziwa.
- Ngalo, udokotela ohlinzayo uthola ukufinyelela esifundeni se-retroperitoneal, lapho ethola khona umvini owonakele.
- Umkhumbi owandisiwe kanye namagatsha aseduze ayaboshwa.
- Inxeba yokuhlinzwa i-sutured, ibhande eliboshwe lisetshenziswa kusuka phezulu.
Ukuhlukunyezwa kwenziwa ngaphansi kwe-anesthesia yendawo, kepha umfana uzobe eseqedile ukuchitha izinsuku eziningana esigcemeni esibhedlela. Ku-scrotum kudingekile ukuba ugqoke i-corset ekhethekile exhasayo (izinsuku ezingu-3-5), ehlinzeka ukunciphisa uhlobo lwezintambo ze-spermatic kanye nokunciphisa ubukhulu be-syndrome yobuhlungu. Iziqephu zisuswe ngemuva kwezinsuku ezingu-8 emva kokuhlinzwa.
Varicocele - izinkinga
Okungavamile kakhulu, ukuhlukahluka okuhlinzekwa kokuhlinzekwa kokuhlinzwa kuhlangene nemiphumela emibi:
- i-edema ye-testicle (i-hydrocele);
- i-hematoma;
- ukutheleleka kwebhaktheriya;
- ukulimala komthambo kanye nokuhlukumeza;
- i-atrophy ye-testicular;
- ubuhlungu obungapheliyo;
- i-thrombophlebitis;
- ukuphuma nokunye.
Ingozi enkulu ngemuva kokwelapha ukwelashwa varicocele - ukubuyela emuva. Amathuba okutholakala kwalo ancike endleleni ekhethiwe yokungenela okuhlinzekwa. Izinketho ezikhethwa kakhulu kunazo zonke:
- Umsebenzi we-Marmara;
- ukuhlanganiswa kwe-vein;
- ligation laparoscopic.