Phimosis

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I-Phimosis yisimo lapho ijwabu lobudoda lingakwazi ukwelula khona ukuvumela ukuthi libuyiselwe emuva lidlule i- glans . [1] Ukuvuvukala okufana nebhaluni ngaphansi kwejwabu kungenzeka ngokuchama. [1] Ebusheni nasebantwini abadala, kungahle kube nobuhlungu ngesikhathi sokumiswa, kepha kungenjalo akubuhlungu. [1] Labo abathintekile basengozini enkulu yokuvuvukala kwe-glans, eyaziwa njenge- balanitis, nezinye izinkinga. Erect_phimosis


Ezinganeni ezincane, kuyinto ejwayelekile ukungakwazi ukubuyisa ijwabu nhlobo.Ngaphezu kwamacala angama-90% axazululwa eneminyaka eyisikhombisa, yize ukuhoxiswa okugcwele kusavinjelwe ukunamathiselwa kokuqina okungaphezulu kwengxenye engaphezu kwalesi sikhathi. [2]Ngesinye isikhathi, i-phimosis ingabangelwa yisimo esingaphansi kwesibazi ngenxa ye- balanitis noma i- balanitis xerotica obliterans . [2] Lokhu kungatholakala ngokutholakala kokubola kokuvulwa kwejwabu. [2]

Imvamisa, isimo sixazululwa ngaphandle kokwelashwa sineminyaka engu-18. [3] Akufanele kuzanywe imizamo yokubuyisa ijwabu ngesikhathi seminyaka yokuqala yokuphila kowesilisa. [4] Kulabo isimo esingathuthuki kubo, isikhathi singanikezwa noma ukhilimu we-steroid ungasetshenziswa ukuzama ukukhulula isikhumba esiqinile. [4] Uma le ndlela, kuhlangene umzimba esisuka, akuyona ngempumelelo, bese ezinye izindlela zokwelapha ezifana ukusoka kungenzeka Kunconywa.Inkinga engaba khona ye-phimosis yi- paraphimosis, lapho ijwabu eliqinile livaleleka ngemuva kwe-glans. [2] Leli gama livela esiGrekini φίμωσις phimōsis 'muzzling'.

Izimpawu nezimpawu[hlela | Hlela umthombo]

Umthondo ongagundiwe one-phimosis - 1978

Ekuzalweni kwakhe, ungqimba engaphakathi ijwabu ivaliwe kuya glans umthondo.Ijwabu livame ukungahlehleki zisencane, kanti abanye besilisa bangafika eminyakeni eyi-18 ngaphambi kokuba ijwabu labo lihoxiswe ngokuphelele. [5]

Izinhlangano zososayensi bezokwelulekwa ukuthi zingalihoxisi ijwabu losana, ngenhloso yokuvimbela izibazi.Abanye bathi ukungabuyiseli emuva "kungathathwa njengokujwayelekile kwabesilisa kuze kufike ebusheni." [6] [7]UHill uthi ukuhoxiswa ngokugcwele kwejwabu kungenzeka kungatholakali kuze kube sekwephuzile noma ebudaleni. [8]Ucwaningo lwaseDenmark lwathola ukuthi iminyaka yobudala yokuqala yokuhoxa ijwabu yiminyaka eyi-10.4. [9]

URickwood, kanye nabanye ababhali, uphakamise ukuthi i-phimosis yangempela itholakale ngokweqile ngenxa yokwehluleka ukuhlukanisa phakathi kokungajwayelekile okubuyela emuva kokuthuthuka kanye nesimo se-pathological. [10] [11] [12] Abanye ababhali basebenzisa amagama athi "physiologic" kanye "pathologic" ukuhlukanisa phakathi kwalezi zinhlobo ze-phimosis; [13] abanye basebenzisa igama elithi "ijwabu elingabuyiseli emuva" ukuhlukanisa lesi simo sokukhula ne-pathologic phimosis. [10]

Kwezinye izimo imbangela ingahle ingacaci, noma kungaba nzima ukuhlukanisa i-phimosis yomzimba ne-pathological phimosis uma usana lubonakala lunokungazizwa kahle ngenkathi lichama noma lukhombisa ibhaluni elisobala lejwabu. Kodwa-ke, ukufaka amabhaluni akubonisi ukuvinjelwa komchamo. [14]

Kwabesifazane, isimo esilinganayo saziwa njenge- "clitoral phimosis", lapho i- clitoral hood ingeke ihoxiswe, kunciphise ukuvezwa kwe- glans clitoridis . [15]

Ubunzima[hlela | Hlela umthombo]

Icala elijwayelekile le-phimosis
  • Isilinganiso 1: ukuhoxiswa ngokugcwele kwejwabu, liqinile ngemuva kwe-glans.
  • Isigaba 2: ukuvezwa okuyingxenye kwama-glans, i-prepuce (hhayi ukubambelela kokuzalwa) into ekhawulelayo.
  • Isikolo 3: ukuhoxa okuyingxenye, inyama ebonakala nje.
  • Amaphuzu 4: ukuhoxa kancane, kepha ibanga elithile phakathi kwethiphu nocwecwe, okungukuthi inyama nenyama ayikwazi ukudalulwa.
  • Amaphuzu 5: akukho ukuhoxiswa kwejwabu. [16]

Imbangela[hlela | Hlela umthombo]

Kunemibandela emithathu yemishini evimbela ukuhoxa kwejwabu:

  • Ithiphu lejwabu lincane kakhulu ukudlula umthondo we-glans. Lokhu kujwayelekile ezinganeni nasebusheni. [17] [18]
  • Ingaphakathi langaphakathi lejwabu lihlanganiswe ne-glans penis. Lokhu kujwayelekile ezinganeni nasebusheni kodwa okungavamile kubantu abadala. [18]
  • I- frenulum mfushane kakhulu ukuvumela ukuhoxiswa okuphelele kwejwabu (isimo esibizwa nge- frenulum breve ). [18]

I-pathological phimosis (ngokungafani nokungabuyiseki kwemvelo kwejwabu ebuntwaneni) akuvamile, futhi izimbangela ziyahlukahluka.Amanye amacala angavela ku- balanitis (ukuvuvukala kwepenisi ye-glans). [19]

I-lichen sclerosus et atrophicus (okucatshangwa ukuthi iyisimo esifanayo ne-balanitis xerotica obliterans ) ithathwa njengesizathu esivamile (noma esiyinhloko) [20] se-pathological phimosis. [21] Lesi yisimo sesikhumba semvelaphi engaziwa esenza ukuthi indandatho emhlophe yezicubu ezifakwe ngaphakathi (i-cicatrix) yakhe ngasemaphethelweni we-prepuce.Lesi sicubu se-inelastic sivimbela ukuhlehla.

I-Phimosis ingavela ngemuva kwezinye izinhlobo zokuvuvukala okungapheli (njenge- balanoposthitis ), i- catheterization ephindaphindwayo, noma ukuhlehliswa kwejwabu ngenkani.

I-Phimosis nayo ingavela kubantu abanesifo sikashukela abangalashwa ngenxa yobukhona be-glucose emchameni wabo okwenza ukutheleleka kujwabu. [22]

UBeaugé uqaphele ukuthi imikhuba engajwayelekile yokushaya indlwabu njengokucindezela umbhede noma ukugcoba ijwabu phambili ingadala i-phimosis.Iziguli zelulekwa ukuba ziyeke ukwandisa amasu okushaya indlwabu futhi zikhuthazwa ukushaya indlwabu ngokuhambisa ijwabu phezulu naphansi ukuze zilingise ngokuseduze isenzo socansi.Ngemuva kokunikeza lesi seluleko uBeaugé waphawula ukuthi akakaze ancome nakanye ukusoka. [23] [24]

I-Phimosis ezinganeni ezindala nakubantu abadala ingahluka ngobukhulu, kanti abanye bayakwazi ukuhoxisa ijwabu labo ngokwengxenye (i-phimosis ehlobene), kanti abanye abakwazi ngokuphelele ukuhoxisa ijwabu labo, noma ngabe ipipi lisesimweni esibucayi (i-phimosis ephelele).

Ukwelashwa[hlela | Hlela umthombo]

I-Physiologic phimosis, ejwayelekile kwabesilisa abaneminyaka eyi-10 nangaphansi, ijwayelekile, futhi ayidingi ukungenelela. [17] [25] [26] Ijwabu elingabuyiseli emuva livame ukuhlehliswa ngesikhathi sokuthomba . [26]

Uma i-phimosis ezinganeni ezindala noma kubantu abadala ingabangeli izinkinga ezinzima nezimbi, izindlela zokuhlinza zingasebenza.Ukhetho lwezokwelapha luvame ukunqunywa ukuthi ukusoka kubhekwa njengokukhetha kokugcina noma njengenkambo oyithandayo. 

Kuhlinzwa[hlela | Hlela umthombo]

I-Preputioplasty:



Umdwebo 1. Umthondo onendandatho eqinile ye-phimotic okwenza kube nzima ukuhoxisa ijwabu.


Umdwebo 2. I-Foreskin ihoxisiwe ngaphansi kwe-anesthetic ngendandatho ye-phimotic noma i- stenosis evimba umphini wepipi futhi yakha "okhalweni".



Umdwebo 3. Ukuqhekeka kuvalwe kamuva.



Umdwebo 4. Umthondo onesikhumba sejwabu esithukululiwe ubuyiselwe esikhundleni se-glans.

Isibikezelo[hlela | Hlela umthombo]

Inkinga ebucayi kunazo zonke yi- paraphimosis Kulesi simo, i-glans ivuvukile futhi ibuhlungu, kanti ijwabu livinjelwa ukuvuvukala endaweni ehoxisiwe kancane. Umthondo osondele kakhulu uyimbaba. Olunye ucwaningo luthole i-phimosis njengengozi yokugcinwa komchamo [27] kanye ne- carcinoma yesitho sangasese sowesilisa . [28]

  1. 1.0 1.1 1.2 Empty citation (help)
  2. 2.0 2.1 2.2 2.3 Pathologic and physiologic phimosis: approach to the phimotic foreskin. March 2007.  Cite error: Invalid <ref> tag; name "Mc2007" defined multiple times with different content
  3. "Natural Foreskin Retraction in Intact Children and Teens". Peaceful Parenting.
  4. 4.0 4.1 Empty citation (help)
  5. "Phimosis in children". ISRN Urology 2012: 707329. 5 March 2012. doi:10.5402/2012/707329. PMC 3329654. PMID 23002427. http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=3329654. 
  6. Troubles with the foreskin: one hundred consecutive referrals to paediatric surgeons. September 2003. 
  7. Gairdner was wrong. October 2010. http://www.cfp.ca/content/56/10/986.2.long. 
  8. Circumcision for phimosis and other medical indications in Western Australian boys. June 2003. http://www.mja.com.au/public/issues/178_11_020603/matters_arising_020603-1.html. 
  9. [Pathological or physiological phimosis?]. April 2005. Archived from the original on 2016-02-07. https://web.archive.org/web/20160207060238/http://www.phimosis.ca/VP44785.pdf. Retrieved 2021-10-11. 
  10. 10.0 10.1 "Is phimosis overdiagnosed in boys and are too many circumcisions performed in consequence?". Annals of the Royal College of Surgeons of England 71 (5): 275–7. September 1989. PMC 2499015. PMID 2802472. http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=2499015. "Authors review English referral statistics and suggest phimosis is overdiagnosed, especially in boys under 5 years, because of confusion with developmentally nonretractile foreskin." 
  11. "Circumcision for phimosis and other medical indications in Western Australian boys". The Medical Journal of Australia 178 (4): 155–8. February 2003. PMID 12580740. . Recent Australian statistics with good discussion of ascertainment problems arising from surgical statistics.
  12. "Cost-effective treatment of phimosis". Pediatrics 102 (4): E43. October 1998. PMID 9755280.  A review of estimated costs and complications of 3 phimosis treatments (topical steroids, praeputioplasty, and surgical circumcision). The review concludes that topical steroids should be tried first, and praeputioplasty has advantages over surgical circumcision. This article also provides a good discussion of the difficulty distinguishing pathological from physiological phimosis in young children and alleges inflation of phimosis statistics for purposes of securing insurance coverage for post-neonatal circumcision in the United States.
  13. "Pathologic and physiologic phimosis: approach to the phimotic foreskin". Canadian Family Physician 53 (3): 445–8. March 2007. PMC 1949079. PMID 17872680. http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=1949079. 
  14. Ballooning of the foreskin and physiological phimosis: is there any objective evidence of obstructed voiding?. August 2004. 
  15. "The prevalence of phimosis of the clitoris in women presenting to the sexual dysfunction clinic: lack of correlation to disorders of desire, arousal and orgasm". Journal of Sex & Marital Therapy 28 (Suppl 1): 181–5. 2002. doi:10.1080/00926230252851302. PMID 11898701. 
  16. The response of phimosis to local steroid application. pp. 329–332. 
  17. 17.0 17.1 Analysis of shape and retractability of the prepuce in 603 Japanese boys. November 1996.  Cite error: Invalid <ref> tag; name "kayaba" defined multiple times with different content
  18. 18.0 18.1 18.2 Further fate of the foreskin. Incidence of preputial adhesions, phimosis, and smegma among Danish schoolboys. April 1968. 
  19. Balanitis and balanoposthitis: a review. June 1996. 
  20. [The sclero-atrophic lichen as principal cause of acquired phimosis in pediatric age]. 
  21. Common skin disorders of the penis. 
  22. Phimosis as a presenting feature of diabetes. Archived from the original on 2013-01-05. https://archive.today/20130105075939/http://www3.interscience.wiley.com/journal/118508219/abstract?CRETRY=1&SRETRY=0. Retrieved 2021-10-11. 
  23. The causes of adolescent phimosis. http://www.cirp.org/library/treatment/phimosis/beauge2/. 
  24. Conservative Treatment of Primary Phimosis in Adolescents. http://www.cirp.org/library/treatment/phimosis/beauge/. 
  25. Prepuce: phimosis, paraphimosis, and circumcision. February 2011. 
  26. 26.0 26.1 Further fate of the foreskin. Incidence of preputial adhesions, phimosis, and smegma among Danish schoolboys. April 1968. 
  27. [A case of urinary retention caused by true phimosis]. June 2008. 
  28. Penile cancer: importance of circumcision, human papillomavirus and smoking in in situ and invasive disease. September 2005.