Umthondo omncane
i-Micropenis kuwumthondo omuncane,umbandela evamile iyi amaphiko(kulinganiswa phezulu) uqonde penile obuphelele okungenani 2.5 ngeziphambeko ejwayelekile lincane kusho ubukhulu womuntu umthondo, [1]noma umncane kakhulu kunalokho mayelana yomuntu omdala uma kuqhathaniswa nokwakhiwa okumaphakathi kwe- 12.5 centimetres (5 in) . [2] Isimo sivame ukuqashelwa ngemuva nje kokuzalwa.Leli gama livame ukusetshenziswa kwezokwelapha lapho lonke ipipi, i- scrotum, ne- perineum zingenakho ukungacaci, njenge- hypospadias .I-Micropenis yenzeka cishe ku-0.6% wabesilisa.[2]
Izimbangela
[hlela | Hlela umthombo]Ezimweni ezingajwayelekile ezihlotshaniswa ne-micropenis, iningi lezimo zokuncishiswa kokukhiqizwa kokubeletha kwe-androgen noma umphumela, njengokuthuthuka okungavamile kwamasende (i-testicular dysgenesis), i- Klinefelter syndrome, i- Leydig cell hypoplasia, amaphutha athile we- testosterone noma i-dihydrotestosterone synthesis ( 17,20-lyase defence, 5α-reductase defence ), androgen insensitivity syndromes, insider pituitary stimulation ( gonadotropin defence), nezinye izinhlobo ze- hypogonadism yokuzalwa. I-Micropenis nayo ingenzeka njengengxenye yama-syndromes amaningi we-malformation symromes angafaki ama-chromosomes ocansi. Kwesinye isikhathi kuyisibonakaliso sokuntuleka kokukhula kwama-hormone noma i-congenital hypopituitarism .Izakhi zofuzo eziningana ze- homeobox zithinta usayizi wepipi nowedijithi ngaphandle kokungajwayelekile kwe-hormone.
Ngaphezu kwalokho, ekuvezweni kwe-utero kweminye imishanguzo yokuzala esuselwe ku-estrogen efana ne- diethylstilbestrol (DES) ixhunyaniswe nokungajwayelekile kwezitho zobulili noma ipipi elincane kunejwayelekile.
Ngemva kokuhlaziywa ukuthola noma yimaphi izimo ezichazwe, micropenis zingaqhubekela iphathwa isakhasa nge imijovo ahlukahlukene hormone, ezifana womuntu gonadotropin chorionic futhi testosterone .
Iningi labafana abaneminyaka eyisishiyagalombili kuya kweleshumi nane ubudala abathunyelwe kuma-micropenis abanaso isimo se-micropenis. Ukukhathazeka okunjalo kuvame ukuchazwa ngokulandelayo:
- a umthondo ithukuswe amafutha suprapubic (lwamafutha engeziwe emhlabeni Mons pubis )
- umzimba omkhulu nohlaka uhlaka lwangaphambi kokubeletha oluvele luvele lincane kakhulu
- ukubambezeleka kokuthomba ngezizathu zonke zokulindela ukukhula kwesikhathi esizayo
Ukwelashwa
[hlela | Hlela umthombo]Ukwelashwa kweHormone
[hlela | Hlela umthombo]Ukukhula kwendoda kokubili ngaphambi kokuzalwa nangesikhathi sobuntwana nokuthomba kuthonywa kakhulu yi- testosterone futhi, ngezinga elincane, i- hormone yokukhula . Kodwa-ke, ama-hormone endogenous kamuva anenani elikhulu ekwelapheni i-micropenis ebangelwa ukusilela kwamahomoni, njenge- hypopituitarism noma i- hypogonadism .
Kungakhathalekile ukuthi iyini imbangela ye-micropenis, uma yaziwa isencane, inkambo emfushane ye-testosterone ivame [3] (imvamisa azikho ngaphezu kwezinyanga ezintathu). Lokhu kuvame ukukhuthaza ukukhula okuncane, okuqinisekisa amathuba okukhula okuqhubekayo lapho usuthomba, kepha kuyaqabukela kufinyelele kusayizi ojwayelekile. Ayikho i-testosterone eyengeziwe enikezwa ngesikhathi sobuntwana, ukugwema i- virilization engadingeki nokuvuthwa kwamathambo . (Kunobunye ubufakazi bokuthi ukuphatha i-testosterone ngaphambi kwesikhathi kungaholela ekwehliseni usayizi wepenis kumuntu omdala. ) [4]
Ukwelashwa kwe-testosterone kuqalwa kabusha ebusheni kubafana abane-hypogonadism kuphela. Ukukhula kwePenile kuqedwa ekugcineni kokuthomba, kufana nokuqedwa kokukhula kokuphakama, nokunikezwa kwe-testosterone eyengeziwe kubantu abadala abangemva kokubeletha kuveza ukukhula okuncane noma okungekho okunye.
Ukuhlinzwa
[hlela | Hlela umthombo]Ngoba ukwelashwa kwehomoni akuvamile ukufeza usayizi ojwayelekile, amasu amaningana okuhlinza afana ne- phalloplasty yokwandiswa kwepipi ahlelwe futhi enziwa, kepha ngokuvamile awathathwa njengempumelelo ngokwanele ukwamukelwa kabanzi futhi awavamile ukwenziwa ebuntwaneni.
Ezimweni ezimbi kakhulu ze-micropenis, awunawo noma yimuphi umphini, futhi i-glans ibonakala ihlala cishe esikhunjeni se-pubic. Kusukela ngawo-1960 kuya ngasekupheleni kweminyaka yama-1970, bekuvamile ukuthi kunconywe ukuphinda kunikezwe ucansi nokuhlinzwa. Lokhu bekungenzeka ikakhulukazi uma ubufakazi buphakamisa ukuthi impendulo ku-testosterone eyengeziwe ne-pubertal testosterone izoba mpofu. Ngokwamukelwa ngumzali, umfana wayezophinde anikezwe kabusha futhi aqanjwe kabusha njengentombazane, futhi kwenziwa ukuhlinzwa ukususa ama-testes nokwakha isitho sangasese sangasese . Lokhu kwakususelwa kumqondo osubuzwa manje wokuthi ubunikazi bobulili babunjwe ngokuphelele kusukela ekuhlalisweni komphakathi, nokuthi indoda enepipi elincane ayitholi ndawo eyamukelekayo emphakathini.
Isibhedlela iJohns Hopkins, isikhungo esaziwa kakhulu ngale ndlela, senze izabelo eziyishumi nambili kusukela ngo-1960 kuya ku-1980, ikakhulukazi owaDavid Reimer (onqenqemeni lwendoda yakhe lwacekelwa engozini yokusoka), enganyelwe nguJohn Money . Maphakathi nawo-1990s, ukwabelwa kabusha kwakungavamisile ukunikezwa, futhi womathathu amagceke ayephonswe inselelo. Izifundo zangaphambili zokuhlinzwa okunjalo, zizwakalisa ukungagculiseki kwazo ngomphumela wabantu abadala, zabamba iqhaza elikhulu ekuqedeni lo mkhuba. Ukunikezwa kabusha kwezocansi akuvamile ukwenziwa namuhla nge-micropenis ebucayi (yize kwesinye isikhathi kusadingidwa ngombuzo wokukhulisa umfana njengentombazane).
Imithombo
[hlela | Hlela umthombo]- ↑ Lee PA; Mazur T; Danish R et al (1980). "Micropenis. I. Criteria, etiologies and classification". The Johns Hopkins Medical Journal 146 (4): 156–63. PMID 7366061.
- ↑ 2.0 2.1 ScienceDaily.com (2004). "Surgeons Pinch More Than An Inch From The Arm To Rebuild A Micropenis," 6 Dec. 2004, URL accessed 2 April 2012.
- ↑ "Testosterone enanthate therapy is effective and independent of SRD5A2 and AR gene polymorphisms in boys with micropenis". J. Urol. 172 (1): 319–24. 2004. PMID 15201804.
- ↑ "Micropenis: does early treatment with testosterone do more harm than good?". J. Urol. 154 (2 Pt 2): 825–9. 1995. PMID 7609189.