Varicocele e intsha esikhulakhulile: Izimbangela, ukwelashwa, imiphumela

varicose emithanjeni cord spermatic crimp - omunye pathologies kuvame kakhulu kwabesilisa. varicocele isiqongo zokuxilonga eneminyaka engu 14-15. Ngokuvamile iminyaka 15-30 - yilokho engu lapho angahlangani kwenzeka kaningi kunabo. Iningi yalesi sifo kubonakala umsubathi abantu behileleka okhandlayo. Ngakho-ke, singasho kugcwale bagomela ngokuthi umthwalo kwemisipha udlala indima ebalulekile ngemithambo intambo spermatic.

Lokhu zokugula has nomthelela obonakalayo besilisa umsebenzi zokuzala. Futhi uma ucabangela ukuthi lo varicocele ahlupheke-30% yesizwe sonkana wesilisa, ukuphuthuma inkinga kuba sobala.

Uyini varicocele?

Intambo Spermatic kuhlanganisa phakathi kwezinye izakhi kanye pampiniform plexus emithambo yegazi. Kuyinto lokhu futhi wamangala lapho ebona yenza varicocele. Ngemithambo intambo spermatic is pathologically washintsha, babe osuke usuvulekile futhi tortuous.

Kungani lokhu kwakwenzeka? Lesi sifo kwenzeka ngenxa yokwephulwa outflow emithambo yegazi, okuholela igazi aqoqana plexus emithambo yegazi, elula futhi deforming odongeni isitsha.

Etiology ka varicocele

Imikhumbi okuqondene simiso bakhiphe elezinga eliphansi vena cava, anemisila valve akhethekile, ngoba igazi ogeleza usuka phansi phezu kwabo. Ngaphandle kwale lithathelwe, iningi igazi nje ngeke Usufike inhliziyo; Nokho, ukuba khona kudivayisi valve kakhulu ngempumelelo ukuvimbela yokujama tsi legazi retrograde (nasemuva) ezinyakazayo yayo.

Isizathu esikhulu varicocele e intsha esikhulakhulile - ukwehluleka valve wamasende emthanjeni. Ngokuvamile, igazi lingena kusukela pampiniform plexus e umthambo kwezinso noma ngqo bakhiphe elezinga eliphansi vena cava ngokwayo ku emithanjeni wamasende. Lokho inkinga nezinga lokugcina valve futhi ziyimbangela eyinhloko lesi sifo.

Valvular esingamahlalakhona kungaba isiqalo (ngenxa kwezinso azalwa naso umthambo wamasende, ukuba buthakathaka kwezicubu noma ungqimba wokugcina we zezinzwa izicubu dysplasia) nokwesibili (ezivukayo ngenxa senyusa izinga lomfutho womoya simiso bakhiphe elezinga eliphansi vena cava noma vein kwezinso). Izimbangela secondary valve esingamahlalakhona kukhona zonke izinqubo sokugembula ukuthi cindezela spermatic intambo, wamasende, umthambo kwezinso noma ngqo bakhiphe elezinga eliphansi vena cava, okwenza kube nzima ngayo igazi kubo outflow :. Neoplasm hernia besisu, ukuvuvukala, njll kunjalo, kudala isimo lapho siqala igazi stagnate e imithambo yegazi yomuntu intambo spermatic.

Ukwahlukaniswa varicocele

UBANI uncoma ngezigaba elandelayo sifo:

1. plexus Vienna pampiniform kahle hhayi kuphela kuchazwa ngokuthinta kodwa futhi zibukeke lubonakale. Egg esishwabene.
2. Esebenzisa umfanekiso kungenziwa palpated, nakuba engabonakali.
3. Positive Valsalva iqhinga. Bheka noma palpate umthambo kuthiwa isampula akunakwenzeka.

Nokho, ezweni lethu ngokuvamile ezisetshenziswa ngezigaba Yu. F. Isakova. Yena kanye lowo odlule, ihlukanisa izigaba ezintathu, nakuba kobukhulu isifo kuvezwa oda reverse. Kubukeka kanje:

1. Vienna ongabonakali, kungukuthi kunqunywa touch. varicocele okusolwayo kungenzeka kuphela ngokususa Valsalva iqhinga.
2. Vienna kahle palpable, kodwa engabonakali.
3. Emithanjeni ebonakalayo futhi palpable. Iqanda Kushintshwe.

By the way! Valsalva iqhinga wenziwa kanje. Sibekezele imile ucelwa ukukhwehlela. Ngenxa yalokho, umfutho ngalo ingaphakathi lesisu liyaphuma, pampiniform vein plexus zigcwala. Ngokuvamile, i-Ngokuqhathanisa isampula wathi futhi wenziwa isikhundla lisalele. Kulokhu, isivivinyo izokhombisa ukuthi akanalo igciwane.

emitholampilo isithombe

Ngokuvamile varicocele e intsha esikhulakhulile kwenzeka ngaphandle emizweni subjective. Akuvamile, ezinye iziguli esekhala umuzwa wobukhulu noma ubuhlungu scrotum ngemva kokuzivivinya. Nokho, lezi zimpawu kufanele aphathwe ngokuqapha, ngoba ngokuvamile izimpawu zokuqala ukuvuvukala amasende neziqhumane yabo (orchitis futhi orchiepididymitis).

I esiyingozi varicocele?

Amasende ezingabantu - yindawo lapho kumiswa isidoda amangqamuzana, amangqamuzana lwegciwane, efaka umquba iqanda. Lemigwamanda kubaluleke kakhulu ngokuya iqhaza kwazo umsebenzi zokuzala.

Varicocele ngenxa yokugcwala ku plexus emithambo yegazi esiningi igazi ngenxa yendawo lokushisa kuyanda, okuyinto has nethonya elilimazayo spermatogenesis. Ngaphezu kwalokho, e varicocele liwohloka supply kwezicubu nge-oksijini amaseli wamasende kwenzeka hypoxia; iphazamiseke igazi-testis isithiyo, okungase kubangele isizukulwane omzimba, spermicides (ngoba ziqondakala izivikeli mzimba njengoba ejenti nobutha). Varicocele uvame ukuhambisana ukuphazamiseka hormone njengoba ithonya elibi inqubo spermatogenesis.

Amasende ezingabantu ezikhathalela kakhulu zonke lezi zinqubo, ngakho noma iyiphi kuzo kalula ukuphazamisa kumiswa sperm isidoda.

Kufanele kuphawulwe nokho, ukuthi indima varicocele kwetinhlavu ukungazali kusenziwa wafunda. Akuwona wonke umuntu okholelwa ukuthi izindlela ngenhla asenkulumweni pathogenesis ka varicocele e intsha. Ngakho-ke indima varicose emithanjeni cord spermatic ku ukungazali besilisa uhlala kancane impikiswano.

Yini okumelwe uyenze?

I ngokuvamile kutholakala ukuthi uphethwe yini varicocele e intsha. Ukwelashwa, ngokulandelana, wenziwa entsheni. Kuyinto, njengoba wazi, kuyinto zezinhlobo ezimbili: ngoludala futhi kuhlinzwa. Uma sikhuluma varicoceles e intsha, nanti iphuzu lokuqala ungakwazi ngokushesha ukubuswa out. ukuphathwa okulondoloza yalesi sifo alikho. Kodwa inani imisebenzi esetshenziswa ukuqeda iziguli lesi sifo likhulu.

Izinhlobo ukungenelela kuhlinzwa e varicocele

Yonke imisebenzi on the amasende zingahlukaniswa zibe amaqembu amaningana:

1. kokungenela Steel, esekelwe excision ka ngemithambo spermatic. Okwamanje, ayisasetshenziswa, ngoba ngemva Isicelo yabo-90% amacala yoma wamasende uyalandelwa.

2. Operations ukulungisa Iqanda izakhi we inguinal umsele noma imisipha aponeurosis. alisetshenziswa Manje, njengoba ephelezelwa yoma wamasende (20-70% of amacala).

3. resection ingxenye scrotum ne amaqanda yangaphandle latching. Varicocele Ukushiyeka kwenzeka Nokho, ngo-100% izimo, lokhu msebenzi nokungabi okwamanje esetshenziswa.

4. Ligation vein wamasende ngenhla crease inguinal. Lolu hlobo lwe-operation kuholela ukumisa we retrograde ukugeleza kwegazi futhi unikeza kulencane iphesenti kokushelela. Nokho, ucwaningo luye lwabonisa ukuthi varicocele akazibekanga zokugula njalo. Lesi sifo kungaba uphawu ukukhuluma yenkinga, okuholela nomfutho wegazi ophezulu emithambo yegazi. Kulokhu, lo msebenzi kungase babhebhethekisa lesi simo.

5. Operations ukudala anastomoses semithambo. Ingqikithi yabo itholakala lokuthi ukuthi Reflux emithambo yegazi inakekelwa, kodwa ngokudala anastomosis phinda inani Igazi eleqile kanye emithanjeni liyancipha.

Njengamanje, ekwelapheni varicocele e intsha esikhulakhulile operation - akusiyo njalo ukuphazamiseka olunzulu ngokuvula komgodi ongaphakathi kwamathumbu. Kunemithi yokwelapha kancane koda.

Ukuhlinzwa encane ukufinyelela

Ukusebenza ezivamile ukwelapha varicocele - Marmara. Wenza ngaphansi izinzwa wendawo. Imbilapho, kuthabathela ecaleni lapho lakhiwa inqubo sokugembula kwenziwa imbobo 2-3 cm. Kule ukufinyelela dissected izakhi intambo spermatic, onikezwe Vienna, ligature overtighten futhi ephambana. Isilonda sutured ngongqimba.

Njengoba ulandela kusukela incazelo msebenzi lalihlehliswa, futhi kungaba ngisho ukwenziwa esigulini esingalalisiwe esibhedlela. Sutures ziyasuswa ngosuku 8.

Postoperatively, phakathi nesonto lokuqala nenkanuko edlulele ezibalulekile scrotum (ibangelwa egqoke iziqu). Ngenyanga 1st kufanele sigweme izenzo zocansi.

ukwenza i-clip Laparoscopic

Enye indlela nge nomphumela omuhle yezimonyo. Ngokusebenzisa wokubhoboza odongeni kwamathumbu esebenzisa amathuluzi akhethekile isehlane wamasende vein, klipiruyut futhi aphambana kubo.

Kuqhathaniswa Ukuhlinzwa okukhulu, le ndlela kunezinzuzo eziningana:

1. Dlala isikhathi nasezinkingeni ezilandela ngemva kokuhlinzwa ngenxa ukungabi sekuyaphela amanxeba ngemuva kokuhlinzwa ezenziwa wokubhoboza hhayi ukusika.
2. Ayikho ingozi hernia nasezinkingeni ezilandela ngemva kokuhlinzwa.
3. A nomphumela omuhle yezimonyo.
4. Iya kancane sengozini yokuthola nasezinkingeni ezilandela ngemva kokuhlinzwa.

flebosklerozirovanie endovascular

Le ndlela kuyinto ehlukile ukuze ukuhlinzwa. essence yayo itholakala iqiniso ukuthi umthambo wamasende sclerosing ejenti yethulwa, ekhuthaza kumiswa ihlule kanye nokumiswa ukugeleza kwegazi ngokusebenzisa emthanjeni. It wenziwa kuphela uma kungekho isizathu ukuthi iqalise yesibili umphini esingamahlalakhona kanye nomfutho wegazi ophezulu emithambo yegazi.

Into esemqoka ukuqonda iziguli ezine varicocele, - isikhathi imisebenzi kubalulekile. It is wafakazela ukuthi ukwelashwa kusenesikhathi kakhulu kunciphisa ingozi iziyaluyalu spermatogenesis kanye kumiswa nenzalo.