Varikotsele muvechidiki - maitiro emazuva ano ekurapa

Kuwedzera kwechipatara kunobata kwete mutezo yeropa yemakumbo ezasi, asiwo mitsetse yepermatic cord. Ichi chimiro chevaricose vevine chinowanzosvika munguva yekuyaruka, kunyanya panguva yekutanga kwekuyaruka kwekuyaruka . Pasina kurapa kwakakwana, chirwere chinogona kutungamirira kumigumisiro isingaoneki.

Varikotsele - zvikonzero

Urologists haazive chaizvo chinokonzera dambudziko rinotsanangurwa. Chinhu chinonyanya kukonzera varicose mitsipa yechinyorwa isheredity. Kana hama dziine zvirwere zvakafanana zvevascular, zvakasimba tsoka kana mwoyo kusakundikana, mukana wekuvandudza chirwere mumwana zvakanyanya kuwedzerwa. Zvimwe zvinokonzerwa nezvikonzero zvevaricocele muvechiri kuyaruka:

• Hemonal disorders pamwe neveousous wall insufficiency;
• basa rakasimba remuviri;
• kuvhiringidzika mukutsinhanisa nzira;
• overweight ;
• kukwirira kweropa mukati munharaunda.

Varicocele - degree

Zvikamu zvina zvekufambira mberi kwechirwere chekuongorora zvakaongororwa. Pazero kana subclinical stage, mitsetse inoputika zvishoma. Munguva iyi varicocele muvana haigoni kuwanikwa pakuongororwa nemumwe nyanzvi, asi mishonga yeropa yakachinjwa inoonekwa pakuita phlebography kana ultrasound. Chimiro chemukati chechirwere hachifambidzwi nezviratidzo, naizvozvo hazviwanzoongororwa.

Varigocele 1 degree muvechiri kuyaruka

Chikamu chakareruka chechirwere chinoratidzwa nekuwedzera kusingagumi kwemitsipa yepermatic cord. Pa1 degree of testicular varicocele, wechidiki haana zviratidzo zvekuchinja kwemapurisa, asi chinetso chinogona kuongororwa pamubvunzurudzo weurologist. Nokuda kweizvi, muedzo wakakosha wakagadzirwa, panguva iyo mukati-mimba kudzvinyirira kunowedzera kuwedzera. Chikamu chekutanga chekuenderera mberi kwevarongeri muvechiri kuyaruka chakanyatsoratidzwa panguva yekutsvakurudza kwezvinhu. Kudzora mitsipa kunosiyana nemifananidzo ye ultrasound nemigumisiro yephlebography.

2 degrees

Ivhareji yakasimba yevaricose inonyanya kuzivikanwa, midziyo yakakanganiswa inoputika kunyange pasina kusagadzikana kwemuviri uye yakawedzera kumanikidzwa kwemuviri. Ichi chimiro chevaricocele muvechiri kuyaruka chinowanzoongororwa nehurongwa hwekudzivirira hwekudzivirira weimwe nyanzvi. Izvo zvinokonzera maronda pachigamba chechipiri chechirwere chisati chave chakawedzerwa zvakanyanya, asi masvingo evascula anenge atova kutarisirwa. Mukomana anokwanisa kunzwa zviratidzo zvokutanga zvehutano.

3 degrees

Kurondedzera rudzi rwechirwere zviri nyore kuona nekuzviongorora. Zvipembenene zvakakuvadzwa zvinonyatsooneka pasina michina yezvokurapa uye kuongororwa kwe laboratori. Teenage varicocele pazvikamu zvitatu zvakabatanidzwa neatrophy ye testicle. Kuchinja kunowanzoitika kumativi ose echando, kunyange kana varicose mitsetse yakakanganisa imwe nyanzvi (kunyanya kuruboshwe). Severe varicocele muvechiri kuyaruka inofambidzana nekuratidzika kwekliniki zviratidzo zvechirwere. Vakomana vanofunga:

• kusuruvara, kunzwa kusuruvara apo uchifamba kana umire;
• marwadzo muzvinyorwa;
• sinuous subcutaneous formations mu testicle;
• kuzvimba kana kuzvimba kwezvinhu zvakakanganisika;
• kurwadziwa kukuru panguva yekushanda;
• semakumbo emakumbo;
• kuderera kwehuwandu uye huwandu hwemasti.

Ndezvipi zvinokonzera varikotsele?

Pane mazano ayo varicose veins mumatsetse anokwanisa kukanganisa kupera kwemaitiro avo (kubereka kwehuta) uye atrophy. Kubva ikozvino muvanhu vakuru chete vakaratidzwa kuwirirana kwekushaya vana uye varicocele - migumisiro yechirwere muhucheche haina kunyatsodzidza. Matambudziko mune zvidzidzo ndeyekuoma kwekuwana mbeu mukati mevakomana vasati vasvika pakupedzisira. Kunyangwe muhupo hwezvinhu zvehupenyu, hazvikwanisi kutaridzirwa zvakaenzana maererano nemirairo yakatarwa, nokuti zvirevo zvenyama mu pubertal period zvakasiyana zvikuru.

Nzira yekuziva varicocele?

Iva nechokwadi chokuti chirwere chinorondedzerwa mumatangiro epakutanga chakaoma nekuda kwekushaya kwezviratidzo zvakananga uye kuratidzwa kwechirwere ichi. Nekubatsira kwema laboratory, zvakare, hazvigoneki kuziva varicocele - kuongororwa kweropa kuongororwa kwehomoni hakuzi kuzivikanwa. Varicose mitsipa mumaprotum kazhinji haisi kukonzera kusagadzikana kwekupedzisira uye izvi zvinowanikwa mumatanho ekupedzisira.

Kuti uone varicocele muvechiri kuyaruka nzira dzinotevera dzinoshandiswa:

1. Valsalva test. Mukomana wacho anobvunzwa kuti arambe achifema uye akasimba zvakasimba. Iyi nzira inokurudzira kuwedzera mukati memimba-mumimba nekudzivirira kwemidziyo yakanyanyisa.
2. Ultrasound kuongorora. Iyi teknolojia inopa kuongororwa kwakavimbika kwechiitiko chemitsipa uye inoratidza mamiriro ezvinhu epakati mumapuraneti matatu.
3. Testiculometry. Nekubatsirwa kwechigadzirwa chinokosha (orchidometer), kukwana chaiyo kwemakumbo kunotsanangurwa.
4. Dopplerography . Iyo nzira yekugadzira yekutsvakurudza, kuratidza mamiriro emidzi yemaropa, masvingo avo.
5. Computer tomography. Iyi teknolojia inoshandiswa kazhinji, zvinodiwa kuti kusiyana kwevaricose mitsemara kubva mumatumbu mu retroperitoneal zone uye thrombosis ye vena cava.
6. Phlebography. Chidzidzo chacho chinonyanya kushandiswa kuvanhu vakuru. Mumwe wechidiki anogoverwa bedzi kana ruzivo rwemakasarudzo apfuura rwakaderera.

Nzira yekurapa varicocele?

Kuoma kwekurapa dambudziko riri kuongororwa muvakomana vezera rekutsvaga ndega njodzi yekudzoka zvakare. Munguva yekuyaruka, kuzadzwa kwemitsipa uye kuomeswa mukati mechivanze chemuviri nguva dzose uye zvakanyanya kuchinja, saka zviri nani kudzorerazve kurapwa kusvikira jaya iri nemakore gumi nemaviri (kunze kwekunge pane zviratidzo zvevaricose vevine).

Vabereki vakawanda vanofarira kana varicocele ivo pachavo inogona kubva kubva kumwana wechidiki. Urologist inopindura mubvunzo uyu zvisina kunaka, iyo yakatsanangurwa chirwere pane imwe nhanho yekubatsira haina kumira. Nzira chete yekugadzirisa kurwisa iko kutsvaga kubviswa kwevaricocele muvechiri kuyaruka - kurapwa pasina chirwere chisati chagadzirwa. Hapana mishonga kana mapoka mapoka anobudisa zvakakodzera kurapwa kwemaitiro. Kushandiswa kwavo pachavo kunogona kutungamirira kumatambudziko asingagadziriswi, kusanganisira kushaya.

Varikotsele muvechidiki - basa

Kusati kwatemwa kwekupindira kwekuvhiya, kuongorora kwakakwana nekuita kwechigadzirwa kana chigadzirwa chekushandisa kunoitwa. Izvi zvinobatsira kutsanangurira zvakadzama uye zvakakomba zvevariccele muvechiri kuyaruka-kana basa racho rinosarudzwa chete neurologist zvichienderana nemigumisiro yakawanikwa, zviratidzo zvepamusoro uye nguva yemukomana. Kana murwere ari muduku zvikuru kuti aite chirongwa ichi, varicose mitsemara iri pane imwe nzvimbo kana nyore yekutanga yekufambira mberi, chirwere chekuvhiya chinogona kusarudzwa. Mumamiriro ezvinhu akadaro, ivo vanongopera kuongororongedza nekudzivirira kwee testes.

Mazuva ano kurapwa kwevaricocele muvechiri kuyaruka kunoitwa nenzira dzakawanda:

• laparoscopy;
• nzira yeMarma;
• endovascular intervention;
• nzira Ivanissevich.

Varicocele - laparoscopic operation

Mhando yakatarwa yokupindira inopinda inowanzosavhiringidza. Nzira yacho inowanikwa pasi peanesthesia yakawanda, asi haifaniri kutora nguva refu yekugadzirisa. Mushure mokunge laparoscopic therapy varicocele muvechiri kuyaruka unogona kuenda kumba mangwana. Nzira yakazara yekugadzirisa inosvikira masvondo makumi mana, asi varwere vaduku vakawanda vanongoda mazuva 12-15 chete. Iko kushanda kwevaricocele mumusikana wechidiki:

1. Dumbu remuviri rakazadzwa necarbon dioxide kuti zvive nyore kuwana mishonga.
2. A 10-mm tube (trop) inowanikwa munzvimbo inoverengeka. Ikamera yemavhidhiyo kamera inowanikwa kuburikidza nayo.
3. Pamativi akaiswa ma-5-millimeter makwikwi, ayo anoshandiswa se "tunnels" yemishonga yezvokurapa.
4. Zvikamu zvakanakisisa zvinowanikwa pamakumbo akawedzerwa.
5. Ikosi yepermatic cord is sutured.
6. Trocars inobviswa. Mavanga kubva pakugadzirisa kwavo anogunun'una.

Varikotsele - kushanda kweMarmara

Iyi nzira inofungidzirwa kuti inorwadza, inoshanda uye yakachengeteka. Microsurgical varicocelectomy ine zvinokosha kune dzimwe nzira dzokubvisa varicocele - Marmara nzira inowanzosangana nehutano uye hudzoka zvakare (zvishoma pane 4% dzezviitiko), mishonga inoshungurudzika zvishoma, kushandiswa muzvipatara hazvidiwi. Nzira:

1. Pamugumo wepermatic cord pasi peanesthesia yemunharaunda, kudonhedzwa kuduku kunoitwa (kusvika 3 cm).
2. Achishandisa microscope kana binocular loupe, chiremba anoona mishonga yakakanganisika uye anoisunga.
3. The incision is sutured.

Kuvhiyiwa kwekupedzisira - varicocele

Imwe zita rekuvhiya kunoitwa pamusoro pekugadziriswa kwekudzivirira kwemuviri. Kurapa kwakadai varicocele kuvana nevechiri kuyaruka hazviwanzogadziriswa nekuda kwezvinhu zvekukura mumuviri uye upamhi hwemitsipa yeropa. Nokuda kwegadziriro yekugadziriswa kwegadziriro, kuvharwa kwemuviri mukuru wevakadzi kunoitwa. Nayo, catheter inoshandiswa yakaiswa, iyo inopinda mukati memidziyo inotevera:

• inferior vena cava;
• renal vein;
• the vein of the testicle.

Zvose zvinoshandiswa zvinowanikwa pasi pekutonga kwei-X-ray mafura. Apo mishonga yezvokurapa inosvika pakatarisana, ropa rinopfigirwa (kubata) nekuisa paki inokosha. Iyi nzira yekurapa inonyanya kukodzera kurwisa varicocele kune vanhu vakuru nevechiri kuyaruka kupfuura makore gumi nemakore gumi nemaviri. Panguva ino, upamhi hwemidziyo yeropa hunofanana nehukuru hwekatheta yekuvhiya.

Operation Ivanissevich pa varikotsele

Rudzi rwakarondedzerwa rwehutano nenzira yekutonga inofanana nekukanganiswa kwezvakawedzererwa. Operation Ivanissevich - midziyo:

1. Munharaunda yeiacac, kusvibiswa kweblique kwema 5 cm murefu yakaitwa.
2. Kuburikidza naro, chiremba anovhiya anokwanisa kuwana nzvimbo ye retroperitoneal, kwaanowana mhepo yakakanganiswa.
3. Imbiyo yakasimbiswa uye matavi ari pedyo akaputirwa.
4. Ronda rekuvhiya rinogunun'una, bhanhire risina kumira rinoshandiswa kubva kumusoro.

Kushushikana kunoitwa pasi peanesthesia yemunharaunda, asi mukomana achazopedza mazuva anoverengeka muwadi yechipatara. Pamusoro pezvinyorwa zvinodiwa kuti ufukidze ruzivo rwakasimudzira (corset) mazuva matatu (3-5), iyo inopa kuderedzwa kwemaitiro emudonzvo wechirwere uye kuderera mumusana wechirwere chirwere. Seams vanobviswa shure kwemazuva 8-9 mushure mekuvhiyiwa.

Varicocele - zvinetso

Hazviwanzoitiki, zvikamu zvakasiyana-siyana zvoupurogiramu dzokuvhiya zvinosanganiswa nemigumisiro yakaipa:

• edema ye testicle (hydrocele);
• hematoma;
• bhakitiriya utachiona;
• kukanganisa muyeri uye vas deferens;
• testicular atrophy;
• chronic pain;
• thrombophlebitis;
• kubuda ropa uye vamwe.

Dambudziko guru kana mushure mekurapwa varicocele - kuorazve. Kuita kwekuitika kwayo kunoenderana nenzira yakasarudzwa yekupindira. Izvo zvinosarudzwa zvikuru ndezvokuti:

• Marmara operation;
• embolization of the vein;
• laparoscopic ligation.