Ukuhlinzwa Kokubopha Ama-Tube: Inketho Yokuzithwasa Ukuzala Kowesifazane

Tubes tied yigama elivamile lenqubo yokuzala engenazo izingane ebizwa nge-tubal ligation. Ekusukeleni i-ligation kowesifazane, amashubhu e-fallopian ayasikwa, avalwe, noma afakwe uphawu ukuze kuvikelwe ukuthi isidoda sifinyelele iqanda [1].

Ishubhu le-fallopian lamukela amaseli eqanda avela ema-ovarini. Lapha, isidoda sivundisa iqanda lowesifazane, bese liya esibelethweni ukuze lifakwe khona. Ekusukeleni i-tubal ligation, eyaziwa nangokuthi “ukubopha amashubhu”, le shubhu le-fallopian livinjelwa.

Le nqubo ibhekwa njengefomu lokuvikela ukukhulelwa elihlala unomphela. Ukuhlinzwa kokubopha amashubhu kuphumelela kakhulu, ngephansi kuka-1% amathuba okukhulelwa ngemva kwenqubo [2].

Iyini I-Tubal Ligation?

Ukukhiqizwa kwamaqanda kowesifazane kubandakanya ama-ovari, amashubhu e-fallopian, isibeletho, nesitho sangasese sowesifazane. Ama-ovari enza iqanda elilodwa ngomjikelezo, elikhululwa ema-ovarini ngesikhathi sokuvuthwa kweqanda (ovulation). Iqanda bese lihamba liye eshubhini le-fallopian, lapho iseli lesidoda livundisa iqanda [3].

Nokho, Uma owesifazane engafuni ukukhulelwa, ngaleyo ndlela angahlinzwa i-tubal ligation. Kulo msebenzi wokuhlinza, amapayipi e-fallopian ayasikwa noma avalwe, okuvimba isidoda ukuthi sifinyelele iqanda ngaleyo ndlela kuvikelwe ukukhulelwa.

Izizathu Zokukhetha I-Tubal Ligation

Izizathu ezivame kakhulu ezenza owesifazane akhethe i-tubal ligation yilezi:

1. Ezinye izifazane zenza lesi sinqumo ngenxa yezizathu zempilo lapho bezwa sengathi umzimba wazo awusakwazi ukuletha ukukhulelwa okunempilo [4].
2. Kwezinye izifazane, kuyisinqumo sabo siqu hhayi ngenxa yezingozi zempilo. Ezinye izifazane zizwa ziqinisekile ukuthi azifuni ukuba nezingane eziningi noma noma yiziphi izingane nhlobo. I-tubal ligation iyisixazululo esihlala unomphela sokuvikela ukukhulelwa kubo.
3. Kuphinde kube indlela ephumelela kakhulu yokuvikela ukukhulelwa uma kuqhathaniswa namaphilisi okulawula ukuzala, ama-patch, noma amadivayisi e-intrauterine (IUDs). Lokhu kungaletha ukuthula kwengqondo kwabesifazane abafuna ukuya ocansini kodwa bengafuni ukuba nezinye izingane.

Ukulungiselela Ukuhlinzwa kwe-Tubal Ligation

Ngaphambi kokuba wenze i-tubal ligation, kunezinyathelo eziningana okufanele uzicabangele. Okokuqala, udinga ukuxoxa ngalo lonke le nqubo nalokho ongakulindela ngemva kwenqubo nodokotela wakho noma umhlinzeki wakho wezempilo.

Ngemva kweseshini yokubonisana, owesifazane kudingeka enze eminye imihlololwazi yangaphambi kokuhlinzwa, ehlanganisa ukuhlolwa kokukhulelwa, ukuhlolwa kwegazi, nokuhlolwa okuphelele komzimba. Ukuhlolwa kwesitho sangasese sowesifazane (pelvic exam) kuvame ukuba yingxenye yale nqubo yokuhlola. 

Ngaphambi kokwenza ukubopha amashubhu, ezinye izifazane zikhetha ukugxila empilweni yokuzala ukuze kuqinisekiswe ukuthi imizimba yazo ilinganiselwe kahle. Izithasiselo ezicebile ngezakhi zomzimba zingasekela impilo yamahomoni nenhlalakahle yonke, okwenza kube lula ukubhekana nezinguquko ngemva kwenqubo.

Kubalulekile futhi ukucabangela umthelela wengqondo nowemizwa wokuzingciyisa unomphela.

Okufanele Kucatshangelwe Ngaphambi Kokuhlinzwa

Ngaphambi kwenqubo, kuzodingeka usayine ifomu lemvume elinemininingwane. Leli fomu ligcizelela ukuthi lolu hlinzo luhlala unomphela. Kubalulekile kakhulu ukuwuqonda wonke amazinga obungozi nezinzuzo ngaphambi kokuqhubeka.

Kufanele ube nawo wonke amaqiniso ngaphambi kokuhlinzwa, kuhlanganise nezinzuzo nezinkinga zalo, ngaphambi kokuthi ulwenze. Kubalulekile futhi ukuxoxa ngalolu hlinzo neqabane lakho, uma likhona. Isinqumo sokwenza ukubopha amashubhu kufanele senziwe ngokubonisana neqabane lakho.

Inqubo Yokubopha Amashubhu

Ukubopha amashubhu (tubal ligation) kuhilela ukuvimba noma ukuvala amashubhu e-fallopian ukuze kuvinjelwe ukukhulelwa. Kukhona izindlela ezahlukene zokubopha amashubhu, okuhlanganisa ama-clip, ukuvuthisa (cauterization), kanye ne-salpingectomy.

Izindlela Zokubopha Amashubhu (Tubal Ligation)

Kukhona izindlela eziningana zokubopha amashubhu akho. Indlela ekhethwa ngawe izoncika ekuthandeni kodokotela ohlinzayo, isimo sempilo yakho, nokuthanda kwakho.

1. Enye indlela ihilela ukufakwa kwama-clip noma izindandatho emashubhini e-fallopian. Lokhu kuvimba amashubhu futhi kuvimbele amaqanda ekuphuma emashubhini e-fallopian aya esibelethweni.
2. Enye indlela ukuvuthisa (cauterization) [5]. Lokhu kubandakanya ukusebenzisa ugesi, ukushisa, noma ubanda ukuze kushiswe kuvalwe amashubhu. Le ndlela ivame ukusetshenziswa ekuhlinzweni kwe-laparoscopic.
3. Indlela yesithathu i-salpingectomy, okuwukususwa kwemisele yokuqhubekisela iqanda (fallopian tubes) [6]. Lokhu kuvame ukwenziwa ngesikhathi esifanayo nokuhlinzwa kokubeletha ngokuhlinzwa (C-section).

Okulindelekile Ngesikhathi Sokuhlinzwa

Isinyathelo sokuqala ekuhlinzweni kwe-tubal ligation ukunikezwa i-local anesthesia. Lokhu kusho ukuthi uzolala futhi ngeke uzwe nobuhlungu.

Ukuhlinzwa akuguquli ukusebenza kwama-ovari noma ukukhiqizwa kwamahomoni abesifazane. Akuthinti nemijikelezo yokuya esikhathini noma izinga lamahomoni. Ngemva kwenqubo, iziguli zelulekwa ukuba ziqaphele noma yiziphi izimpawu ezingajwayelekile bese zifuna usizo lwezokwelashwa uma kunesidingo.

Izingcuphe Nezinto Okufanele Uziqaphele

Njengoba kulindelekile kunoma iyiphi inqubo yokuhlinzwa, i-tubal ligation ayikhululi emithwalweni yezingozi ezithile. Lezi zifaka ukopha, ukutheleleka, nokulimala kwamanye amathumbu omzimba azungezile. Amabala okuzithenisa kowesifazane nawo angakhathaza ezinye izifazane.

Nazi ezinye izinto okufanele uzicabangele:

• I-tubal ligation ayivikeli ekuthelelekeni ngezifo ezithathelwana ngocansi (STI).
• Ezinye izifazane zingazisola ngesinqumo, ikakhulukazi uma zisencane noma izimo zazo zempilo zishintsha.
• I-tubal ligation ayibangeli ukuya esikhathini kokugcina kusenesikhathi (early menopause).
• Inqubo ayiguquki ezimweni eziningi, ngakho-ke ayifanele abesifazane abangase bafune ukukhulelwa esikhathini esizayo.

Ezinye Izindlela Zokuzithenisa Kwabesifazane

Ngaphezu kokubopha imisele, kukhona nezinye izindlela zokuzithenisa kwabesifazane zokulawula ukuzala zesikhathi eside kodwa ezingezona unomphela.

Izindlela zokuvikela ukukhulelwa ezisebenza isikhathi eside kodwa eziguqukayo (LARC) ezifana namadivayisi afakwa esibelethweni (IUD) kanye nama-implant wokuvikela ukukhulelwa zingezinye zezinketho ezisebenzayo zokuthola umphumela ofana nokuzithenisa kowesifazane [7]. Lezi zindlela zisebenza kakhulu futhi zingakhishwa uma owesifazane esenquma ukuthi ufuna ukukhulelwa.

Uma ufuna inqubo unomphela efana ne-tubal ligation, ukuhlinzwa kokukhipha isibeletho (hysterectomy) njengendlela yokulawula ukuzala nakho kuyinketho. Kuyingxenye yezindlela zokuzithenisa kwabesifazane eziholela ekungabini nokuya esikhathini ngemuva kwenqubo.

Izindlela ezihlukile ezingafaki ukuhlinzwa kuma-tubal ligation nazo zikhona. Lezi zifaka amaphilisi okulawula ukuzala, amaphetshi, namasongo esitho sangasese sowesifazane. Indlela ngayinye inezinzuzo zayo kanye nokubi kwayo.

Umphumela Oyinhloko

Kwezinye izifazane, ukuzithambisa kwenziwa ngenqubo ebizwa nge-tubal ligation noma ukuhlinzwa kokubopha amashubhu e-fallopian ("tube-tied surgery"). Lokhu kuhlanganisa ukusika, ukuvimba, noma ukuvala amashubhu e-fallopian lapho kwenzeka khona ukuchamiselana (fertilization). Amanye amagama asetshenziswa kule nqubo yokubopha amashubhu afaka phakathi i-female vasectomy, i-women vasectomy, kanye ne-tubal occlusion. Ukuhlinzwa kokubopha amashubhu e-fallopian kubhekwa njengenye yezindlela ezisebenzayo kakhulu zokuvimbela ukukhulelwa unomphela, enempumelelo engaphezu kuka-99%.

Lapho ishubhu le-fallopian liboshiwe, livimba ukuxhumana kwesidoda neqanda, okwenza kungabikho ukukhulelwa unomphela. Njengoba kuyinqubo engaguquki, abesifazane kumele bazinze engqondweni futhi baqiniseke ukuthi ngempela bayalidinga leli khetho. Njengoba abesifazane bengakhetha i-tubal ligation, amadoda nawo anenketho efanayo engapheli ebizwa nge-vasectomy. Ukufunda mayelana ne-gama lezokwelapha elithi vasectomy nalenqubo kungaba usizo emibhangqwaneni ecabangela ndawonye izinketho zokuvimbela ukukhulelwa ezingapheli.

Imibuzo Evame Ukubuzwa

Kusho ukuthini ukuzithambisa (sterilization)?

Ukuzithambisa (sterilization) inqubo lapho owesilisa noma owesifazane evinjelwa ekukhuleliseni ngokwenza izinguquko ezithile emzimbeni. Isibonelo, inqubo yokubopha amashubhu e-fallopian ("getting tubes tied") iwukuzithambisa ngokuhlinzwa kwabesifazane.

Ungazenza kanjani ungakwazi ukukhulelwa?

Ungazenza ungakwazi ukukhulelwa ngosizo lwezinketho ezahlukene zokuhlinzwa nezingezona ezokuhlinzwa. I-vasectomy kowesilisa kanye ne-tubal ligation kowesifazane yizwezindlela ezisebenzayo zokuzithambisa ukuze ungakwazi ukukhulelwa.

Kubizwa ngokuthini uma ubopha amashubhu akho e-fallopian?

I-tubal ligation yigama lezokwelapha elisetshenziswa uma ubopha amashubhu akho e-fallopian ("tubes tied"). Lena indlela yokuzala engapheli yokuzithambisa (sterilization) yokulawula ukuzala kwabesifazane.

Izinsiza Ezisetshenzisiwe

1. Marino, S., Canela, C. D., Jenkins, S. M., & Nama, N. (2024, February 16). I-Tubal Sterilization. StatPearls - NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK470377/ 
2. Professional, C. C. M. (2024f, May 1). I-Tubal Ligation. Cleveland Clinic. https://my.clevelandclinic.org/health/treatments/4933-tubal-ligation 
3. Holesh, J. E., Bass, A. N., & Lord, M. (2023, May 1). I-Physiology, Ovulation. StatPearls - NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK441996/ 
4. Yiziphi ezinye zezinkinga ezivamile zokukhulelwa? (2024, May 29). https://www.nichd.nih.gov/health/topics/pregnancy/conditioninfo/complications 
5. NCI Dictionary of Cancer Terms. (n.d.). Cancer.gov. https://www.cancer.gov/publications/dictionaries/cancer-terms/def/cauterize 
6. Kotlyar, A., Gingold, J., Shue, S., & Falcone, T. (2017). Umphumela we-Salpingectomy Ekusebenzeni Kwama-ovari. Journal of minimally invasive gynecology, 24(4), 563–578. https://doi.org/10.1016/j.jmig.2017.02.014 
7. Professional, C. C. M. (2024a, May 1). Izinketho Zokulawula Ukuzala. Cleveland Clinic. https://my.clevelandclinic.org/health/articles/11427-birth-control-options