Ukwelashwa Okucatshangelwayo Ukungasebenzi Kwe-Erectile
nguGérard V. Sunnen, MD
I-Bellevue Hospital neNew York University
Eminyakeni yamuva amandla okuziphendukela kwemvelo ukuguqula ukusebenza kwesistimu yezinzwa ezizimele iye yaqhubeka ihlolwe. Izindlela zokwelapha ezihlanganisa ukuguqulwa kwegazi, i-biofeedback, ukuqeqeshwa kokuphumula kanye namasu okuzindla kuye kwabonisa ukuthi izinqubo zomzimba ezenzeka ngezansi ezingeni lokuqwashisa zingangena endaweni yokulawulwa kokuzizwa okubalulekile ekuziphatheni ngokwabo (Schwartz, 1973; Griffith, 1972).
Ukwelashwa ngokuzindla kusetshenziswe ngempumelelo ukuguqula izifunda ezivusa inkanuko kanye nokwenza izifundazwe eziguqukile zokwazi (UDeikman, 1963; Maupin, 1969). Ukutadisha kwasekuqaleni kweyogis yaseNdiya (iBrosse, 1946) kukhombise amandla abo wokulawula isilinganiso senhliziyo. Kusukela lapho, izifundo zemikhuba yokuzindla ziveze ulwazi ngamakhono azo okuphuza izinga lokuphefumula, ukwehla kwengcindezi yegazi, ukwehlisa ukusetshenziswa komoya-mpilo, ukuqhuba kwesikhumba okuphansi, nokwenza izinguquko ze-EEG ngokwanda kwe-alpha wave preponderance kanye ne-amplitude (Anand et al., 1961; UWallace noBenson, 1972; UBenson et al., 1975).
Isizathu sokusebenzisa inqubo yokuzindla ekwelapheni ukuhlukunyezwa ngokobulili kwavela emithonjeni ehlukene. Phakathi nenkathi yokuhlola, isiguli esisodwa kulolu cwaningo sathi wayeqaphele ukunyamalala okubonakalayo kwemizwa yocansi emzimbeni wakhe wobulili, ikakhulukazi ezimakwe ngezikhathi lapho ezama ukulala naye. Wachaza ngokuthi i-anesthesia yezocansi futhi wayiphambene nomqondo ojwayelekile wokugcwala nokufudumala ayekubone ngaphambi kokuba isimo sakhe siphume. Kamuva, bonke abantu kulolu cwaningo bahlolwe ngalesi simo; Amadoda ayisithupha kwabayisishiyagalolunye abike ukungabikho kwemizwa yobulili, kanti amadoda amathathu asele ahlehlise ukuhlukunyezwa kwesisu.
Izindlela eziholela ekuphenduleni kwe-erectile zihlanganisa ukuphumula kwe-musculature ye-vascular ne-engorgement elandelayo ye-penile spongiosum. Uma ucelwa ukuba ufakazele ezindaweni ezingezansi zobulili ngesikhathi sempendulo ye-erectile, abantu bazohlala bechaza izinzwa zokugcwala nokufudumala.
Ucwaningo lwakamuva lokuphendula kowesilisa ngokocansi (Koshids & Sohado, 1977) ukusebenzisa i-thermography kukhombisile ukwanda kwemfudumalo yezitho zobulili okwenzeka ngemuva kwemizuzu engu-2 ngemuva kokuchayeka kwi-movie evusa inkanuko.
Kwakucatshangelwa ukuthi ezinye izimo zokungabi namandla emphakathini zingabandakanya ukungabi nalutho kulezo zindlela ezingokwengqondo ezithinta ukufudumala ngokobulili nokuthi ukuqeqesha umuntu ukuba abuyele emuva lokhu kuzwa kungabuyekeze ikhono lobulili. Ukuzindla kwakubonakala kufanelwe kakhulu ngale njongo ngoba kunganikeza ukukhuliswa okuqondile komzwelo nokuletha ukungenelela okugxilwe ku-locus yezindlela zokuguqula umzimba.
Indlela
Iziguli eziyisishiyagalolunye ezingenamandla okugcina kanye nobudala obuyiminyaka eyi-32 zifakiwe kulolu cwaningo. Bonke babe nalesi sibonakaliso ngaphezu kwenyanga ngencazelo yezinyanga ezingu-2-1 / 2. Iziguli ezinhlanu ziye zaqala ukubhekana nesimo esibuhlungu, kanti abanye abane babika ukunyakaza okuphawulekayo kwesibonakaliso. Owokuqala wayevame ukuba nomlingani ongaphezu koyedwa ozocansi, futhi lo mlando uhlobanise ubunzima bawo ekungavumelani okungapheli nomlingani oyedwa. Ukuhlolwa kwezokwelapha akuveze ukuthi kukhona okungavamile.
Isizathu sokusebenzisa ukuzindla ekwelapheni sichazwa yilowo nalowo ngokusemandleni ukuze kuncishiswe imiphumela yokusikisela. Imiyalelo yanikezwa ku-mechanics yenqubo yokuzindla. Iziqephu zokuzindla zifaka phakathi ukukhetha okulungiselelwe okufanelekile kanye nokwamukelwa kwesimo sengqondo lapho zonke izenzakalo zangaphandle, ukukhathazeka, ukwesaba nokucabanga okungahambisani nalesi sipiliyoni kunganakiwe. Imiyalelo yanikezwa ngobuciko bokungacabangi imicabango engenayo kanye nomsebenzi wokulondoloza ukuqwashisa okucacile ngaphandle kokukhuphuka ukulala. Isiguli ngasinye siceliwe ukuba sifinyelele ezingeni lokuphumula esisezingeni eliphansi ngokuhlezi nokugxila ekuqapheliseni ngesigqi sokuphefumula. Lokhu ngokuvamile kuthatha imizuzu ye-3, bese izinga lokuphefumula, izinga lokushaya kwenhliziyo, nezwi le-muscle lahlehla ekunciphiseni kokuphumula. Ngaleso sikhathi iziguli zacelwa ukuba zishintshe ukunakekelwa kwazo endaweni yabo yobulili futhi zizindle ngokuhlangenwe nakho kwemizwa emnandi yokushisa imfudumalo, ukunakekelwa ukuba ungadli izintuthwane zenhliziyo uma wenza kanjalo. Ngemuva kokuzivocavoca kokuqala ehhovisi, isiguli ngasinye sacelwa ukuba siphinde senze le nqubo kabili nsuku zonke ngezikhathi ze-15.
Imiphumela
Iziguli ezinhlanu zibike ukuhlangenwe nakho okuncane kokushisa ngokobulili ngaphakathi kwezinsuku ezingu-10, kanti amanye amabili ngemva kwamasonto e-2 asebenzayo. Le nzwa yaqina futhi ingasetshenziswa ngokushesha njengoba ukuqeqeshwa kuqhubeka. Iziguli ezimbili ezisele zibike ukuzwa okusheshayo kodwa zaphazanyiswa ngokuqhubekayo imicabango engenayo futhi ayikwazanga ukugxila ekuqapheliseni. Lezi ziguli, nakuba zashukunyiswa, azizange zithole ukufudumala komzimba ngokobulili futhi azizange zihlakulele ikhono le-erectile. Omunye walezi ziguli waqhubeka izinsuku ezingu-7, enye enye yamaviki e-2 ngaphambi kokudangala ngethinga.
Labo abakwazi ukuletha ukufudumala ngokobulili bakwazi ukuyikhiqiza ngokuvumelana nezilingo ezilandelayo zokuzindla. Iziguli eziyisikhombisa eziphumelele zibike ukubuyela kwezinto ezenziwa erectile ngaphakathi kwamasonto e-2 ekufinyeleleni kokufudumala ngokobulili. Ukusebenza kwe-coital kwabikwa kulaba bantu ukuthi babuyele emazingeni angama-presymptom, futhi kuziguli ezintathu ukuba zithuthuke ngaphesheya kwalokho.
Iziguli ezimbili zathuthukisa ikhono lokufeza izikhathi ezithandwayo ngesikhathi sokuzindla, ngokuvamile emva kwemizuzu ye-10 yokusebenzisa le mboni.
Ukulandelwa ezinyangeni ze-3 ngemuva kokuphumelela kwekhono le-erectile kubonise ukuzinza kokuzuzwa kokwelashwa kweziguli ezinhlanu. Omunye isiguli wasilahlekelwa ukulandelwa.
Ingxoxo
Okuhlangenwe nakho ngaleli qembu elincane leziguli kusikisela ukuthi amasu athile okuzindla alungile angasiza ekunakekeleni ukungakwazi ukusebenza kwe-erectile. Abantu abafanelekayo ngalesi simiso bashukunyiswa ngokwanele ukubeka eceleni izikhathi ezimbili zemizuzu engu-15 yansuku zonke yokuzicabangela futhi babe nokukwazi ukukhulula emifuleni yabo yokucabangisisa ukuze bagxile engxenyeni ye-anatomical, ukucinga nokukhulisa imizwa yokushisa, futhi ngesikhathi esifanayo uhlale uqaphile futhi ukhululekile. Abantu abakwa-2 abangazange bazuze kule mboni babonakala benenkinga ngesinye noma esinye isici sale nqubo eyinkimbinkimbi yengqondo.
Ekubukekeni imiphumela yalolu cwaningo, kuyasiza ukuqaphela ukuthi kwezinye izifundo izinga lokuxoxwa okuzenzekelayo kusuka ekungeneni kwamandla okwesikhashana kuye kwabikwa ukuthi liphakeme. I-Ansari (1976) ithola isilinganiso se-68% sokukhishwa kwezinyanga ezingu-8 ngemuva kokuhlolwa kokuqala.
Abalingisi abanolwazi bakhonjisiwe ukuthi bacubungula ukucindezela ngokuyimpumelelo njengoba ulwazi lwabo lukhuphuka (UGoleman noSchwartz, 1976). Kungenzeka ukuthi izifundo zethu eziphumelele zikwazile ukubhekana nezimo zocansi ngokuzola okukhulu kunokuhlangenwe nakho kwazo kwangaphambilini, ngakho-ke ukuvinjelwa okuncane kokuphendula ngokocansi. Kuyathakazelisa ukuthi bonke abantu abaphumelele kulolu cwaningo babike imizwa eyengeziwe yokuthula kwangaphakathi ezimpilweni zabo zansuku zonke, kuyilapho amadoda amabili angazange asabele kule ndlela yokwelashwa engabikanga ushintsho emandleni abo okubhekana nengcindezi.
Ukuphumelela kwalolu hlelo kungase futhi kuhlale ekufundeni okuqondile kokulawulwa kwemikhawulo ku-ANS yesisu. Iqiniso lokuthi izikhonzi eziphumelele zabika ukufudumala komzimba ngaphakathi kwamaminithi ambalwa okuzivocavoca, kanti zangeke zenze njalo ngaphambi kokuba zithole ukwelashwa, nokuthi abantu ababili babike ukuthi ikhono elitholakale lokudala izikhetho ngokuzithandela bangase basekele le nqubo.
Izindlela zokwelapha zalolu lwazi zilindele ukutadisha okuqhubekayo kodwa kakade zibolekisa ithemba kubantu abakhethiwe ababhekene nokusebenza okungeyona erectile yesibili.
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