Inhloko yesifo socansi (2017)

I-Clinical Neurology ne-Neurosurgery

LINKA KU-ARTICLE

Volume 164, Januwari 2018, Amakhasi 11-13
 

abstract

Ikhanda elihlotshaniswa nokuya ocansini noma umsebenzi wokushaya indlwabu liyinhlangano yomtholampilo eyaziwa kahle kepha ikhanda lezithombe zobulili ezingcolile alikhulunywa. Sibika insizwa ethile eyayinenkinga yokuhlaselwa ikhanda ekhanda ephathelene nezithombe zocansi kuphela kodwa hhayi ngesinye isenzo sobulili noma esingesihle. Ukwenza kusebenze vasoconstriction ngesikhathi sezinhlungu zatholakala. Ekugcineni, ngomlomo indomethacin zivimbela kahle izinhlungu. Ngakho-ke, ikhanda lekhanda lezithombe zobulili ezingcolile liyisihlukanisi sekhanda esivelele esihlukile kwezinye ukuphazamiseka kwekhanda okuhlobene nobulili. Ezothando ezihlukumeza ngokocansi i-cerebrovascular dysregulation Umphumela we-visuoneural uncoupling ngokuphendula isisusa se-erotic sihlongozwayo. Ikhanda lezithombe ezingcolile zobulili lingabukelwa phansi njengoba linabantu obulala izinhlungu ukusetshenziswa ngokweqile kungavimba izehlakalo zangempela emhlabeni wangempela.

Amagama angukhiye

  • Izithombe zobulili ezingcolile
  • bekhanda
  • Umsebenzi wezocansi
  • Okumnandi
  • Heterosexual
 1. Isingeniso

Ubuhlungu bekhanda obuhambisana nomsebenzi wezocansi (i-HSA) bungumthombo wezinkinga zekhanda ezihlobene nobulili. Intercourse yisenzo esiphambili sokuya ocansini, silandela ukushaya indlwabu [1]. Kuze kube manje, kunoyedwa kuphela umuntu okubikwa ukuthi uphethwe ikhanda ngenxa yezithombe zocansi [2]. Lapha, sibika esinye isiguli okutholakele kuso ama noveli amabili asekela ikhanda lezithombe zobulili ezingcolile lobuhlungu obuqondene nobulili obuqondayo i-cerebrovascular dysregulation.

I-2. Umbiko wecala

Indoda eneminyaka engu-40 ichaze ukushaywa yi-holocranial kanye nekhanda elibuhlungu, ikakhulukazi e-vertex, entanyeni nasemathempelini womabili, unyaka owodwa. Ubuhlungu buqale kungakapheli i-1 min ngemuva kokubuka izithombe zobulili ezingcolile ze-intanethi futhi amandla ayo akhula kancane kancane ngaphandle kwe-orgasm. Ubuhlungu budamba kuphela kuze kube yilapho isiguli siyeke ukubuka. Isiguli sikuphikile noma yini aura, uphawu oluhambisanayo, isici se-autonomic noma ukuphakama kwengcindezi yegazi ngesikhathi sobuhlungu. Kodwa-ke, ukuvuselela okucashile noma okuhlose ukwenzeka kwezocansi (SA), njengokushisa kobuso, i-palpitation, ukuphefumula ngokushesha, umphimbo owomile kanye / noma ukuqina kwe-penile, kwandulele ukuqala kobuhlungu. Ubuhlungu benkomba babucasulwa kuphela yizithombe zocansi, kepha hhayi amavidiyo noma izithombe eziqukethe izinto ezingezona ezokwesabisa noma ezingathathi hlangothi, bekhumbula isimo sobulili kwezocansi, ukushaya indlwabu yodwa / ukuhlangana kukodwa ngaphandle kwezithombe zobulili ezingcolile, umzimba onqunu womlingani ekuhlanganyeleni, ukuzwa ukuzitika ngocansi noma ngomlomo isimemo, noma umsebenzi ongeyona eyezocansi. Mayelana nokuqukethwe kwevidiyo evusa inkanuko, ubuciko obuhlukile obungqingili buye baba yisisusa esinamandla ikakhulukazi ngokusondelana okucacile. Ukuqina bekuphakathi ngokulingana kokuya ocansini nobuntu, lesbian ukwenza ucansi nokwenza ucansi. Isenzo sobungqingili besilisa abuzange buvuse buhlungu. Ubuhlungu babunamandla kubadlali abasebancane kunabadala ngaphandle komehluko wobuzwe noma ngaphansi kokucabanga kokuzibandakanya.

Isineke sathandana nobungqingili futhi sashada iminyaka engu-5. Wanelisa ubudlelwane bakhe bomshado nobungqingili, futhi wakwenqaba ukwenza ucansi lomuntu owesilisa nowesilisa nganoma yiluphi uhlobo, umuntu athandana naye noma wahlukumeza ngokocansi ngaphambili. Isiguli sasingenangxaki yokuphazamiseka kwengqondo, isifo sezokwelapha, muva nje craniofacial ukulimala, migraine kanye nokunye ukuphazamiseka kwekhanda okuyisisekelo, noma ukusetshenziswa kwe izidakamizwa ezingekho emthethweni noma izinto ezikhuthaza ubulili noma imiyalo, futhi akazange enze ubugebengu bezocansi noma obungeyona ubulili ngaphambili. Uphuzo oludakayo lwalungaphansi kwe-20 gm ngeviki iminyaka ye-10. Izinga leKinsey lalingama-0 amaphuzu kanti i-Female Gender Identity Scale for Male yayizikolo ze-2. Ukuhlolwa kwe-Neurological and ngokomzimba akuzange kuveze ukutholakala okungajwayelekile. Amakhemikhali wegazi, i-serology futhi testosterone zaziphakathi kobubanzi bereferensi. Ikhanda imaging magnetic resonance kanye ne-angiography akazange adalule ukutholakala okungajwayelekile, okufana ne-tonsillar herniation, esikhathini esingenabuhlungu (I-Fig. 1A). I-Electroencephalogram bonisa ingemuva le-alpha. I-2.0 MHz umbala ophendukayo owedlule iveze inani eliphakeme lokulungiswa kwe-engeli (ohlangothini lwesokudla u-74.1 cm / sec vs ohlangothini lwesobunxele u-122 cm / isekhondi; umehluko u-47.9 cm / isekhondi) futhi usho i-velocity yegazi lobuchopho (ohlangothini lwesokudla u-49.0 cm / umzuzwana vs ohlangothini lwesobunxele 80 cm / sec; umehluko 31 cm / sec) ngakwesobunxele umthambo ophakathi nendawo ngesikhathi sobuhlungu (I-Fig. 1B no-C) ngokusebenzisa ithambo lesikhashana iwindi le-acoustic. I-velocity in i-artery ejwayelekile, yangaphakathi nangaphandle ye-carotid artery, kanye ne i-arter posteral cerebral artery, ayizange iguquke ngokungajwayelekile. Isivinini esiphakeme sasingu-75-85 cm / umzuzwana emthanjeni wobuchopho ophakathi nesikhathi esingenabuhlungu. Ngemuva kokwaziswa, isiguli savuma ukuthatha indomethacin I-25-50 mg ku-15 min ngaphambi kokubuka izithombe zobulili ezingcolile futhi lokho kuvimbele ngempumelelo ukwenzeka kobuhlungu. Ukwakhiwa kwengqondo akuzange kuncome umlutha wokuphazamiseka ukusetshenziswa kwe-inthanethi noma izithombe zocansi.

I-3. Ingxoxo

Ukusabalala kwesikhathi se-HSA kulinganiselwa ku-1%. Muva nje, i-Anand & Dhikav [2] kubike isiguli sokuqala esisemthethweni sekhanda lezocansi. Babecabanga ngobuhlungu obabangelwa trigeminovascular Umphumela kanye nokuqunjelwa kwemisipha, kusekelwe ekwandeni okuphezulu kwe migraine ku-HSA kanye nokuhlaselwa kwesimo esigulini sabo. Kodwa-ke, iziguli zabo nezethu azizwa i-migraine noma i-trigeminovascular ikhanda kanye nobuhlungu be-preorgasmic abufani nokuqunjelwa kwemisipha. Esigulini sethu, kunemiphumela emibili emisha etholakele ephathelene nalesi sikhanda esiyingqayizivele, okungukuthi, ukwenziwa kwe-SA ngaphambili nange vasoconstriction ngesikhathi sobuhlungu. Le miphumela iphakamisa ikhanda lezithombe zobulili ezingcolile ngobuhlungu obuqondene nobulili obubandakanya inethiwekhi yaseSA, njengokuthi ngxenye elilawula ukusabela kokuzenzakalelayo.

In inkomba yesiguli, Ubuhlungu ngokuyinhloko benzeka kanye nobukhulu bawo bufana nobukhulu beSA, okwenza kusebenze ukuvusa umdlandla kungenzeka kube ngunogada wesango kanye module ekhanda lezithombe ezingcolile. Ngokuvamile, ubukhulu bokusebenza kwe-activation buxhomeke ezicini ezimbalwa, ezinjengobulili, iminyaka, izinga le amahomoni ocansi, isimo sobulili, nemodi yezikhuthazo zocansi. Ukwenza kusebenze okuphakeme kwizenzo zobungqingili, umcabango wokuziphonsa kanye nowesifazane ongumlingisi osekelisweni lesineke lesiguli leso [3] kanye nomcabango wokubamba iqhaza [3] futhi isebenze noma iqinise i-SA yayo. Kuyamangaza ukuthi izinhlungu ziqonde ngqo e-SA kuphela ngenxa yezithombe zocansi kodwa hhayi kwezinye izinto zangempela zocansi ezenziwa kwiziguli zenkomba. Lesi simo siveza indlela ehlukile yesiginali kanye nendlela yobuhlungu ekhona phakathi kwekhanda lezithombe zobulili ezingcolile kanye nezinye i-HSA yize kushukunyiswa okufanayo okubonakalayo.

Isivalo segazi sangaphakathi esisezingeni eliphakeme kakhulu lapho sibuhlungu sibonisa i-SA-mediated i-cerebrovascular dysregulation ukuba ngumthombo ongaba khona wobuhlungu kwiziguli zenkomba. Iphethini yokukhuphuka ngokunokwenzeka ihlobene nokukhuthaza okungabonakali noma okunobudlova, ukukhuthaza okungabonakali kwe-erotic kuma-migraineurs noma umuzwa obuhlungu. Esikhundleni salokho, iyahambelana ne-vasoconstriction egxile, efana ne reversible cerebral vasoconstriction syndrome. Eqinisweni, i-vasoconstriction ye-dysregulatory ngezikhathi ezithile inomthelela kwekhanda le-preorgasmic ezigulini ze-HSA [4] okufanayo nezethu. Kuhlangene, kuphakanyiswa ikhanda lekhanda lezithombe ezingcolile. Kodwa-ke, futhi kungathinteka kwezinye izinto, njengokucindezela okuvela ekukhathazekeni, amahloni, umuzwa wecala noma eminye imizwa engemihle, ikakhulukazi emphakathini wezenkolo.

Isiguli sethu sisabele kahle ekuvinjelweni indomethacin njengoba kubonakala kwamanye ama-syndromes we-indomethacin asabelayo [5]. I-Indomethacin ngezikhathi ezithile izuzisa uhlobo lwe-HSA ye-preorgasmic ne-orgasmic efana neyethu. Amakhemikhali ayo asetshenziswa ukucindezela ukuvuvukala yi inhibition yokuncintisana use cyclo-oxygenase 1 kanye ne-2, phospholipase I-A2, noma i-gluthation S-transferase. Esigulini esedlule sekhanda lezingcolile, izinhlungu zakhululeka ibuprofen futhi paracetamol inhlanganisela [2]. Ngakho-ke, kuphakanyiswa i-prophylaxis yesikhathi esifushane ye-indomethacin noma i-ibuprofen ekhanda lezithombe zobulili ezingcolile.

I-4. Iziphetho

Ubuhlungu bekhanda bezithombe zobulili ezingcolile buyisihlukanisi sekhanda esivelanayo esiphathelene nokusetshenziswa kwezithombe zocansi futhi sihluke kwezinye i-HSA. Kuphakanyiswa ukuthi kubangelwe ukuvela kokungaboni ngasolinye ne-SA-mediated i-cerebrovascular dysregulation. Ukwelashwa kokuvimbela nge indomethacin uyazuza. Ikhanda lezithombe zobulili ezingcolile kufanele lixwayiswe njengoba i-vasomotor ushintsho lukhona. Kungabukelwa phansi kubantu abaningi njengoba obulala izinhlungu ukusetshenziswa ngokweqile kungavimba izehlakalo zangempela emhlabeni wangempela.

Ukungqubuzana kwesithakazelo 

Ababhali, ngalokhu, bathi akukho kungqubuzana kwezintshisekelo kulo mbiko.

Kuvuma 

Lolu cwaningo luvunyelwe yi-Chang Gung Medical Foundation Institutional Review Board (inombolo ye-Code 201700247B0).

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