Akatswiri amanena kuti Botox imatha kusamuka, koma siinayambe kuvomerezedwa
Zaka 30 zapitazo, mankhwala oyamba asanamwalire adakula kuchokera kuchipatala ndikuphatikiza mankhwala ndi pharmacotherapy. Zingadabwe kuti Botox, yomwe ndi poizoni wopangidwa ndi bakiteriya Clostridium botulinum ndipo kawirikawiri imagwiritsidwa ntchito kuwonetsa makwinya a nkhope , ikhoza kuthandizira kukwera msanga msanga. Komabe, zochuluka zafukufukuzi zikufotokozedwa ngati lingaliro, ndipo kugwiritsa ntchito Botox kwa kumangoyamba msanga sikunayambe kuvomerezedwa ndi FDA.
Kufotokozera Kutha Kwambiri Kumayambiriro
Chithandizo cha kukwera msanga msangamsanga chimadalira momwe chikhalidwechi chikufotokozera.
Kawirikawiri, kukwera msanga kwadongosolo kumagawidwa m'magulu awiri: moyo wonse kapena wopeza.
Kuthamangitsidwa kwa nthawi zonse kumayamba ndi zoyamba zogonana. Kuthamangitsidwa kumachitika mofulumira-kaya asanalowe mkati kapena mkati mwa maminiti amodzi kapena awiri olowera.
Kuchokera kumayambiriro koyambirira kumatha kusonyeza mwadzidzidzi kapena pang'onopang'ono kutsata mbiri ya kusintha kwabwino. Komanso, vutoli lingakhale lochokera mu urological, chithokomiro, kapena maganizo.
Kwa zaka zambiri, tanthawuzo la kukwera msanga msanga kwasintha. Chiyambi cha maphunziro ambiri a kukwera msanga msanga ndikutanthauzira kwina kwa DSM-IV-TR:
- Kuthamanga kosalekeza kapena kobwerezabwereza ndi kuchepetsa kugonana kosachepera, kapena patangotha nthawi pang'ono kulowa mkati ndipo munthuyo asanafune. Wachipatala ayenera kulingalira zomwe zimakhudza nthawi ya chisangalalo, monga msinkhu, chikhalidwe cha wokondana kapena vuto lachiwerewere
- Kusokonezeka kumayambitsa mavuto ovuta kapena osadziwika
- PE sikuti imangokhala chifukwa cha zotsatira zake mwachindunji (monga kuchotsedwa kwa opioid).
Mu 2014, International Society for Sexual Medicine inapereka ndondomeko yotsatilayi yotsimikiziridwa yotsutsika kwa nthawi zonse.
- Kugonana kwachimuna komwe kumadziwika ndi kutsekemera kumene nthawi zonse kapena nthawi zonse kumachitika musanalowe mkati mwa mphindi imodzi,
- Kulephera kuchepetsa kuthamangitsidwa pazinthu zonse, kapena pafupifupi zonse, zozizwitsa za m'mimba
- Zotsatira zolakwika zaumwini monga kupsinjika, kukhumudwa, kukhumudwa, ndi / kapena kupewa kugonana.
Pa 80 peresenti ya amuna omwe ali ndi nthawi yokwanira yowonongeka, kuyendayenda kumapezeka mkati mwa masekondi 30 mpaka 60 a kugonana. Otsalira 20 peresenti ya amuna awa amatha kupuma kumene kumatha pakati pa mphindi imodzi ndi ziwiri.
Kuyerekeza koyambirira kumayambira pakati pa 30 peresenti ndi 70 peresenti ya amuna a ku America. Malingana ndi zotsatira za kafukufuku wa National Health and Social Life, kufalikira kwa kukwera msanga ku United States ndi 30 peresenti ndipo kumakhudza amuna a mibadwo yonse. Kuthamangira kwa msinkhu kumakhala kofala kwambiri kwa anyamata a zaka zapakati pa 18 ndi 30. Kusamuka kwa nthawi yayitali kumakhudzanso amuna omwe ali ndi mphamvu zopanda malire omwe ali ndi zaka zoposa 45 ndi 60.
Zindikirani, amuna ena nthawi zina amatha kukwera msanga, ndipo izi sizingakhale zokhudzana nazo. Kuwonjezera pamenepo, ngakhale kuti matanthauzo omveka a kukwera msanga kwa msinkhu amasonyeza kuti zikuchitika ndi pafupifupi kugonana kulikonse, ngati kumachitika pakati pa 10 peresenti ndi 20 peresenti ya nthawi yomwe kugonana kuyesedwa, ndiye chithandizo chingakhale choyenera.
Kuchiza Kutha Kwambiri Kwambiri Ndi Botox
Jekeseni wa Botox umagwira ntchito pofooketsa kapena kufooketsa minofu komanso kutseka mitsempha. Zotsatira za Botox zatha pakati pa miyezi itatu ndi khumi ndi iwiri.
Zotsatira zovuta zomwe Botox zimaphatikizapo kutupa, kuvulaza, ndi kupweteka pa malo opangira jekeseni.
Kuphatikiza pa kusinkhasinkha nkhope, apa pali njira zina za Botox:
- Kuonjezera kupweteka kwa thukuta (ie, hyperhidrosis)
- Maso opindika (ie, strabismus)
- Migraines osatha
- Kuwala kosalamulirika (mwachitsanzo, blepharospasm)
- Chikhodzodzo chokwanira
Mafupa a bulbospongiosus ndi ischiocavernosus ndi mbali ya penile shaft, ndipo minofu imeneyi ndi yofunikira kwambiri potsegula. Panthawi yopuma, izi zimapangitsa kuti minofu ikhale yosamveka.
Botox imatsegula kumasulidwa kwa acetylcholine kumapeto kwa mitsempha, ndipo zimangododometsedwa kuti njirayi ingalepheretse kusinthasintha kwa zizindikiro za bulbospongiosus ndi ischiocavernosus ndipo motero amathandiza kuchepetsa kutaya.
Pakhala pali zodandaula zomwe zimatchulidwa ponena za kugwiritsira ntchito Botox kuti athetse kukhetsa msanga. Choyamba, akatswiri ena akudandaula kuti Botox idzatsekereza kutsegula kwathunthu ndipo izi zidzasintha kuti asamangidwe. Pakhalanso zodetsa nkhaŵa zogulira ntchito za Botox kuti zitha kusamba msanga.
Pa chivomerezo cholembedwa ndi Allergan mu 2012, njira zosiyana za Botox zothandizira kuti chithandizo cham'mbuyomu chisafike msanga, chiphatikizapo zotsatirazi:
Njira yothandizira kupititsa patsogolo msanga kwa wodwala omwe akusowa, imaperekedwa, komwe njirayi imaphatikizapo gawo lotsogolera mderalo, mwa jekeseni, botulinum neurotoxin kwa mbolo ya wodwalayo, motero amachiza kusamba msanga kwa wodwalayo. Makamaka maonekedwe, botulinum neurotoxin imayikidwa mu malo awiri a penile, ndipo mu zitsanzo zina malo osachepera atatu.
Olemba a pulogalamuyi amasonyeza kuti Botox ikhoza kulowa mu glans kapena frenulum ya mbolo (pafupi ndi nsonga ya mbolo). Kuwonjezera apo, Botox ingagwiritsidwe ntchito pazomwe zikufunikira, ndi zotsatira zake mpaka miyezi isanu ndi umodzi. Njirayi iyenera kuyamba kugwira ntchito mkati mwa maola 48 mpaka 72, ndipo payenera kukhala palibe kapena zolepheretsa zotsatirapo.
Kafukufuku wambiri wofalitsidwa ponena za kugwiritsira ntchito Botox akuwonetsedwa ngati malingaliro ndi kulongosola. Mwachiwonekere, Botox ayenera kugwira ntchito yochizira msanga koma nthawi zambiri kufufuza kumafunika kuchitidwa kuti zitsimikizire. Pa August 15, 2017, Allergan anathetsa mayesero a chipatala 2 omwe akuyesa kugwiritsira ntchito Botox kuti athetse kusamba msanga, koma zotsatira za phunziroli sizikupezeka.
Zithandizo Zina Zowonongeka Koyamba
Ngakhale kuti palibe mankhwala ovomerezeka a FDA okhwima asanakwane, pali zina zothandizira kuti zithetse vutoli.
Kusankha serotonin-reuptake inhibitors (SSRIs) ndi tricyclic zowononga kwambiri zatsimikiziridwa kuti zimapindulitsa kwambiri pochiza kusamba kwa msanga. Makamaka, paroxetine, sertraline, fluoxetine, citalopram, ndi clomipramine zonse zakhala zikugwiritsidwa ntchito poyeretsa msanga. Kugwiritsiridwa ntchito kwa mankhwalawa pochiza kusamba kwa msanga kulibe.
Mankhwalawa amatha kutengedwa tsiku lililonse kapena pakufunika. Ngakhale mankhwala opatsirana nthawi yaitali ndi othandiza kwambiri kuposa momwe akugwiritsire ntchito, ntchito yowonjezera nthawi yayitali imayambitsa mavuto ambiri. Ndi mautumiki opitirira, SSRI imakhala yothandiza kwambiri ikafika pamtunda, zomwe zingatenge masabata. Komabe, phindu likhoza kuchitika kale.
Mmodzi wa SSRI amene amathandiza makamaka kuti asamangidwe msanga ndi dapoxetine (Priligy). SSRI yochita kafukufukuyo yapangidwa makamaka mwachindunji kuti chithandizo cha kukamwa msanga kusanakwane chikhoza kugwiritsidwa ntchito. Dapoxetine ikhoza kutengedwa maola ochepa musanayambe kugonana.
Njira inanso yomwe ingathandize kupewa kuthamanga msanga kumaphatikizapo kugwiritsa ntchito mankhwala otsegula m'mimba pofuna kuchepetsa kupweteka kwa mbolo. Kuphatikiza pa anesthesia, kondomu ingagwiritsidwe ntchito kupititsa patsogolo kuchepa. Mankhwala otsegula m'maganizo omwe amagwiritsidwa ntchito pazifukwazi ndi lidocaine ndi prilocaine.
Pomalizira, anthu ang'onoang'ono omwe amatha kukwera msanga angapindule pochita masewero a pelvic kapena machitachita a Kegel.
Bwanji Ponena za Mankhwala Othandiza?
Pakalipano, akatswiri ambiri amaganiza kuti kumwa mowa msanga kumakhala kovuta kwambiri. Chifukwa chake, chithandizo chamankhwala cha nthawi yaitali chimaonedwa kuti n'chopanda phindu kwa moyo wonse wa msanga. Kuwonjezera pamenepo, kafukufuku wam'tsogolo awonetsa kuti mankhwala opatsiranawo sagwira ntchito pochiza moyo wonse wa msanga.
Mu nkhani ya 2014 yomwe imatchedwa "Kuthamanga kwapakati: kutanthauzira, matenda, matenda," Kirby analemba izi motsatira njira zothandizira ndi zokhudzana ndi maganizo kuti asamangoyamba msanga: "Mankhwala akhala akugwiritsidwa ntchito kwa zaka zingapo, koma kafukufuku wochuluka amasonyeza kuti zopindulitsa sizikubwera. Komabe, odwala ambiri amavutika nkhawa ndipo amatha kuyamikira matenda a psychotherapy. "
Pofuna kupeza njira yothandizira odwala nthawi yayitali, njira yogwiritsira ntchito mankhwala ingagwire ntchito. Njirayi imaphatikizapo njira yothera, chidziwitso cha khalidwe labwino, ndi mankhwala osokoneza bongo. Ndi njira yoyamba kuyima, mwamuna amadziwa chisangalalo chapakatikati pa kugonana ndikusiya kugonana kwa mphindi imodzi. Munthuyo akabwezeretsedwa, kugonana kumayambiranso. Mwinanso, pogwiritsa ntchito njirayi, munthuyo amanyengerera mbolo musanayambe kukonza kuti achepetse kuimitsa ndikusiya kuyimitsa.
> Zotsatira:
> Ashburn TT, Thor KB. Kugwiritsa Ntchito Mankhwala Osokoneza Bongo: Kuzindikiritsa ndi Kugwiritsa Ntchito Zatsopano Zamagwiritsa Ntchito Mankhwala Osokoneza Bongo. Nat Rev Drug Discov. 2004; 3: 673-83. https://doi.org/10.1038/nrd1468
> Gastiola, Gustavo M. Njira Yothandizira Kutha Kwambiri Kusanayambe ndi Botulinum Neurotoxin. 11 Dec. 2012.
> Kirby M. Premature ejaculation: kutanthauzira, matenda ndi matenda. Zotsatira za Urology & Men's Health. 2014; 5: 23-28. https://doi.org/10.1002/tre.406
> Serefoglu EC, Silay MS. Kachilombo ka fetulin-A jekeseni ikhoza kukhala yopindulitsa pa chithandizo cha moyo wautali msanga. Lingani Zolemba. 2010; 74: 83-4. https://doi.org/10.1016/j.mehy.2009.07.038