Phimosis

**I-Phimosis** yisimo lapho ijwabu lobudoda lingakwazi ukwelula khona ukuvumela ukuthi libuyiselwe emuva lidlule i- glans .  Ukuvuvukala okufana nebhaluni ngaphansi kwejwabu kungenzeka ngokuchama.  Ebusheni nasebantwini abadala, kungahle kube nobuhlungu ngesikhathi sokumiswa, kepha kungenjalo akubuhlungu.  Labo abathintekile basengozini enkulu yokuvuvukala kwe-glans, eyaziwa njenge- balanitis, nezinye izinkinga. 

Ezinganeni ezincane, kuyinto ejwayelekile ukungakwazi ukubuyisa ijwabu nhlobo.Ngaphezu kwamacala angama-90% axazululwa eneminyaka eyisikhombisa, yize ukuhoxiswa okugcwele kusavinjelwe ukunamathiselwa kokuqina okungaphezulu kwengxenye engaphezu kwalesi sikhathi. Ngesinye isikhathi, i-phimosis ingabangelwa yisimo esingaphansi kwesibazi ngenxa ye- balanitis noma i- balanitis xerotica obliterans .  Lokhu kungatholakala ngokutholakala kokubola kokuvulwa kwejwabu. 

Imvamisa, isimo sixazululwa ngaphandle kokwelashwa sineminyaka engu-18.  Akufanele kuzanywe imizamo yokubuyisa ijwabu ngesikhathi seminyaka yokuqala yokuphila kowesilisa.  Kulabo isimo esingathuthuki kubo, isikhathi singanikezwa noma ukhilimu we-steroid ungasetshenziswa ukuzama ukukhulula isikhumba esiqinile.  Uma le ndlela, kuhlangene umzimba esisuka, akuyona ngempumelelo, bese ezinye izindlela zokwelapha ezifana ukusoka kungenzeka Kunconywa.Inkinga engaba khona ye-phimosis yi- paraphimosis, lapho ijwabu eliqinile livaleleka ngemuva kwe-glans.  Leli gama livela esiGrekini φίμωσις *phimōsis* 'muzzling'.

## Izimpawu nezimpawu

Ekuzalweni kwakhe, ungqimba engaphakathi ijwabu ivaliwe kuya glans umthondo.Ijwabu livame ukungahlehleki zisencane, kanti abanye besilisa bangafika eminyakeni eyi-18 ngaphambi kokuba ijwabu labo lihoxiswe ngokuphelele. 

Izinhlangano zososayensi bezokwelulekwa ukuthi zingalihoxisi ijwabu losana, ngenhloso yokuvimbela izibazi.Abanye bathi ukungabuyiseli emuva "kungathathwa njengokujwayelekile kwabesilisa kuze kufike ebusheni."  UHill uthi ukuhoxiswa ngokugcwele kwejwabu kungenzeka kungatholakali kuze kube sekwephuzile noma ebudaleni. Ucwaningo lwaseDenmark lwathola ukuthi iminyaka yobudala yokuqala yokuhoxa ijwabu yiminyaka eyi-10.4. 

URickwood, kanye nabanye ababhali, uphakamise ukuthi i-phimosis yangempela itholakale ngokweqile ngenxa yokwehluleka ukuhlukanisa phakathi kokungajwayelekile okubuyela emuva kokuthuthuka kanye nesimo se-pathological.    Abanye ababhali basebenzisa amagama athi "physiologic" kanye "pathologic" ukuhlukanisa phakathi kwalezi zinhlobo ze-phimosis;  abanye basebenzisa igama elithi "ijwabu elingabuyiseli emuva" ukuhlukanisa lesi simo sokukhula ne-pathologic phimosis. 

Kwezinye izimo imbangela ingahle ingacaci, noma kungaba nzima ukuhlukanisa i-phimosis yomzimba ne-pathological phimosis uma usana lubonakala lunokungazizwa kahle ngenkathi lichama noma lukhombisa ibhaluni elisobala lejwabu. Kodwa-ke, ukufaka amabhaluni akubonisi ukuvinjelwa komchamo. 

Kwabesifazane, isimo esilinganayo saziwa njenge- "clitoral phimosis", lapho i- clitoral hood ingeke ihoxiswe, kunciphise ukuvezwa kwe- glans clitoridis . 

### Ubunzima

* Isilinganiso 1: ukuhoxiswa ngokugcwele kwejwabu, liqinile ngemuva kwe-glans.
* Isigaba 2: ukuvezwa okuyingxenye kwama-glans, i-prepuce (hhayi ukubambelela kokuzalwa) into ekhawulelayo.
* Isikolo 3: ukuhoxa okuyingxenye, inyama ebonakala nje.
* Amaphuzu 4: ukuhoxa kancane, kepha ibanga elithile phakathi kwethiphu nocwecwe, okungukuthi inyama nenyama ayikwazi ukudalulwa.
* Amaphuzu 5: akukho ukuhoxiswa kwejwabu. 

## Imbangela
Kunemibandela emithathu yemishini evimbela ukuhoxa kwejwabu:

:* Ithiphu lejwabu lincane kakhulu ukudlula umthondo we-glans. Lokhu kujwayelekile ezinganeni nasebusheni.  
:* Ingaphakathi langaphakathi lejwabu lihlanganiswe ne-glans penis. Lokhu kujwayelekile ezinganeni nasebusheni kodwa okungavamile kubantu abadala. 
:* I- frenulum mfushane kakhulu ukuvumela ukuhoxiswa okuphelele kwejwabu (isimo esibizwa nge- frenulum breve ). 

I-pathological phimosis (ngokungafani nokungabuyiseki kwemvelo kwejwabu ebuntwaneni) akuvamile, futhi izimbangela ziyahlukahluka.Amanye amacala angavela ku- balanitis (ukuvuvukala kwepenisi ye-glans). 

I-lichen sclerosus et atrophicus (okucatshangwa ukuthi iyisimo esifanayo ne-balanitis xerotica obliterans ) ithathwa njengesizathu esivamile (noma esiyinhloko)  se-pathological phimosis.  Lesi yisimo sesikhumba semvelaphi engaziwa esenza ukuthi indandatho emhlophe yezicubu ezifakwe ngaphakathi (i-cicatrix) yakhe ngasemaphethelweni we-prepuce.Lesi sicubu se-inelastic sivimbela ukuhlehla.

I-Phimosis ingavela ngemuva kwezinye izinhlobo zokuvuvukala okungapheli (njenge- balanoposthitis ), i- catheterization ephindaphindwayo, noma ukuhlehliswa kwejwabu ngenkani. 

I-Phimosis nayo ingavela kubantu abanesifo sikashukela abangalashwa ngenxa yobukhona be-glucose emchameni wabo okwenza ukutheleleka kujwabu. 

UBeaugé uqaphele ukuthi imikhuba engajwayelekile yokushaya indlwabu njengokucindezela umbhede noma ukugcoba ijwabu phambili ingadala i-phimosis.Iziguli zelulekwa ukuba ziyeke ukwandisa amasu okushaya indlwabu futhi zikhuthazwa ukushaya indlwabu ngokuhambisa ijwabu phezulu naphansi ukuze zilingise ngokuseduze isenzo socansi.Ngemuva kokunikeza lesi seluleko uBeaugé waphawula ukuthi akakaze ancome nakanye ukusoka.  

I-Phimosis ezinganeni ezindala nakubantu abadala ingahluka ngobukhulu, kanti abanye bayakwazi ukuhoxisa ijwabu labo ngokwengxenye (i-phimosis ehlobene), kanti abanye abakwazi ngokuphelele ukuhoxisa ijwabu labo, noma ngabe ipipi lisesimweni esibucayi (i-phimosis ephelele).

## Ukwelashwa
I-Physiologic phimosis, ejwayelekile kwabesilisa abaneminyaka eyi-10 nangaphansi, ijwayelekile, futhi ayidingi ukungenelela.    Ijwabu elingabuyiseli emuva livame ukuhlehliswa ngesikhathi sokuthomba . 

Uma i-phimosis ezinganeni ezindala noma kubantu abadala ingabangeli izinkinga ezinzima nezimbi, izindlela zokuhlinza zingasebenza.Ukhetho lwezokwelapha luvame ukunqunywa ukuthi ukusoka kubhekwa njengokukhetha kokugcina noma njengenkambo oyithandayo.

File:Stretching of foreskin to cure phimosis.jpg|Ukwelula ukuvulwa kwejwabu ngeminwe emibili
File:Stretching of foreskin to cure phimosis using silicon ear plugs.jpg|Ukwelula ukuvulwa kwejwabu ngomhubhe wenyama wobubanzi obuhlukile


### Kuhlinzwa

## Isibikezelo
Inkinga ebucayi kunazo zonke yi- paraphimosis Kulesi simo, i-glans ivuvukile futhi ibuhlungu, kanti ijwabu livinjelwa ukuvuvukala endaweni ehoxisiwe kancane. Umthondo osondele kakhulu uyimbaba. Olunye ucwaningo luthole i-phimosis njengengozi yokugcinwa komchamo  kanye ne- carcinoma yesitho sangasese sowesilisa .