Ukulimala kwepipi

**Ukulimala kwe-penile** yisimo esiphuthumayo sezokwelapha esihlupha ipipi.Ukulimala okuvamile kufaka ukuphuka, ukuxoshwa, ukuklanywa, ukuboshwa, nokunqunywa. 

## I-Epidemiology
Ukuhlukumezeka okungena futhi okucacile kuhlanganisiwe kwakha cishe i-90% yakho konke ukulimala kwe-penile yomphakathi (i-45% lilinye), ngokusha nezinye izingozi ezakha i-10% esele. 

## Izinhlobo

### Ukwephuka

Ukuphuka kwepenile kungumphumela wokuqhekeka kwe-tunica albuginea. Zijwayelekile kakhulu futhi zingahle zivele ngokuqhekeka okuncane noma okuphelele kwe-urethral, yize lokhu kungavamile.    Ukulimala kwe-urethral kwenzeka kuma-10-38% wamacala. Ukwephuka kulashwa ngokuhlinzwa okuphuthumayo, futhi kungatholakala ukuthi kune- ultrasound, ikakhulukazi ezimeni zezingane.   Ukwephuka kwePenile kubangelwa ukuhlukumezeka kwesitho sangasese esime mpo, imvamisa ngokukugoba ngokuzumayo ngesikhathi sokuya ocansini nomlingani owamukelayo ngaphezulu komlingani ongena, noma ngesikhathi sokushaya indlwabu .Kubonakala ngomsindo omkhulu ophumayo ngesikhathi sokulimala, umphumela wokuqhuma kwe-tunica albuginea.Ezinye izimpawu zibandakanya ubuhlungu obukhulu, ukulahlekelwa ukwakhiwa, nokuvuvukala. Izimpawu zokulimala kwe-urethral zifaka i-hematuria, igazi e-meatus, ne-dysuria. Uma kushiywe kungalashwa, izinkinga zibangela amacala angama-28-53%; lokhu kufaka ukugobeka unomphela kwenduku, i-fistula, i- urethral diverticulum, i- priapism, kanye nokungasebenzi kahle kwe-erectile . 

### Ukuzithoba nokuxoshwa

Ukulimala kwe-degloving kanye ne-avulsion kufaka ukususwa kwesikhumba somthondo, okuyisimo esiphuthumayo sezokwelapha.Ukwelashwa kwalokhu kulimala kubandakanya ukuvalwa kwesikhumba esidabukile, noma ukufakelwa kwesikhumba ukufaka isikhumba esilahlekile ekulimaleni.Ukufakwa kwesikhumba kwakhiwe ukuzama ukugcina ukusebenza kwe-erectile nokuzwa. 

### Ukulimala kwezicubu ezithambile

#### Ukuklinywa

Ukulimala ngokuklinyeka endodeni, okubizwa nangokuthi ukulimala ejele, okubangelwa izinwele, amabhande enjoloba, noma ezinye izinto kungukulimala kwesibili kwezicubu ezithambile ezinganeni.  Ukuklinyeka kwezinwele kungaba nzima ukukuxilonga ngenxa yokwakheka kwepenisi; izinwele ezibangela ukuklinywa zingafihlwa ngaphansi kwe-coronal sulcus uma zivuvukile. Kubantu abadala, ukulimala ngokuklinywa okudinga ukwelashwa kungadalwa yizinto ezahlukahlukene ezisetshenziselwa inhloso yokwanelisa ngokocansi, ukunweba isikhathi sokwakhiwa, noma i- enuresis, kufaka phakathi izindandatho zensimbi, okumele zisuswe ngezinsimbi ezikhethekile zokusika. Into nayo ingasuswa ngokudicilela phansi ipipi.  Ngoba i-vasculature yepenisi icindezelwe, izinkinga eziningi zingavela ekulimaleni kokuklinywa, kuya ngokuthi imithambo, imithambo, noma yomibili icindezelwe, kufaka phakathi ukuvinjelwa kwemithambo okuncane, okuguqukayo; i-ischemic necrosis; esibhibhayo futhi izinso umonakalo ; i-lymphedema ; isilonda; i-fistula e-urethrocutaneous, ukulahlekelwa ukuzwa; ukulimala kwe-urethral; ispsis ; kanye ne- autoamputation . 

Ukulimala kokuklinywa kwePenile okudinga ukunakekelwa kwezokwelapha akuvamile: kusukela incazelo yabo yokuqala ngo-1755, kube namacala abikiwe cishe angama-60-120.Yize kuvame ukuba bucayi, kubikwe amacala wokuklinywa okungapheli namacala abucayi afinyelela inyanga eyodwa.  

Izinto ezahlukahlukene zibandakanyekile ezimweni zokuklinywa:

* Indandatho yomshado 
* Indandatho yensimbi 
* Ibhodlela 
* Ibhande lobumsulwa

#### Ukubanjwa
Ukulimala okujwayelekile kwezicubu ezithambile kungukulimala kokubanjwa okubandakanya ipipi elibanjwe uziphu; lokhu kulimala kuvame kakhulu ezinganeni ezisencane ezingasokile futhi ezihlala zikha phezulu.Zelashwa ngokususa uziphu nge- anesthesia yendawo kusetshenziswa umsiki wethambo, ukuthambisa, noma i-hacksaw, ukuqaqa uziphu, noma ukususa izicubu ezithintekile, futhi kungavinjelwa ezimweni eziningi ngokusoka .  Uma ingelashwa ngokushesha, izicubu abathintekayo kungaba bandisa futhi batheleleke. Kwezinye izimo, ukusoka okuphuthumayo kuyadingeka. 

## Izinkomba