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45. WHAT IS UTEROVAGINAL PROLAPSE_ महिलामा पाठेघर खस्नु भनेको के हो , किन हुन्छ ? केहि जानौ !!! BY DR. SURYA B. PARAJULI, NEPAL



महिलामा पाठेघर खस्नु भनेको के हो <
dlxnfdf x'g] kf7]3/ cfkm\gf] /xg] ;fdfGo 7fFp 5f8]/ of]gLdfu{df emg'{ of of]gLaf6 aflx/ lg:sg] k|s[ofnfO{ kf7]3/ cfË v:g' elgG5 . o;nfO{ lrlgg] c? gfdx?df kms'G8f] v:g], b]psf] v:g], r]nf:yfg v:g], x8 v:g], uef{zo v:g] cflb x'g\ . g]kfnL ;dfhdf dlxnfdf b]lvg] of] Ps k|d'v k|hgg ;d:of xf] .


पाठेघर खस्ने प्रकारहरु के के हुन् <
!_ kf7]3/ g} v:g] -Uterine Prolapse
@_ lk;fa y}nL v:g] -Cystocele
#_ lk;fa gnL v:g] -Urethocele_
$_ dnåf/÷cfGb| v:g] -Rectocele/Enterocele_

पाठेघर कसरि खस्छ  <
ha kf7]3/nfO{ c8\ofP/ /fVg] df;k]zLx? sdhf]/ x'Fb} hfG5g\ of pQm df;k]zLsf gzfx? sdhf]/ aGb} hfG5g\ ta kf7]3/ tn v:g] k|s[of ;'? x'G5 . o; qmddf kf7]3/, of]gL / of];Fu ;DalGwt cËx? cfkm\gf] lgwf{l/t :yfg 5f]8]/ tn cfpF5g\ .

पाठेघर खस्ने प्रक्रिया तथा लक्षण / चिन्ह के के हुन् <
klxnf] l8u|L kf7]3/sf] d'v -Cervix_ O:rLon :kfOg eGbf tn emb{5 . of]gLdf s]xL j:t' em/]sf] h:tf] x'G5 . of]gL cln v's'nf] dxz'; x'g], 9f8 b'Vg] klg x'G5 . of}glqmofdf c;lhnf] klg pTkGg x'G5 .

bf];|f] l8u|L kf7]3/sf] d'v -Cervix) of]gLsf] d'v -Introitus_ ;Dd cfpFb}5 t/ aflx/ lg:sb}g . ;'Tbf of] cfkm} leq hfG5 . kf7]3/n] lk;fasf] y}nLnfO{ lyRg] ePsf]n] l5g l5gdf lk;fa km]g{ hfg dg nfU5 . vf]Sbf, ef/L af]Sbf klg of]gLsf] d'vdf s]xL a;]sf] h:tf] x'G5 . sDd/ tyf 9f8 b'Vg] ;d:of ;'? x'G5 . gf]6M bf];|f] l8u|L;Dddf kf7]3/ of]gL aflx/ cfpFb}g .

t];|f] l8u|L  kf7]3/sf] d'v -Cervix_ of]gLsf] d'v -Introitus_ eGbf aflx/ lg:sG5 . of] a]nfdf d"qfzonfO{ klg lyRg] ePsf]n] l5gl5gdf lk;fa nfUg], vf]Sbf, xfF:bf lk;fa r'lxg] x'G5 . kf7]3/ tn cfPsf]n] tGt' tflgP/ 9f8 Psbd} b'Vg yfN5 .

rf}yf] l8u|L of}gLsf] d'v -Introitus_ af6 ;Dk"0f{ ?kdf kf7]3/ aflx/ lg:sG5 . o;nfO{ k|f]l;8]G;Lof klg elgG5 . of] lkGr 6]:6 -Pinch test_ u/L kQf nufOG5 . aflx/ lg:s]sf] kf7]3/df 3fp x'g], ;+qmd0f x'g] / lxF8\bf lt3|fdf kfl5g] eO{ cToGt} kL8fbfoL x'G5 .

डेक्युविटस अल्सर कसरि हुन्छ <
v;]sf] kf7]3/df lj:tf/} 5fnfsf] ?kdf kl/jt{g b]lvG5, km'6\5, ;+qmd0f x'G5 / cGTodf 3fpsf] ?kdf kl/0ft x'G5 . of] kl/jt{g b]lvg'sf] sf/0f of]gLsf] d'vdf /Qm ;+rfng aGb ePsf]n] xf] .

पाठेघर खस्ने कारणहरु के के हुन् <
hGdhft kf7]3/ cfkm\gf] x'g'kg]{ 7fpFdf geP/ cGo 7fpFdf x'g' . ;fgf] pd]/df aRrf kfpg' . ux|f} ef/L af]Sg] sfd ubf{ . ;'Ts]/L x'Fbf /fd|f] :ofxf/ / vfgf gkfpg' . nfh / eosf sf/0f :jf:Yo s]Gb| ghfg' . w]/} ;Gtfg hGdfpg' / hGdfGt/ gx'g' . of}gfËdf af/Daf/ ;+qmd0f x'g' . bf];|f] jf t];|f] k6s ;'Ts]/L u/fpFbf aRrf aflx/ lg:sg] ;dodf /fd|f] pkrf/ ug{ g;Sg' . k]6df kfgL el/g'df .af/Daf/ vf]sL nflu/xg' -w'Fjf, bfp/f tyf r'/f]6sf] k|of]u_ k]6df 6\o'd/ ePdf ,w]/} slAhot eO/x]df .

उपचार प्रक्रिया के छन् <
!_ /f]syfd ljlw 
@_ ;fwf/0f pkrf/ 
#_ zNolqmof pkrf/

रोकथाम कसरि गर्ने <
cfdf ue{jtL x'Fbf g} kf]lifnf] vfg]s'/f vfg], ;/;kmfO{df Wofg lbg] . aRrf hGdfpFbf ;xL c:ktfndf, ;xL ;dodf pko'Qm ljlwsf] k|of]u ug]{ . aRrf kfPkl5 l56f] lxF8\g yfNg] / k]NeLs km\nf]/ PS;/;fOh ug]{ . aRrf hGd]sf] sDtLdf & dlxgf;Dd ux|f} tyf ufx|f sfdx? gug]{. rfF8f] csf]{ aRrf ghlGdof];\ eGg kl/jf/ lgof]hgsf] ljljw ;fwgsf] k|of]u ug]{ .

साधारण उपचार के के हुन् <
!_ of]uf;g गर्ने 
gf}sf;g, xnf;g, ;jf{Ë cf;g आदि पर्दछन 

@_ lsuTg Jofofd गर्ने 
kf7]3/sf tGt' al/kl/sf df+;k]zLnfO{ klg alnof] kfg]{ JofofdnfO{ …lsun JofofdÚ elgG5 . of] Jofofdn] hg]gGb|Losf df+;k]zLnfO{ alnof] klg d2t u5{ . klxnf] Jofofddf lk;fa ubf{v]/L aLrdf g} Psl5g /f]s]/ ;f;dfly tfGg sf]lzz ug'{k5{ . o;f] ubf{ of]lg al/kl/sf df+;k]zL v'lDrOG5g\ . of] a]nfdf v'DrfP/ g} !)–!%;Dd ug'{kb{ 5 . clg k'gM lk;fa km]g'{ kb{5 . lk;fa km]l/;s]kl5 of]gLal/kl/sf df+;k]zLnfO{ ;+s'rg ug]{ Jofofd af/Daf/ ug{ ;lsG5 . klxnf]k6s lk;fa w]/}a]/ c8\ofP/ /fVg rfx|f] x'G5 . t/ $–^ rf]6L u/]kl5 of] ;xh x'G5 . lk;fa ubf{ /f]SgnfO{ s;/L v'Drfpg' k5{ eGg] s'/f hfg]kl5 lk;fa gkm]/]sf] a]nfdf klg ug{ ;lsG5 . !), !%, @) b]lv %) rf]l6;Dd of] Jofofd ug{ ;lsG5 . kf7]3/ gv;]sf t/ xf5\o'F ubf{ clnstf lk;fa r'lxg] dlxnfx?sf] klg of] Jofofd u/] /fd|f] x'G5 .

#_ l/Ë k];/L कसरी  /fVg <]
kf7]3/ s]xL dfq tn em/]sf] 5 / dlxnf cem aRrf kfpg rflxG5g\ . eg] …l/Ë k];/LÚ-r'/f cfsf/sf] a:t'_ of]lgleq /fVg'kg]{ x'G5 . l/Ë k];/L g/d /a/ jf Knfli6sn] ag]sf] x'G5 . of] kf7]3/sf] cfsf cg';f/ ldnfP/ /flvG5 / ljleGg cfsf/df kfOG5 . of] dlxnfsf] of]lgdf 3';fPkl5 kf7]3/ cfkm\gf] 7fpFdf cl8/xG5 . t/ obL l/Ë k];/L ;fgf] jf 7"nf] eof] eg] dlxnfnfO{ ls t b'Vg] x'G5 ls t cfkm} aflx/ lg:sG5 . To;}n] l/Ë k];/L s:tf] / sqf] /fVg] eGg]af/]df :jf:Yo sfo{stf{n] ljrf/ ug'{k5{ .klxnf] >]0fLsf kf7]3/ v:g] k|lqmofdf l/Ë k];/Lsf] k|of]usf] h?/t kb}{g . bf];|f] >]0fLsf] kf7]3/ v;fOdf l/Ë k];/Lsf] k|of]u ul/G5 . o;n] dlxnfnfO{ kf7]3/ v;]sf] a]nfdf w]/} /fxt lbG5 .  l/Ë k];/L s]jn s]xL ;dosf] nflu dfq xf] / clGtd pkrf/ eg]sf] t zNolqmof g} xf] .

l/Ë k];/L /fv]kl5 dlxnfn] Wofg lbg'kg]{ s'/fx?
lsun Jofofd ug]{ . u'KtfËsf] ;/;kmfO{df Wofg lbg'k5{ . k|To]s lbg :gfg ubf{ of}gfË klg ;kmf ug'{k5{ . Pslbgdf *–!)lunf; kfgL lkpg'k5{ . lk;fa Rofk]/ a:g' x'Fb}g . lbgdf $–% rf]6L lk;fa km]g'{k5{ . l/Ë k];/L xfn]sf] s]xL lbgkl5 ufx|f]h:tf] eof], lbzflk;fa ug{ ufx|f] eof] jf l/Ë k];/L v:of] eg] t'?Gt :jf:Yo rf}sLdf uP/ kl/If0f ug{ nufpg'k5{ . l/Ë k];/L ;fgf] / 7"nf] eP/ of] ;d:of x'g;S5 . o:tf] a]nfdf gofF l/Ë k];/L km]g'{k5{ . obL s'g} ;d:of 5}g eg] l/Ë k];/L xfn]sf] Ps dlxgfkl5 hfFr u/fpg'k5{ .obL Ps dlxgfdf ;lsPg eg] x/]s # dlxgfdf l/Ë k];/L km]g{ :jf:Yo rf}sL hfg}k5{ .clg x/]srf]l6 gofF l/Ë k];/L km]g'{k5{ . l/Ë k];/L ;do–;dodf gkm]g]{ xf] eg] ;+qmd0f x'G5 / dlxnfsf] :jf:Yodf klg v/fa c;/ x'ghfG5 . lk;fasf] ;+qmd0f af/Daf/ x'G5 . obL l/Ë k];/L xf]n]sf] a]nfdf ue{ /xg uof] eg], $ dlxgfkl5 l/Ë k];/L x6fpg :jf:Yo rf}sL hfg'k5{ . obL s'g} ;d:of 5}g eg] l/Ë k];/L xfn]sf] Ps dlxgfkl5 hfFr u/fpg'k5{ . obL Ps dlxgfdf ;lsPg eg] x/]s # dlxgfdf l/Ë k];/L km]g{ :jf:Yo rf}sL hfg}k5{ . clg x/]srf]l6 gofF l/Ë k];/L km]g'{k5{ . l/Ë k];/L ;do–;dodf gkm]g]{ xf] eg] ;+qmd0f x'G5 / dlxnfsf] :jf:Yodf klg v/fa c;/ x'ghfG5 . lk;fasf] ;+qmd0f af/Daf/ x'G5 .obL l/Ë k];/L xfn]sf] a]nfdf ue{ /xg uof] eg], $ dlxgfkl5 l/Ë k];/L x6fpg :jf:Yo rf}ls hfg'k5{ .olb l/Ë k];/L xfn]kl5 tn n]lvPsf dWo] s'g} ;d:of d¥of] eg] t'?Gt :jf:Yo rf}sLdf ;Nnfx lng hfg'k5{ .tnaf6 uGxfpg] kflg au]df ,lrnfpg] ePdf,w]/} ;]tf] kflg uPdf ,jl/kl/ 3fph:tf] ePdf, b'Vg] ePdf, tNnf] k]6 b'v]df,lx8\g] ufx|f] x'g] ePdf,lk;fa ubf{ ufx|f] ePdf, of}gls|of ubf{ b'v]df,of}lgaf6 /ut au]df .

l/Ë k];/L /fv]sf] dlxnfn] kl/jf/ lgof]hg ug{ x'G5 <
l/Ë k];/L /fv]sf] dlxnfn] sk/–6L afx]s cGo c:yfO{ kl/jf/ lgof]hgsf ;fwgx? ckgfpg ;S5g\ . :yfoL kl/jf/ lgof]hg ug{ eg] ufx|f] x'G5 .

शल्यक्रिया उपचार हरु के के हुन् <
!_ PG6]l/o/ sf]Nkf]/\ofkmL 
@_ sf]Nkf]k]l/lgof]/\ofkmL 
#_ OG6]/f]l;n pkrf/ 
$_ k]NeLs ˆnf]/ l/k]o/ 
%_ kmf]b/luN; ck|]zg 
^_ eN6 k|f]Nofk;\ l/k]o/ 
&_ ln kmf]6{ ck/]zg
*_ ;/lesf]k]S;L 
(_ ehfOgn lx:t]/]S6f]dL
zNols|ofdf kf7]3/nfO{ ;Dxfn]/ /fVg] df+zk]l; / tGt'nfO{ g} k'gM anLof] kl/ kf7]3/ / jl/kl/sf cËx?nfO{ tn v:gaf6 /f]Sg] sfd ul/G5 . sd pd]/sf dlxnf tyf :jf:Yo kf7]3/ ePsfdf ul/g] o; zNols|ofnfO{ PFR elgG5 .c:j:y kf7]3/ tyf bf];|f],t];|f] tyf rf}yf] l8u|Ldf v;]sf] kf7]3/ g} lgsfn]/ kmflnG5 .

zNolqmofkl5 Wofg lbg'kg]{ s'/fx? के के हुन् <
kof{Kt cf/fd ug]{, ! dlxgf;Dd ux|f} ef/L gprfNg], # dlxgf kl5 dfq ;fljssf] sfddf kms{g] .k|z:t kf}li6s tTjn] o'Qm vfgfx? Vffg] .of}g ;DjGw s]lx ;dokl5 /fVg ;lsG5 t/ ^ xKtf ;Dd s'g{ /fd|f] dflgG5 .zNols|of cuf8L ;Dk"0f{ hfFr u/L olb pRr /Qmrfk bd, dw'd]x eP pkrf/ ul/G5 .ljleGg ;dodf x'g] :jf:Yo lzlj/ af6 lgMz'Ns ;d]t pkrf/  ug{ ;lsG5 .