Seksualna edukacija

13 Jan, 2009

Nehormonska kontracepcija - Intrauterini uložak

— Autor makans @ 14:31
Opis
Kod ovog kontraceptivnog metoda koristi se dejstvo uložaka različitih oblika koji se uvode u matericu. Moderni ulošci su obično dopunjeni bakarnom žičicom. Ulošci se u matericu uvode ambulantno bez anestezije. Radi lakšeg odstranjivanja iz materice većina njih je snabdevena vlaknima koja posle uvođenja vire iz kanala grlića materice u vaginu i ne mogu se videti spolja.

Mehanizam delovanja
Osnovni mehanizam delovanja intrauterinih uložaka sastoji se u tome što u materici deluju kao strano telo, privlače veliku količinu belih krvnih zrnaca i ona napadaju spermatozoide koji napreduju kroz matericu nagore. Ovaj efekat pojačan je prisustvom bakarne žičice; oslobođeni bakar toksično deluje na spermatozoide i istovremeno ih blokira na putu kroz polne organe. Intrauterini ulošci obično se ugrađuju na najviše pet godina, zatim se preporučuje da se oni promene, što se može učiniti prilikom jedne seanse.
 
Prednosti
Glavna prednost uloška s bakrom je jednostavnija upotreba, a zatim i njihova cena koja je najniža u odnosu na sva ostala moderna kontraceptivna sredstva. Zdravstvene prednosti ne poseduju, uz jedan iznenađujući izuzetak - danas je već vrlo verovatno da snižavaju rizik od kasnijeg razvoja raka endometrijuma. 

Rizici
Nemedikamentni ulošci i ulošci s bakrom pojačavaju neznatno dužinu i intenzitet menstrualnog krvarenja. 
Glavni nedostatak uloška je u tome što ne poseduje neke od pogodnosti hormonalnih metoda. Ne štiti od tumora i cisti jajnika, ne štiti od upala unutrašnjih polnih organa . Zaštita od vanmaterične trudnoće je manja nego zaštita od normalne intrauterine trudnoće.Pojava ovih nepovoljnosti ne važi za hormonalno aktivne uloške, koji rizik od obe pojave snižavaju, isto kao i gestagena kontracepcija. Među nepovoljnosti uložaka neophodno je uvrstiti i to da može da dođe, mada retko, do povreda materice prilikom njihovog uvođenja ili odstranjivanja, i što izuzetno mogu iz materice da ispadnu (što eventualno žena ne mora ni da primeti). Po isteku pet godina preporučuje se da se uložak zameni.

Kontraindikacije
Apsolutne kontraindikacije, tj. stanje kada se intrauterina kontracepcija isključuje, predstavljaju samo neobjašnjivo krvarenje iz materice i urođene mane materice. Praktično se tu ubrajaju i stanja prilikom kojih je za uvođenje uloška bila neophodna narkoza (zatvoren grlić materice). Ulošci koji sadrže bakar, osim toga, ne mogu da se ugrađuju ženama s Vilsonovom bolešću i ženama koje su alergične na bakar.
Relativne kontraindikacije (tj. stanja kada je neophodna pojačana opreznost) su: hronične ili ponovljene infekcije materice i jajovoda, promiskuitet, veliki miomi materice, neobjašnjivi bolovi u karlici, imunosupresivno lečenje. Kod uložaka koji sadrže bakar tu se dodaje i jako, često ili bolno menstrualno krvarenje, ranija vanmaterična trudnoća, poremećaji koagulacije krvi sa pojačanim krvarenjem, ozbiljna anemija. 

Podela preparata
Intrauterini ulošci mogu da budu inertni, bez daljih biološki dejstvujućih materija . Ovi ulošci imaju veoma različite oblike. Novu generaciju predstavljaju ulošci s bakarnom žičicom čija je površina obično 375-380 mm2. Većinom su oblika koji više-manje podseća na slovo T. Postoje i zlatni i srebrni ulošci, skuplji su i nemaju nikakvih prednosti.


Komentari

  1. Često su jedino primenjivo sredstvo kontracepcije, ali daju dosta komplikacija, a viđene su i trudnoće pored njih...nažalost.

    Autor sanjarenja56 — 13 Jan 2009, 15:33

  2. svaka cast za blog! :)

    Autor nastasja — 13 Jan 2009, 19:41

  3. @nastasja: hvala :)

    Autor makans — 13 Jan 2009, 19:49

  4. Sjajan blog!Svaka čast za izbor teme!

    Autor gvido — 16 Jan 2009, 18:00

  5. Sjajn blog!Svaka čast za izbor teme

    Autor gvido — 16 Jan 2009, 18:00

  6. :)

    Autor malecki — 18 Jan 2009, 19:53

  7. Extra tema!

    Autor i1540 — 20 Jan 2009, 11:13

  8. Bravo za temu...

    Autor Jo — 20 Jan 2009, 19:56

  9. Ricambio
    ricambi originali KIA nel commercio di ricambi originali
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    Autor MichaelUnott — 09 Sep 2020, 06:15


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